Gross Anatomy

Introduction to the Head; Front of Skull and Face


Anatomy Tables for Today's Topic


Bones
Muscles
Nerves
Arteries
Veins
Lymphatics
Viscera

Bones of the Face

Bone/Cartilage Structure Description Notes
frontal the anterior bone of the skull which underlies the forehead articulates with the parietal bone posteriorly; zygomatic, ethmoid and sphenoid bones inferiorly; maxilla, nasal and lacrimal bones anteriorly; it is formed from two ossifications centers which normally fuse in the midline - if they do not fuse, a midline "metopic suture" is the result
superior orbital margin arch of bone above the orbital opening skin over this region is supplied by branches of the frontal nerve (supraorbital and supratrochlear nn.)
superciliary arch the ridge of bone above the orbital margin located deep to the eyebrow, blunt trauma to this region often results in cuts within the eyebrow
glabella midline point between the paired superciliary arches
supraorbital notch notch in the superior orbital margin occasionally present as a foramen; opening for the passage of the for supraorbital neurovascular bundle
lacrimal small bone forming part of the medial wall of the orbit articulates: anteriorly with frontal process of maxilla, superiorly with frontal bone, posteriorly with ethmoid, inferiorly with orbital process of maxilla; forms part of the canal for the nasolacrimal duct
nasal thin bone that forms part of the bridge of the nose articulates with the frontal bone superiorly, the frontal process of the maxilla laterally and the contralateral nasal bone medially
mandible the U-shaped bone forming the lower jaw contains the inferior teeth; formed from the mesenchyme of the 1st pharyngeal arch, and its muscles are innervated by the nerve of the 1st arch (mandibular division of cranial nerve V)
body the anterior part of the mandible paired halves are fused in the midline at the symphysis menti
symphysis menti the midline symphysis between the two halves of the mandible the two halves of the mandible fuse during the first postnatal year
mental protuberance the projection on the anterior midline of the mandible the bone of the chin; mental means relating to the mind, a reference to the act of resting the chin on the hand while thinking (see the sculpture by Rodin: "The Thinker")
mental foramen the opening on the anterior surface of the body of the mandible inferior to the premolar teeth transmits the mental neurovascular bundle; covered superficially by the depressor anguli oris and depressor labii inferioris mm.
ramus the angled portion of the mandible that joins the posterior portion of the body it rises nearly vertically from the body; the chondyloid process and the coronoid process extend from the superior end of the ramus; the mandibular foramen is located on the medial surface of the ramus; the medial pterygoid m. attaches to the medial surface and the masseter m. attaches to the lateral surface of the ramus
angle the posteroinferior bend formed by the union of the body and the ramus
mandibular neck the constriction below the articular chondyle on the chondylar process of the mandible part of the lateral pterygoid m. inserts into the pterygoid fossa of the mandibular neck
maxilla bone forming the midface it forms the inferior orbital margin and contains the teeth and maxillary sinus
frontal process the part of the maxilla that projects superiorly medial to the orbit it articulates with the nasal bone, the frontal bone and the lacrimal bone; it forms part of medial orbital wall & margin; it forms the anterior part of the canal for the nasolacrimal duct
orbital process the part of the maxilla that forms the floor of the orbit also known as the orbital surface of the maxilla; it contains the infraorbital groove and canal; it forms the roof of the maxillary sinus
zygomatic process the lateral projection of the maxilla it articulates with the zygomatic bone
infraorbital groove groove in orbital process of the maxilla located in the posterior part of the orbit transmits the infraorbital neurovascular bundle from the infraorbital fissure to the infraorbital canal
infraorbital canal canal in orbital process of the maxilla located in the anterior part of the orbit the direct continuation of the infraorbital groove; transmits the infraorbital neurovascular bundle from the infraorbital groove to the infraorbital foramen
infraorbital foramen opening at the anterior end of the infraorbital canal located inferior to the orbit it transmits the infraorbital neurovascular bundle
alveolar process "U"-shaped process of bone that holds the maxillary teeth contains sockets (alveoli) for the roots of the maxillary teeth
anterior nasal spine anterior projection of bone in the midline, inferior to the anterior nasal aperture the cartilaginous part of the nasal septum sits atop this structure
temporal bone forming the lateral side of the skull temporal refers the passage of time, which is marked by the appearance of gray hair on the side of the head
facial canal a canal which courses through the petrous part of the temporal bone it transmits the facial n. from the internal acoustic meatus to the stylomastoid foramen
carotid canal a canal which courses through the petrous part of the temporal bone it transmits the internal carotid a. and the internal carotid plexus of nerves into the cranial cavity
mastoid process the process located posteroinferior to the external acoustic meatus it projects inferiorly from the junction of the petrous and squamous parts of the temporal bone; it contains the mastoid air cells that open into tympanic cavity through the mastoid antrum
jugular fossa a depression on the posterior surface of the petrous part of the temporal bone it forms the anterior margin of the jugular foramen; the occipital bone forms the posterior margin of the jugular foramen
styloid process the spike of bone that projects inferiorly from the petrous part of the temporal bone it is the attachment site for the stylohyoid, styloglossus and stylopharyngeus mm. and the stylomandibular and stylohyoid ligaments
tympanic part the part of the temporal bone consisting of the external acoustic meatus and the tympanic ring the medial 1/3 of the external acoustic meatus is bony and the lateral 2/3 is formed by cartilage
