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Anatomy of the Face

 

This course has been designed to introduce you to the anatomy of the face. It will provide you with sound a basic knowledge of the major bones in the face and their functions, muscles of the face and the nerves of the face. Designed to help individuals wishing to increase their own personal knowledge at their own time.

The Face anatomy module has been written by Mr Miles Berry MS, FRCS (Plast) who has published on this subject. He was a Lecturer in Surgery at one of London’s most prestigious Medical Schools and is an active hands-on trainer of hundreds of candidates.

The course has been complied in module format allowing you to work around a busy lifestyle and continue your learning at a time which best suits. The learning component of the module is assessed at the end with an examination. A pass mark of 90% is required to receive a certificate and a repeat is permitted if the required level is not achieved first time. 3 CME hours are available as a digital certificate on satisfactory completion of the course and exam.

 

Course Title Anatomy of the Face: An Introduction
Course Author Mr Miles Berry MS, FRCS (Plast)
Estimated course length (hours) 2
CME awarded (hours) 2
Pass mark required % 85
Examination attempts 3
Certificate Yes
Exam results and certificate issued 24-48 hours

 

Section 1Anatomy of the Face
Lecture 1 Anatomy of the FaceFree Preview

 Anatomy of the Face

bones in the face labelled medical diagram

In the human skull the facial skeleton consists of 14 bones:

  • 2 Inferial Nasal concha
  • 2 lacrimal
  • 2 Nasal
  • 2 maxillae
  • 2 Palatine
  • 2 Zygmatic
  • The Mandable
  • The Vomer

Note: The Hyoid bone is sometimes included as are the ethmoid bone (or a part of it) and also the sephnoid bone sometimes included, but otherwise all 3 are considered part of the neurocranium.

 

Paired and Non Paired Facial Bones

Of the 14 facial bones 12 are paired and 2 non paired these are the mandable and vomer.

Lecture 2Function of the bonesFree Preview

Function of the bones

The functions of these form cavities for facial organs, tongue, eyes and brain, anchor for facial ligaments, muscle and fat and give protection to the brain and other organs.

The Maxillae is the upper jaw that holds the teeth at the alveolar process (gums)

The 2 Maxillae bones are fused at the intermaxillary suture. This is similar to the mandable which is also a fusion of the 2 mandibular bones at the madibular symphysis.

Nasal bones form the side wall and bridge of the nose.

Lacrimal part of the eye socket on the medial side holds the lacrimal glands

Palatine forms the soft and hard pallet or the roof of the mouth

The Zygomatic (cheek bone or malar) articulates with the

Inferior nasal conch forms part of the nasal septum separating it into 2 chambers

Below the facial bones will be explained in more detail

Lecture 3The bones broken down into more detail Free Preview

The bones broken down into more detail 

The Mandible

The Mandible, also known as the lower jaw or jawbone is the largest strongest bone in the face. It forms the lower jaw and holds the lower teeth in place. The body of the mandible is somewhat curved like a horseshoe and has 2 borders and 2 surfaces. From the outside the mandible is marked with a faint ridge. The superior border which is wider behind than in front is hollowed into cavities for the reception of the teeth. These cavaties are 16 in number and vary in depth and size according to the teeth which they contain. The inferior border is rounded and longer than the superior and thicker in front than behind.

 

The Vomer

One of the 2 unpaired bones that make up part of the nasal septum. Articulates or connects with the sphenoid bone and the ethmoid bones (side rear portion of the eye socket). The Vomer is situated in the median plane, but its anterior portion is frequently bent to one side. It is thin and somewhat quadrilatral in shape and forms the hinder and lower part of the nasal septum. It has 4 borders and 2 surfaces.
The superior border presents a deep furrow, bounded on either side by a horizontal projecting expansion of bone called the wing of vomer. The inferior border articulates with the crest formed by the maxilla and palatine bones.

