Muscles of Facial Expression

Facial Expression

test on ones that shape lower face not upper face

Facial expression is an integral part of being human

The face is highly communicative and this can augment linguistic communication Important elements of facial expression are symmetry, range of motion and diversity Muscles support these elements

For speech, the lips form the focus of facial muscle control

Extremely mobile and morphable Central to facial aesthetics

Innervation
really straight forward

All facial muscles innervated by CN VII, the facial nerve

More detail about facial nerve distribution to come

brainstem pons and medulla

on right: muscles that are cut near their origin

t t t t t t t t

left: full force of the muscles t list of muscles to test on:

t t

same muscles over here

Orbicularis Oris
most important muscle for keeping lips together

Muscle forming bulk of lips Circumoral circles mouth

No real origin or insertion Arises in one angle inserts in other the kissing muscle Keeps food from spewing forward Another sphincter put to good use
muscle people who loose control on this muscle may not be able to keep food or liquid in their mouth

Action: Draws the lips together to seal mouth

under a high degree of voluntary control quite useful for closing sphincter and speech

Orbicularis Oris

Fibers from other facial muscles insert into OO as their termination

Some fibers terminate at corner of mouth Other continue into body of muscle Allows for highly complex motions

soft tissue insertions dont have that much mass to move

Two functional subdivisions:

Orbicularis oris inferior (Ooi) lower lip break up into quadrants Orbicularis oris superior (Oos) upper lip Left and right sides have independent innervation

Innervation: Motor - CN VII

Occasionally divided into funtional quadrants

can move upper lip independently from lower lip

I-Clicker Question
What type of speech sound does the orbicularis oris produce?
A) Alveolar stop B) Velar stop C) Bilabial stop

Smiling and Puffing Muscles

pull the lips apart

Risorius:

does not have bony origin or insertion...both are in soft tissue

courses from fascia close to mandible to corner of mouth Lateral course across face Retracts lips at corners (lateral pull) Smiling muscle

Smiling and Puffing Muscles

much more of a smiling muscle

Zygomaticus major
arises on zygomatic bone and inserts in corner of mouth Elevates angle of mouth and draws it laterally Also a smiling muscle

Smiling and Puffing Muscles

Buccinator: cheek (buccal) muscle

Originates from pterygomandibular raphe

Ligament connecting pterygoid to mandible

Inserts horizontally into upper and lower lips Flattens cheeks, build up pressure buglers muscle Helps move food onto molars Clears food out from buccal cavity

helps build up pressure in your cheeks doesnt have clear role in speech, but in whistles, clear food out from molars and buccal cavity

various origins but all inserting into body of the lips

Lip Elevators
These muscles all insert into mid-lateral region of upper lip Levator labii superiorus: (lift the lip superior)

Originates from lower orbit Inserts into upper lip where fibers intermix with OOS Elevates lip and may help to turn it upwards

Levator labii superiorus alaque nasi - along the very tiny muscle nose

Nasty long name for a small muscle Has two divisions

One muscle inserts into lateral cartilage of nose to dilate nostril Other muscle inserts into OOS and helps to elevate medial upper lip

Lip Elevators
Zygomatic minor

a bit medial to zygomatic major

Arises just in front of zygomatic major and inserts in lateral upper lip Assists in raising upper lip

Levator anguli oris: arises from canine fossa of maxilla and inserts in upper and lower lip corners

Draws corners of mouth up and laterally Due to UL and LL insertions it can assist in generating medial compression

keeps mouth tit

Lip Elevators
Incisivus labii superiorus

wont test us on

Arises from maxilla near canine teeth Runs laterally to angle of mouth Pulls corner of mouth upwards and laterally

Lip Depressors
names correspond to lip elevators...originate from different parts of the skull

Depressor labii inferiorus

Arises from oblique line of mandible inserts in lower lip Pulls lips down and out Arises from lateral margin of oblique line Converges on orbicularis oris and upper lip corner Lowers angle of mouth and assists in generating lip compression

Depressor anguli oris

Lip Depressors
(bottom of jaw(

Mentalis: arises from incisive fossa and insets into skin of chin
(lower lip)