external acoustic meatus the opening in the lateral surface of the temporal bone it extends medially from the surface to the tympanic membrane; it allows sound to reach the tympanic membrane; the medial 1/3 of the external acoustic meatus is bony and the lateral 2/3 is formed by cartilage
tympanic ring the rim of bone surrounding the medial end of the external acoustic meatus it is the attachment site of the tympanic membrane
squamous part the thin flat portion of the temporal bone that constitutes the side of the skull above the ear it articulates with the parietal bone and the greater wing of the sphenoid bone at the squamous suture
zygomatic process the projection of bone that arises anterior to the external acoustic meatus it articulates with the temporal process of the zygomatic bone to form the zygomatic arch
mandibular fossa the depression located medial to the origin of the zygomatic process it articulates with the condylar process of the mandible
articular tubercle an inferior projection located anterior to the mandibular fossa dislocations of the temporomandibular joint result when the mandibular condyle slides anterior to this structure
sphenoid an irregularly shaped bone forming the central portion of the skull it has many parts, including a body, greater wing, lesser wing and pterygoid plates
body central part of the sphenoid bone contains the sphenoid sinuses; attachment point for the wings and pterygoid plates
sphenoid sinuses pneumatized spaces within the body of the sphenoid bone usually paired; it drains into the sphenoethmoidal recess of the nasal cavity
jugum the anterior-most portion of the sphenoid bone articulates with the cribriform plate of the ethmoid bone
chiasmatic sulcus the groove for the optic chiasm located between the jugum & the tuberculum sellae
optic canal canal located at the lateral end of the chiasmatic sulcus and medial to the anterior clinoid process paired; it transmits the optic nerve and the ophthalmic artery from the cranial cavity to the apex of the orbit
tuberculum sellae the anterior limit of the sella turcica the middle clinoid processes project from its lateral ends
sella turcica depression on the superior surface of the body of the sphenoid bone "Turkish saddle"; roughly equivalent to the hypophyseal fossa; area between the tuberculum sellae and the posterior clinoid processes
anterior clinoid process projection at the medial end of the lesser wing of the sphenoid bone the internal carotid artery passes medial to this structure
lesser wing of the sphenoid thin rim of bone projecting laterally from the anterior clinoid process bilateral; it forms the posterior margin of anterior cranial fossa; it articulates anteriorly with the orbital plate of the frontal bone
greater wing of the sphenoid broad plate of bone swinging laterally from the body of the sphenoid bone bilateral; it forms the medial part of the floor of the middle cranial fossa, part of temporal fossae laterally, and the posterior part of the lateral wall of orbit; it articulates anteriorly with the zygomatic bone, superiorly with the frontal & parietal bones (at the pterion), posteriorly with the squamous & petrous portions of the temporal bone
superior orbital fissure slit-like opening between the lesser & greater wings of the sphenoid bone it transmits the oculomotor nerve, the trochlear nerve, the abducens nerve, branches of ophthalmic division of the trigeminal nerve, the superior ophthalmic vein and lymphatics from the cranial cavity into the orbit
foramen rotundum opening in the floor of the middle cranial fossa through the greater wing of the sphenoid bone it transmits the maxillary division of the trigeminal nerve
foramen ovale opening in the floor of the middle cranial fossa through the greater wing of the sphenoid bone it transmits the mandibular division of the trigeminal nerve; it is located between the foramen rotundum and the foramen spinosum
foramen spinosum opening in the floor of the middle cranial fossa through the greater wing of the sphenoid bone it transmits the middle meningeal artery and the meningeal br. of the mandibular division of the trigeminal nerve (cranial nerve V)
spine of the sphenoid process of bone that projects inferiorly from undersurface of greater wing of the sphenoid it is the superior attachment for the sphenomandibular ligament
pterygoid process process that projects inferiorly from the junction of the body & greater wing of the sphenoid bone it has several parts: lateral & medial pterygoid plates, hamulus, pterygoid fossa, scaphoid fossa; the pterygoid plates are separated by the large pterygoid fossa throughout most of their length, and by the small scaphoid fossa superiorly
lateral pterygoid plate thin plate of bone that projects posterolaterally from the pterygoid process it is the attachment site of the lateral & medial pterygoid muscles (lateral pterygoid m. on its lateral surface, medial pterygoid m. on its medial surface)
medial pterygoid plate thin plate of bone that projects posteriorly from the pterygoid process it is the attachment of the superior pharyngeal constrictor m. & the pharygobasilar fascia
scaphoid fossa an oval depression at the superior end of the lateral pterygoid plate it is the site of origin of the tensor veli palatini m.
pterygoid hamulus hook-like projection from the inferior end of the medial pterygoid plate it acts as a pulley for the tendon of the tensor veli palatini m.
pterygoid canal canal that occurs at the junction of the greater wing, the pterygoid process and the body of the sphenoid bone it transmits the nerve of the pterygoid canal from the pterygoid region to the pterygopalatine fossa
zygomatic the bone that forms the cheek the zygomatic bone is frequently fractured in blows to the side of the orbit; the temporal fascia attaches to the zygomatic arch
frontal process the portion of the zygomatic bone that projects superiorly and medially it forms the inferior part of the lateral orbital margin and the anteroinferior part of the lateral orbital wall; it articulates with the frontal bone anteriorly and the greater wing of the sphenoid bone posteriorly
maxillary process the part of the zygomatic bone that projects medially it forms the lateral part of the inferior orbital margin and the anterolateral part of the orbital floor; it articulates with the maxilla