 

The zygomatic

The Zyghomatic bone is one of two bones (sometimes called malar bones) these are responsible for the prominences of the cheeks below and to the sides of the eyes. These bones also help form the lateral walls and floors of the orbits (eye). Each bone has a temporal process, which extends down the back to join the zygomatic process of a temporal bone. Together, these processes form a zygomatic arch. The smooth prominence between the eyebrows is called the glabella.

 

The palatine bone

The Palatine Bone is an important part of the scull. This bone is located at the back of nasal cavity – between the pterygoid process of the sphenoid and the maxilla. The Transverse palatine suture joins this bone and the maxilla. The Palatum enters into the two fossæ formations: the pterygopalatine fossæ and pterygoid fossæ. It is also connected with the inferior orbital fissure.

The bone comprises of one Horizontal plate, one Perpendicular Plate and 3 outstanding processes known as:

  • Pyramidal Process
  • Orbital Process
  • Sphenoidal Process

The Pyramidal Process of the Palatum is located at the back of the greater palatine foramen and is pointed backwards in a lateral manner from joint of the two human Palatines. The Orbital Process and the Sphenoidal Process is located at the top of the vertical part of the Palatines. A deep notch, known as the sphenopalatine notch, separates these two processes.

The sphenopalatine notch separates the Palatum processes located on the superior border of the bone. The lower surface of the sphenoid converts the sphenopalatine notch into sphenopalatine foramen.

There are several small bumps in the corners of the soft palate where it joins the rear side of the tuberosities. These bumps are known as the hamulii. The hamulii are actually the tips of the little projections from the base of the skull, known as the hamular processes of the palatine bone.

 

The inferior nasal concha

The inferior nasal concha is the most caudally based of the three nasal conchae. The pair of curved inferior nasal conchae overhand the wall on either side as a curvature of the nasal septum. The superior and middle nasal conchae form part of the perpendicular plate of the ethmoid bone, the inferior nasal concha is a bony structure by itself. Articulating bony structures include the frontal process of the maxilla anteriorly, the uncinate process of the ethmoid bone and the lacrimal bone anteriorly and medially and the perpendicular plate of the palatine bone posteriorly and medially.

The medial surface is convex, perforated by numerous apertures, and traversed by longitudinal grooves for the lodgement of vessels. The lateral surface is concave, and forms part of the inferior meatus. Its upper border is thin, irregular, and connected to various bones along the lateral wall of the nasal cavity. The inferior border is free, thick, and cellular in structure, more especially in the middle of the bone.

The upper border may be divided into three portions:

• the anterior articulates with the conchal crest of the maxilla

 

Nasal

The nasal bones are two small, symmetrical bones of the midface which build the bridge of the nose. Their superior borders and main bodies form the bridge of the nose while the inferior borders connect with the nasal cartilage to form the superior margin of the nasal aperture.

 

The lacrimal bone

The lacrimal bone is the most fragile bone of the face and one of the smallest bones in the body. Spanning between the middle of each eye socket, each lacrimal is thin and scale like and serves as support for the eye. The pair of lacrimal bones are two of the fourteen facial bones mentioned above.

The lacrimal has two surfaces: the nasal surface, which faces the nose, and the orbital surface, which faces the eye socket. It is similar in size to a fingernail and this rectangular-shaped bone is near the frontal bone, the maxilla, the ethmoid, and the inferior nasal concha.

The orbital surface of the lacrimal is parted by a ridge called the posterior lacrimal crest. It divides the lacrimal bone into two sections: the lacrimal sulcus and the orbial plate. The posterior lacrimal crest also creates a space for the lacrimal duct, a tube that allows tears to travel from the eyes to the nasal passages. The bone receives its name from that function; lacrimal is derived from the Latin word for tears

 

The Maxilla

The maxilla forms the upper jaw by fusing together two irregularly-shaped bones along the median palatine suture, located at the midline of the roof of the mouth. The maxillary bones on each side join in the middle at the intermaxillary suture, a fused line that is created by the union of the right and left ‘halves’ of the maxilla bone, thus running down the middle of the upper jaw. The bones help to form the upper jaw, sub-segments of the eye sockets, and the lower sections and sides of the nasal cavity. Additionally, they reduce the heaviness of the skull, help support the back teeth, and help to allow the voice to resonate.