Wrinkles chin and puffs lower lip out The pouting muscle

Incisivus labii inferior

not on test

Arises from mandible near lower incisors Inserts into lower angle of mouth Pulls corner of mouth laterally and downwards

Lip Depressors

sometimes neck muscle or facial muscle

Platysma: large, thin sheet of muscle

has insertions all the way around the face

Sometimes classified with facial muscles Arises from pectoralis and deltoids Inserts throughout lower mouth, chin and mandible Muscle tenses soft fleshy mouth and assists in mandibular lowering Draws lower lip downwards and laterally May assist in compressing lips
assist in opening mouth and lowering the mandible

Other Facial Expression Muscles

NOT ON TEST YOLO

Orbicularis oculi: sphincter muscle surrounds eye

Upper portion- orbital, lower portion-palpebral Closes and protects eye

Frontalis: wrinkles forehead Corrugator supercilii wrinkles eyebrow Depressor supercilii lowers eyebrow Nasalis: depresses nasal cartilages and narrows the nares Procerus: small, unpaired triangular muscle between eyebrows

Draws eyebrows medially and wrinkles skin over nose

Anterior and posterior nasal dilators

Growth of the Lips

important because they have a role in speech degluttion

Generally follow development of the face

Small at birth

Specialized for forming an oral seal during feeding through presence of papillae Papillae decrease once nursing period is ended Essentially double in width Follows growth during puberty

Initial growth period between 0-2 years

Second growth period between 10-17

Lip control for speech generally matures after jaw movements are stabilized

Relatively early production of bilabial sounds

Aging of Face
Skin loses collagen and hence elasticity Hence contraction of facial muscles eventually produces ______________ Onset of ______________ could perhaps be prevented by not using facial expressions In some cases, the paucity of facial expression in PD makes face look younger
wrinkles wrinkles

Lip Features
Border between lip mucosa and skin is the vermillion border Mucosa of lip much more sensitive than surrounding skin Among the most sensitive regions of body for sensing texture differences

Two point discrimination is almost as good as fingertips Threshold for discrimination also approaches fingertips

Facial Nerve
Provides motor innervation to all the muscles of facial expression Arises from dorsal brainstem at junction of pons and medulla Enters internal acoustic meatus and runs through petrous portion of temporal bone Forms geniculate ganglion in temporal bone:

cell bodies of tongue taste neurons somatic sensory axons of external ear, ear canal, and external ear drum

Facial Nerve
Proceeds to facial canal and exits skull Just before exiting, the stapedial nerve and chorda tympani branches off

Stapedial nerve innervates middle ear muscles Chorda tympani carries taste sensation from the anterior 2/3 of the tongue and innervates salivary glands (submandibular and sublingual)

It runs through middle ear to eventually merge with lingual nerve of CN V (provides general tongue sensation)

Main motor trunk continues in facial canal Exits at stylomastoid foramen

Branches to stylohyoid and posterior digastric emerge here

Facial Nerve
Main motor branch enters parotid gland where 5 divisions emerge:

Temporal

know this not this

Frontalis, occipitalis, orbicularis oculi, corrugator supercilii, procerus

know these division but do not need to know muscles that are innervated by them

Zygomatic: orbicularis oculi Buccal:

Buccinator, orbicularis oris sup., nasalis, levator labii ms, zygomatics, Orbicularis oris inf, depressor labii ms, risorius, mentalis

Mandibular:

Cervical: platysma

good image

Facial Nerve Branches

Facial Nerve Complexities

Complex because fibers from other nerves may join up with facial nerve
Some sensory fibers may be traveling with facial nerve Some sensory fibers are distributed to the external ear Some fibers may carry deep pain from face Other fibers may carry facial proprioception (controversial)

Facial Motor Innervation

Upper facial muscles receive bilateral motor innervation

Both sides of brain innervate each side of face

Lower facial muscles only innervated by contralateral side of brain

sensitivity to loud sounds

entire face paralyzation

lower quadrant is paralyzed

Bells Palsy Vs. Central Seven

case in which nerve in peripherary is interrupted...facial nerve directly interuppted ...person will loose motor control on entire half of face (bells)

right side of brain controls right and left muscles muscles on the right side of face are controlled by left side of brain for lower face for upper these can be controlled by the right side as well as the left

only unilateral innervation for lower face

I-Clicker Question
Which nerve carries sensory information from face?
A) Facial B) Vagus C) Hypoglossal D) Trigeminal

