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Anatomy

Geniohyoid Muscle

  • Origin: Inferior genial tubercles of the mandible.
  • Insertion: Anterior surface of the body of the hyoid bone.
  • Nerve Supply: Branch of C1 through the hypoglossal nerve (CN XII).
  • Arterial Supply: Sublingual branch of the lingual artery.
  • Action: Elevates the hyoid bone and depresses the mandible.

The Orbital Margin

  • The frontal, maxillary and zygomatic bones contribute equally to the formation of the orbital margin.
  • The supraorbital margin is composed entirely of the frontal bone.
  • At the junction of its medial and middle thirds is the supraorbital foramen (sometimes a notch), which transmits the supraorbital nerves and vessels.
  • The lateral orbital margin is formed almost entirely of the frontal process of the zygomatic bone.
  • The infraorbital margin is formed by the zygomatic bone laterally and the maxilla medially.
  • The medial orbital margin is formed superiorly by the frontal bone and inferiorly by the lacrimal crest of the frontal process of the maxilla.
  • This margin is distinct in its inferior half only.

Nerves of the Face

Innervation of the Muscles of Facial Expression

The Facial Nerve (CN VII)

 

  • The seventh cranial nerve supplies the superficial muscle of the neck (platysma), the muscles of facial expression, the auricular muscles and the scalp muscles.
  • CN VII is the sole motor supply to the muscles of facial expression.
  • The facial nerve emerges from the skull though the stylomastoid foramen.
  • Almost immediately, it enters the parotid gland. It runs superficially in this gland before giving rise to its five terminal branches: temporal, zygomatic, buccal, marginal mandibular, and cervical.
  • These nerve emerge from the superior, anterior and inferior margins of the gland and spread out like the abducted digits of the hand to supply the muscles of facial expression.
  • The temporal branches of CN VII cross the zygomatic arch to supply all the superficial facial muscles superior to it, including the orbital and forehead muscles.
  • The zygomatic branch of CN VII passes transversely over the zygomatic bone to supply the muscles in the zygomatic, orbital and infraorbital regions.
  • The buccal branches of CN VII pass horizontally, external to the masseter muscle, to supply the buccinator and the muscles of the upper lip.
  • The marginal mandibular branch of CN VII supplies the muscles of the lower lip and chin.
  • The cervical branch of CN VII supplies the platysma and the superficial muscles of the neck.

Movements of the Temporomandibular Joint

  • The two movements that occur at this joint are anterior gliding and a hinge-like rotation.
  • When the mandible is depressed during opening of the mouth, the head of the mandible and articular disc move anteriorly on the articular surface until the head lies inferior to the articular tubercle.
  • As this anterior gliding occurs, the head of the mandible rotates on the inferior surface of the articular disc.
  • This permits simple chewing or grinding movements over a small range.
  • Movements that are seen in this joint are: depression, elevation, protrusion, retraction and grinding

The Oropharynx

  • The oral part of the pharynx has a digestive function.
  • It is continuous with the oral cavity through the oropharyngeal isthmus.
  • The oropharynx is bounded by the soft palate superiorly, the base of the tongue inferiorly, and the palatoglossal and palatopharyngeal arches laterally.
  • It extends from the soft palate to the superior border of the epiglottis.

 

The Palatine Tonsils

  • These are usually referred to as "the tonsils".
  • They are collections of lymphoid tissue the lie on each side of the oropharynx in the triangular interval between the palatine arches.
  • The palatine tonsils vary in size from person to person.
  • In children, the palatine tonsils tend to be large, whereas in older persons they are usual small and inconspicuous.
  • The visible part of the tonsil is no guide to its actual size because much of it may be hidden by the tongue and buried in the soft palate.

The Soft Palate

  • This is the posterior curtain-like part, and has no bony support. It does, however, contain a membranous aponeurosis.
  • The soft palate, or velum palatinum (L. velum, veil), is a movable, fibromuscular fold that is attached to the posterior edge of the hard palate.
  • It extends posteroinferiorly to a curved free margin from which hangs a conical process, the uvula (L. uva, grape).
  • The soft palate separates the nasopharynx superiorly and the oropharynx inferiorly.
  • During swallowing the soft palate moves posteriorly against the wall of the pharynx, preventing the regurgitation of food into the nasal cavity.
  • Laterally, the soft palate is continuous with the wall of the pharynx and is joined to the tongue and pharynx by the palatoglossal and palatopharyngeal folds.
  • The soft palate is strengthened by the palatine aponeurosis, formed by the expanded tendon of the tensor veli palatini muscle.
  • This aponeurosis attaches to the posterior margin of the hard palate.

Genioglossus Muscle

  • Origin: Mental spine of the mandible.
  • Insertion: Dorsum of the tongue and hyoid bone.
  • Nerve Supply: Hypoglossal nerve (CN XII).
  • Arterial Supply: Sublingual and submental arteries.
  • Action: Depresses and protrudes the tongue.

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