Muscles of the Face

Muscle Origin Insertion Action Innervation Artery Notes
buccinator pterygomandibular raphe, mandible, and the maxilla lateral to the molar teeth angle of mouth and the lateral portion of the upper and lower lips pulls the corner of mouth laterally; presses the cheek against the teeth buccal branches of the facial nerve (VII) facial a. although the buccinator is important in mastication, it is innervated by the buccal branch of the facial nerve and NOT by the buccal nerve from V3 (a sensory nerve)
depressor anguli oris oblique line of the mandible angle of the mouth pulls the corner of the mouth downward marginal mandibular & buccal branches of the facial nerve (VII) inferior labial branch of the facial a., mental a. a "frown" muscle
epicranius frontalis: galea aponeurotica; occipitalis: superior nuchal line frontalis: skin of the eyebrows; occipitalis: galea aponeurotica elevates the eyebrows and wrinkles the forehead frontalis: temporal branches of the facial nerve (VII); occipitalis: posterior auricular branch of the facial nerve (VII)

frontalis: supraorbital and supratrochlear aa.; occipitalis: occipital a.

the frontalis and occipitalis muscles are two bellies of the epicranius muscle; also known as: occipitofrontalis m.
frontalis galea aponeurotica skin of the eyebrow elevates the eyebrows and wrinkles the forehead temporal branches of the facial nerve (VII) supraorbital and supratrochlear aa. frontalis is the anterior belly of the epicranius muscle
levator labii superioris inferior margin of the orbit skin of the upper lip elevates the upper lip buccal branch of the facial nerve (VII) infraorbital a., superior labial branch of the facial a. levator labii superioris is used to bare the upper incisor teeth, as in a sneer
occipitalis superior nuchal line galea aponeurotica pulls the scalp posteriorly; elevates the eyebrows posterior auricular branch of the facial nerve (VII) occipital a. occipitalis is the posterior belly of the epicranius muscle
occipitofrontalis frontalis: galea aponeurotica; occipitalis: superior nuchal line frontalis: skin of the eyebrows; occipitalis: galea aponeurotica elevates the eyebrows and wrinkles the forehead frontalis: temporal branches of the facial nerve (VII); occipitalis: posterior auricular branch of the facial nerve (VII)

frontalis: supraorbital and supratrochlear aa.; occipitalis: occipital a.