I-Clicker Question
Does it take more muscles to smile or frown?
A) smile B) frown C) equal approximately

takes more effort C

Types of Sensation
come from face, toungue, larynz, pharyx, and mucousa

speech dependents on movement as well as sensory

Sensory information includes

Fine touch Crude touch Proprioception posture, ability of brain to be aware of posture Pain not important for speech but for life : pain, temperature, & reflex Temperature Sensory information also elicits various reflexes

very important for infants

Facial Sensation
As described, lip sensation is highly acute and discriminative
Generally sensation over the face is also acute and shows good discrimination But not as sensitive as lips

This level of sensation is important because lip muscles do not have muscle spindles or tendon organs

Facial Sensation
Compare with limb Sensation

face needs discriminative touch sensation so brain knows how face is shaped

Muscle spindles are typically present in skeletal muscles of the limbs and trunk Joint sensors within joints Sensors convey position information, contraction degree and tension information to brain

Facial muscles do not have these sensors despite being skeletal muscles

Facial Sensation
How does brain learn facial proprioception?
In other words, what sensory information relates to facial position, muscle tension, mouth opening degree This information is important for learning how to shape facial structures for speech sounds

Facial Sensation
Information is carried by sensory receptors in skin of face and lips As the facial muscle stretch, compress and/or tense the skin

Tiny sensory receptors carry this information to the brain Brains job is to sort out these different patterns Learn information associated with different facial expressions that convey emotion or shape acoustic sounds

wont see diagram or exam questions on this

Examples of Skin Sensory Receptors

Facial Sensation
In normal speaker brain certainly differentiates accurately between different facial/lip postures
Both visual and auditory information may be helpful in learning These considerations are important in speech learning

Also important in considering how a baby learns the social smile

Smile requires considerable facial coordination

carries sensory information from the face:

Trigeminal Nerve: CN V
Foremost sensory nerve for the face, oral cavity, nasal cavity, and teeth

Largest CN and largest CN nucleus in brainstem

Other sensory portions of nerves such as VII, IX & X actually terminate in CN V nucleus

Carries touch, proprioception and pain from these areas A smaller branch is the motor nerve that mostly innervates muscles of mastication and tensor veli palatini

from scalp, oral track pharynx receives info from

Course of Sensory Branch of CN V

Emerges from lateral pons Trigeminal ganglion is located close to brainstem 3 main branches emerge off ganglia: Opthalmic, maxillary & mandibular
(considered part of peripheal) upper face

V1, V2 & V3

around the middle maxilla bone

like three fingers on side of face

lower face around the jaw

Basically supplies entire face Opthalmic division exits skull through superior orbital fissure

Supplies upper face and portions of meninges

Trigeminal Divisions

three divisions are going carry sensation from the face

these two also carry info from oral tract

Trigeminal Branches
gives idea how nerve travels through periphery

more detailed

import

CN V gives off three branches V2 gives off sup alv and infra orbit V3 mandibular gives of inf. alvelor nerve

imprt

does not include motor branch of CN V (also travels with V3 sepeartely)

Opthalmic Nerve (V1)

number of braches (WONT TEST ON)

Major divisions:
Frontal nerve innervates upper scalp, forehead, medial upper eyelid and upper orbit Nasociliary nerve carries innervation from eyelid, nose, nasal cavity, ethmoidal air sinus Lacrimal nerve also supplies parts of eyelid, conjunctiva and lacrimal gland

regulates moisture levels in eye

these areas are convered by mucous membrane and these are covered by nerve receptors

Trigeminal Nerve (V2)

Maxillary branch emerges from trigeminal ganglia Exits skull through foramen rotundum but gives off branches to the meninges

KNOW

Zygomatic branch supplies skin over maxilla and zygomatic bone Infraorbital branch supplies upper lip, medial cheek and side of nose learning facial postures Superior alveolar branch carries sensation from the upper teeth and gums Palatine nerves supply the hard and soft palate

Trigeminal Nerve (V3)

