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Describe sensory innervation of Face.

Skin of face is supplied by the three divisions of trigeminal nerve i.e. ophthalmic, maxillary and mandibular. A small part over the angle of mandible is supplied by great auricular nerve ( from ventral rami of C2,C3 spinal nerves).

Correlation of Sensory Innervation of Face with the Development of Face

Face can be roughly divided into three regions with respect to sensory innervation – upper1/3rd, middle 1/3rd and lower 1/3rd and is mainly supplied by the three divisions of trigeminal nerve i.e. ophthalmic, maxillary and mandibular nerves.

  • The upper one-third  of face develops from the frontonasal process and is supplied by branches of ophthalmic nerve.
  • The middle third of face develops from maxillary processes and is supplied by branches of maxillary nerve.
  • The lower third of face develops from mandibular processes and is supplied by branches of mandibular nerve.

However, the areas of cutaneous innervation aren’t horizontal, but extend in the posterosuperior direction corresponding to the direction of development of head and brain. Part of the neck skin is drawn up to overlap the angle of the mandible. This part of the skin is therefore supplied by great auricular (C2).

The branches of the three divisions of trigeminal nerve that supply the skin of face are as follows:

Branches of ophthalmic division of trigeminal nerve

  1. Supraorbital
  2. Supratrochlear
  3. Lacrimal
  4. Infratrochlear
  5. External nasal

Branches of maxillary division of trigeminal nerve:

  1. Infraorbital
  2. Zygomaticofacial
  3. Zygomaticotemporal

Branches of mandibular division of trigeminal nerve:

  1. Mental
  2. Buccal
  3. Auriculotemporal

sensory nerve supply of face

Name the nerve and its branches that supply muscles of Face.

The  muscles of face are supplied by the facial nerve. Facial nerve leaves the cranial cavity via stylomastoid foramen, it wind around the lateral aspect of styloid process and enters the parotid gland. Within the parotid gland it gives 5 terminal branches viz.

  • temporal
  • zygomatic
  • buccal
  • marginal mandibular
  • cervical

The branches emerge along the anterior border of the parotid gland and supply the muscles of facial expression. 

terminal branches of facial nerve

Branches of facial nerveMuscles Supplied
Temporal branchFrontalis
Orbicularis oculi
Corrugator supercilii
Zygomatic branchOrbicularis oculi
Buccal branchesZygomaticus major and minor
Upper buccal branchLevator labii superioris alaeque nasi.
Muscles of the nose
Levator anguli oris
Levator labii superioris
Lower buccal branchBuccinator
Orbicularis oris
Marginal mandibular branchRisorius.
Depressor anguli oris
Depressor labii inferioris
Mentalis
Cervical branchPlatysma

Applied Aspects

Bell’s palsy

It is lower motor neuron type paralysis of facial muscles which occurs because of compression of facial nerve in the facial canal near stylomastoid foramen. It results in ipsilateral paralysis of facial muscles. The symptoms of Bell’s palsy include:

  1. Facial asymmetry because of unopposed activity of muscles of normal side.
  2. Loss of horizontal wrinkles on forehead because of paralysis of frontalis muscle.
  3.  Inability to close the eyes and widening of palpebral fissure because of paralysis of orbicularis oculi.
  4. Loss of corneal reflex (efferent limb of the reflex is formed by facial nerve).
  5. Epiphora (tears flow down from the eye) because of paralysis of the lower part of the orbicularis oculi.
  6. Absence of nasolabial fold because of paralysis of levator labii superioris alaeque nasi.
  7. Drooling of saliva from corner of mouth because of paralysis of orbicularis oris.
  8. When the person tries to smile the angle of mouth of the normal side moves upwards and laterally.
  9. Accumulation of food into the vestibule of mouth because of paralysis of buccinator muscle.

Bell's palsy

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