The Face and Facial Expression 235 Human Anatomy

The Face and Facial Expression 235 Human Anatomy Dr Stuart Bunt

Visual Inspection

The muscles of the lips H Orbicularis oris – sphincter muscle of the mouth H Elevators of the upper lip – Zygomaticus minor – Levator labii superioris – Nasalis – Zygomaticus major

Depressors of the lips H H Depressor labii inferioris Platysma Depressor anguli oris Mentalis

Retractors of the angle of the mouth H H Zygomaticus major Depressor anguli oris Risorius Platysma

Muscles attached to the nose H H H Nasalis Levator labii, superioris alaeque nasi Levator labii superioris Zygomaticus minor Procerus

Muscles around the orbit and ear H H H Orbicularis oculi – orbital – palpebral Depressor supercilli Corrugator supercilli Temporoparietalis Procerus Occipito frontalis – frontalis

Problems with eye closure 7 th nerve paralysis General paralysis

Nerve Supply H H Entirely by 7 th Nerve Entirely motor – except taste from ant 2/3 of tongue H H Also supplies tensor tympani of same side NOT upper eyelid – 3 rd Nerve

The Facial Nerve H H H Auditory and facial nerve enter internal auditory canal Fibres leave for Pterygo-palatine ganglion/otic ganglion External petrosal nerve Chorda tympani to tongue Through facial canal in mastoid

Clinical Evaluation H “Upper Motor Neuron” – cortex controls lower opposite face – forehead and eye closure dual consensual reflexes H “Lower Motor Neuron” – all muscles on one side affected – taste affected

7 th nerve damage H Bell’s palsy – – – pain around ear no sensory impairment complete palsy rapid recovery(2 -8 wks) Entrapment in facial canal after infection? – steroids in severe cases where taste affected

Other 7 th nerve lesions H Ramsay-Hunt syndrome – Herpes Zoster of 7 th nerve – very severe pain in ear – vescicles – poor recovery H Hemifacial spasm – irritation of nerve by blood vessel?