the frontalis and occipitalis muscles are two bellies of the occipitofrontalis muscle; also known as: epicranius m.
orbicularis oculi orbital part: medial orbital margin and the medial palpebral ligament; palpebral part: medial palpebral ligament orbital part: skin of the lateral cheek; palpebral part: lateral palpebral raphe closes the eyelids temporal & zygomatic branches of the facial nerve (VII) supraorbital a., supratrochlear a., infraorbital a., angular branch of the facial a. activated involuntarily in the blink reflex; the palpebral part is active in normal blinking and the orbital part is used to forcefully close the eye
orbicularis oris skin and fascia of lips and the area surrounding the lips skin and fascia of the lips purses the lips buccal branch of the facial nerve (VII) superior and inferior labial branches of the facial a., mental a., infraorbital a. the "kissing" muscle
platysma fascia overlying the pectoralis major and deltoid muscles inferior border of the mandible and skin of lower face draws the corners of the mouth down; it aids in depression of the mandible cervical branch of the facial nerve (VII) facial a. platysma is derived from the mesenchyme of the second pharyngeal arch
zygomaticus major upper lateral surface of the zygomatic bone skin of the angle of the mouth elevates and draws the corner of the mouth laterally zygomatic and buccal branches of the facial nerve (VII) transverse facial a., facial a. a "smile" muscle
zygomaticus minor lower surface of the zygomatic bone lateral part of the upper lip elevates the upper lip buccal branch of the facial nerve (VII) transverse facial a., facial a. a "smile" muscle

Nerves of the Face

Nerve Source Branches Motor Sensory Notes
auriculotemporal n. mandibular division of the trigeminal n. (V3) parotid brs., articular brs., anterior auricular brs. secretomotor to the parotid gland by carrying postganglionic parasympathetic fibers from the otic ganglion; [preganglionic parasympathetic fibers originate in the lesser petrosal br. of the glossopharyngeal n. (IX)] skin of anterior ear and the skin anterosuperior to the ear; part of the external auditory meatus; temporomandibular joint two roots of the auriculotemporal n. encircle the middle meningeal a.
buccal branch of the trigeminal n. mandibular division of the trigeminal n. (V3) no named branches no motor branches skin of the cheek, mucosa lining the cheek not a motor nerve; easily confused with the buccal branch of the facial n.
buccal branches of the facial n. facial n. (VII) no sensory branches zygomaticus major & minor, buccinator, orbicularis oris, levator anguli oris, levator labii superioris & alaque nasi, risorius, procerus, nasalis no sensory branches not a sensory nerve; easily confused with the buccal branch of the trigeminal n.
facial n. pons and medulla: nucleus solitarius of medulla via nervus intermedius (SVA sensory root) from geniculate ganglion; superior salivatory nucleus (GVE preganglionic parasympathetic) of pons via nervus intermedius; facial motor nucleus of pons via motor root greater petrosal n. (preganglionic parasympathetic to pterygopalatine ganglion, postganglionic parasympathetic travels with brs. of maxillary division of V), chorda tympani (SVA taste from anterior 2/3 of the tongue; preganglionic parasympathetic to the submandibular ganglion, postganglionic parasympathetic to the submandibular and sublingual glands), n. to stapedius, posterior auricular n., intraparotid plexus with temporal, zygomatic, buccal, marginal mandibular & cervical brs. stapedius m., stylohyoid m., posterior belly of digastric m., muscles of facial expression; secretomotor to lacrimal, submandibular, sublingual, and mucous glands of the nasal and oral cavities taste (SVA) from the anterior 2/3 of the tongue; part of the skin of the external auditory meatus also known as: CN VII, 7th cranial nerve; exits the posterior cranial fossa by passing into the internal acoustic meatus, goes through the facial canal; motor to muscles of facial expression exits the skull at the stylomastoid foramen
infraorbital n. maxillary division of the trigeminal n.(V2) middle alveolar n., anterior superior alveolar n. none mucous membrane of the maxillary sinus; upper premolar, canine and incisor teeth; maxillary gingiva; skin of the lateral nose, lower eyelid, upper lip and zygomatic region infraorbital n.passes through the infraorbital groove, canal and foramen
infratrochlear n. nasociliary br. of the ophthalmic division of the trigeminal n. (V1) no named branches none skin and conjunctiva of the medial upper and lower eyelids; skin of the lateral surface of the nose infratrochlear n. passes inferior to the trochlea (pulley) of the superior oblique m.
mental n. inferior alveolar n. no named branches none skin of the chin the lower lip mental n. passes through the mental foramen
supraorbital n. frontal n, from the ophthalmic division of the trigeminal n. (V1) medial and lateral brs. none skin of the forehead; mucous membrane of the frontal sinus supraorbital nerve passes through the supraorbital foramen (notch)
supratrochlear n. frontal n, from the ophthalmic division of the trigeminal n. (V1) no named branches none skin of the medial forehead and the medial part of the upper eyelid; associated conjunctiva supratrochlear n. passes superior to the trochlea (pulley) of the superior oblique m.