Each half of the fused bones contains four processes. These include the zygomatic, frontal, palatine, and alveolar processes of the maxilla. They also contain the infraorbital foramen, an opening in the bone just below the eye sockets, and the maxillary sinus, which helps to protect important facial structures..

Lecture 4Muscles of the faceFree Preview

Muscles of the face

There are 43 muscles in the face, most of which are controlled by the seventh cranial nerve (also known as the facial nerve). This nerve exits the cerebral cortex and emerges from your skull just in front of your ears. It then splits into five primary branches: temporal, zygomatic, buccal, mandibular and cervical. These branches reach different areas of the face and enervate muscles that allow the face to twist and contort into a variety of expressions.

There have been many articles written regarding the amount of muscles used to make a smile compared to frowning with some papers claiming it takes 43 muscles to frown and 17 to smile.

Below is an image with the major facial muscles, please familiarise yourself with this diagram as it’s an essential part of your learning.

medical diagram showing labelled muscles face

Lecture 5Nerves of the face Free Preview

Nerves of the face 

The nerves of the head and neck include the most vital and important organs of the nervous system,the brain and spinal cord, the organs of the special senses are also found here. in this region we also find the major cranial and spinal nerves that connect the central nervous system to the organs, skin, and muscles of the head and neck.

These structures above all work together to control every part of the body and receive sensory messages from the environment and the body’s internal structures.

The brain which is grayish and found within the skulls weighs in at around three pounds on average, making it one of the most massive organs in the human body. Around 100 billion neurons in the gray matter of the brain control almost all of the body’s activities, including the conscious activities of the mind and the subconscious activities that control the organs and lower bodily processes. The interior of the brain contains mostly white matter that connects the processing areas of gray matter to each other and to all of the muscles and sensory receptors in the body.

The brain is an extremely complex organ, more details about the brain can be found in a future course on the brain under the courses section on the website.

Below is a complex diagram which shows a number of muscles but also identifies the main nerves throughout the face and head, it is essential that before performing any procedure on the face that you are fully training and accredited to perform that treatment.

 

Lecture 6Trigeminal neuralgia Free Preview

Trigeminal neuralgia 

Trigeminal neuralgia is sudden, severe facial pain. It’s often described as a sharp shooting pain or like having an electric shock in the jaw, teeth or gums.
It usually occurs in short, unpredictable attacks that can last from a few seconds to about two minutes. The attacks stop as suddenly as they start.

In most cases trigeminal neuralgia affects part or all of one side of the face, with the pain usually felt in the lower part of the face. Very occasionally it can affect both sides of the face, although not usually at the same time.

People with the condition may experience attacks of pain regularly for days, weeks or months at a time. In severe cases attacks may occur hundreds of times a day.

It’s possible for the pain to improve or even disappear altogether for several months or years at a time (remission), although these periods tend to get shorter with time.

Some people may then go on to develop a more continuous aching, throbbing and burning sensation, sometimes accompanied by the sharp attacks.

Living with trigeminal neuralgia can be very difficult. It can have a significant impact on a person’s quality of life, resulting in problems such as weight loss, isolation and depression. Treatment options usually result in either medication or surgery if the problem persists, it can stop as quickly as it starts.

Lecture 7SummaryFree Preview

Summary

  • The human skull facial skeleton consists of 14 bones
  • 12 bones in the human skull are paired and 2 non-paired
  • The Mandible is the largest bone in the head
  • There are 43 muscles in the face
  • The nerves of the head and neck include the most vital and important organs of the nervous system, the brain and spinal cord
Final Quiz

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