Arteries of the Face

Artery Source Branches Supply to Notes
angular facial a. no named branches orbicularis oculi m. and lacrimal sac angular a. is the terminal branch of the facial a.
carotid, external common carotid superior thyroid a., ascending pharyngeal a., lingual a., facial a., occipital a., posterior auricular a., maxillary a., superficial temporal a. upper neck, face and scalp external carotid a. is the primary blood supply to the face and superficial head; the maxillary a. and superficial temporal a. are its terminal branches
facial external carotid a. ascending palatine a., tonsilar br., submental a., superior labial a., inferior labial a., lateral nasal a., angular a. lower part of the palatine tonsil, submandibular gland, facial muscles and fascia the angular branch of the facial a. anastomoses with the ophthalmic a.
inferior labial facial a. no named branches skin, muscles, fasciae and mucosa of the lower lip inferior labial a. shares its region of distribution with branches of the mental a.
infraorbital maxillary a. anterior superior alveolar a., middle superior alveolar a. maxillary sinus, maxillary incisors, canine and premolar teeth, skin of the cheek below the orbit, mucosa over the maxillary alveolar arch and the adjacent cheek infraorbital a. is one of four terminal branches of the maxillary a. (see also: descending palatine a., sphenopalatine a., posterior superior alveolar a.)
lateral nasal facial a. no named branches lateral side of the nose lateral nasal a. anastomoses with the dorsal nasal a.
mental inferior alveolar a. no named branches skin, superficial fascia and facial mm. of the chin and lower lip mental a.passes through the mental foramen; it anastomoses with the inferior labial a.; it accompanies the mental n.
superior labial facial a. septal br. skin, muscles, fasciae and mucosa of the upper lip, lower part of the anterior end of the nasal septum superior labial a. supplies the orbicularis oris m. and the levator labii superioris m.
supraorbital ophthalmic a. no named branches muscles, skin and fascia of the forehead supraorbital a. accompanies the supraorbital n.
supratrochlear ophthalmic a. no named branches muscles, skin and fascia of the medial forehead supratrochlear a. accompanies the supratrochlear n.
transverse facial superficial temporal a. no named branches parotid gland, masseter m., facial muscles and skin transverse facial a. anastomoses with branches of the buccal, infraorbital and facial aa.

Veins of the Face

Vein Tributaries Drains Into Regions Drained Notes
angular v. supraorbital v., supratrochlear v. facial vein at the inferior margin of the orbit forehead; upper eyelid; root of the nose angular v. is valveless; it connects with the superior and inferior ophthalmic vv. and can be a source of superficial infectious materials entering the cavernous sinus by this route
anterior jugular v. submental v, communicating v. external jugular v. superficial parts of the anterior neck anterior jugular v. is valveless
auricular, posterior small veins of the subcutaneous tissues behind the ear, stylomastoid v. it unites with the posterior division of the retromandibular v. to form the external jugular region behind the ear posterior auricular v. communicates with the occipital v. behind the ear
common facial formed by the union of the anterior division of the retromandibular v. and the facial v. internal jugular v. face and anterior scalp common facial v. may receive drainage from the lingual v.
external jugular v. formed by the joining of the retromandibular and posterior auricular vv.; tributaries: posterior external jugular v., transverse cervical v., suprascapular v., anterior jugular v. subclavian v. head & neck, shoulder external jugular v. contains valves that may not be fully functional
internal jugular v. formed at the base of the skull where the sigmoid sinus ends; tributaries: pharyngeal vv.; lingual v., common facial v., sternocleidomastoid v., superior thyroid v, middle thyroid v. brachiocephalic v. brain, cranial cavity, skull, face, viscera of the neck internal jugular is the largest vein of the nead and neck
retromandibular v. formed by the union of the superficial temporal v. and maxillary v. anterior and posterior divisions of the retromandibular v. side of the head and scalp; deep face retromandibular v. is contained within the parotid gland; anterior division unites with the facial v. to form the common facial v.; posterior division unites with the posterior auricular v. to form the external jugular v.

Lymphatics of the Face

Structure Location Afferents from Efferents to Regions drained Notes
cervical nodes, deep in and around carotid sheath posterior and lateral to the internal jugular v. lymphatic vessels and numerous node groups from the head and neck jugular trunk head and neck superior and inferior subdivisions of deep cervical nodes are delineated by the crossing of the omohyoid m.
cervical nodes, superficial in superficial fascia and along superficial vessels of the head & neck lymphatic vessels from superficial structures in head & neck varies by group; ultimate destination is the jugular trunk head & neck several groups are designated by location: occipital, retroauricular, anterior auricular, superficial parotid, facial, submental, submandibular, external jugular, anterior jugular
occipital nodes superior nuchal line, along the course of the occipital a. and v. lymphatic vessels from the posterior head and neck accessory nodes occipital part of the scalp and the superior neck occipital nodes are 2 or 3 nodes located between the attachments of the sternocleidomastoid m. and the trapezius m.
parotid nodes, deep on the lateral side of the pharyngeal wall, deep to the parotid gland lymphatic vessels from the ear superior deep cervical nodes external acoustic meatus, auditory tube, middle ear deep parotid nodes are part of the deep cervical chain of nodes
parotid nodes, superficial superficial to the parotid gland and also deep to the parotid fascia anterior auricular nodes superior deep cervical nodes anterior surface of the ear and external acoustic meatus; temporal and frontal regions; eyelids, lacrimal gland cheek and nose superficial parotid nodes are up to 10 in number and may be located superficial or deep to the parotid fascia
submandibular nodes along the inferior border of the submandibular gland submental nodes; facial nodes; lymphatic vessels from the submandibular and sublingual regions superior deep cervical nodes; juguloomohyoid node anterior part of tongue, lower lip, floor of the mouth, nose, cheeks, chin, gums and lower incisor teeth, lower surface of palate submandibular nodes may be within the sheath of the submandibular gland; this group consists of from 3 to 6 nodes
submental nodes under the mandible on the mylohyoid m. lymphatic vessels from the lower face and chin submandibular nodes, juguloomohyoid node tip of the tongue, lower lip, floor of the mouth, chin, gums and lower incisor teeth submental nodes are important nodes to examine in cases of oral cancer caused by the use of tobacco products

Viscera of the Face

Organ Location/Description Notes
parotid gland salivary gland located lateral and posterior to the mandibular ramus, beside (para) the ear (oto) largest salivary gland; innervated by postganglionic parasympathetic fibers from the otic ganglion via the auriculotemporal n.
parotid duct thick duct that crosses the superficial surface of the masseter m. parotid duct drains the parotid gland through cheek to the oral vestibule near upper 2nd molar tooth

Other Tables of Interest:

All Anatomy Tables

Tables Organized by System Tables Organized by Region


Some of the material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest and Jaye Schlesinger
Published by ILOC, Inc., New York. Copyright 1995.

Content of these tables has been edited for use in this course by Patrick W. Tank, Ph.D.
Copyright 2007, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences.

Unauthorized use is prohibited.