Mandibular division arises off of trigeminal ganglion and unites with motor branch
Leaves skull through foramen ovale Emerges from foramen and splits into small anterior trunk and large posterior trunk Anterior trunk is mainly motor to muscles of mastication

lower face

loves talking abou t toungue senstation

Trigeminal Nerve

CN V

Large posterior trunk is the sensory supply of the lower face

Inferior alveolar nerve supplies mandibular teeth including gums

Exits mandible through mandibular foramen

Lingual n. emerges fom posterior trunk and provides taste is cordotympany sensation to anterior 2/3 of tongue with CN VII and posterior 1/3 (other part of toungue) Buccal branch carries sensory information from the cheek Auriculotemporal n. supplies side of face, auricle, meatus, eardrum &TMJ

Trigeminal V3
Motor division supplies tensor veli palatini, tensor tympani, lateral pterygoid, masseter, temporalis, anterior belly of digastric, mylohyoid
medial pterygoid

Note: Remember to divide sensation of tongue into anterior and posterior divisions

Arises during embryology

Role in Speech?
facial and jaw muscles need to work together ; facial shape the mouth and jaw opens CN V & CN VII working together

Orofacial or circumoral articulators contribute to:

Shaping the sound output of vowels

LENGTH O vs EEE roundness extension ______________ of vocal tract degree ______________ of oral opening (ahhhh vs eeee) duration ______________ of oral opening (singing vs speaking)

Also

duration

constriction A ______________ of consonant sounds Active in ____________ of overlapping sounds coarticulation

poss questions for exam

Role of facial muscles in Speech?

Which sounds? Which muscles are active in forming labial consonants? Are the upper lip and lower lip separate articulators? Do jaw and lower lip have distinct functions in speech?
by facial muscles

think of sounds like BUH vs FUH ..upper and lower lip in one case are coordinated but other case only lower lip is activated

Jaw Anatomy

Jaw Anatomy
Jaw function for speech and mastication involves moving the mandible around Jaw can be elevated, depressed, protruded and moved from side to side This fascinating range of motion is supported by the horribly complex TMJ and the muscles of mastication Jaw opening muscles essentially open the mouth (important for shaping oral cavity)

Useful for breathing, inserting food and propagating acoustic information

Jaw Anatomy
Jaw closing muscles close mouth which is useful for crushing food and assisting in production of certain sounds Closing muscles also participate in rotational grinding of food and moving jaw laterally One jaw muscle can also elevate larynx how is this accomplished? Effect?

TMJ
Only true joint of the skull that permits movement

Most of the other skeletal muscles of the body move around a joint

Both joints move together

Complicated because it allows rotation, protrusion and lateral motions of the jaw Joint is formed around the condyl head and anterior mandibular fossa of temporal bone

TMJ
Condyle is separated from fossa by an articular disk Joint is surrounded by the articular capsule that arises from surface of mandibular fossa and envelops condyle neck Space within joint is filled by synovial fluid

TMJ Ligaments
Temporomandibular ligament courses backwards from zygomatic arch

Runs externally or laterally Inserts on back of condyle neck

Sphenomandibular and stylomandibular ligaments are medial ligaments

Sphenoid bone to mandible Styloid to mandible

Temporomandibular ligament is the central protective ligament, that restricts movement at the joint and prevents dislocation

Summary of Jaw Muscle Actions

Raising:

masseter, medial pterygoid, temporalis lateral pterygoid, geniohyoid, anterior digastric, mylohyoid, genioglossus lateral pterygoid, medial pterygoid temporalis (posterior), mylohyoid, geniohyoid, anterior digastric, geniohyoid lateral pterygoid, temporalis

Lowering:

Protrusion:

Retraction:

Lateral:

Jaw Opening Muscles

SHS 300

Digastric muscles
Another unusual muscle

Has posterior and anterior bellies united by a central tendon Posterior belly courses anteriorly and inferiorly from mastoid process to hyoid bone body Anterior belly travels from symphysis backwards and laterally to hyoid bone body Small tendinous loop on hyoid stitches muscle together

Digastrics
CN V innervates belly and CN VII innervates belly Actions
If hyoid bone is fixed, contraction of anterior belly opens jaw Posterior belly draws hyoid backwards

Lateral Pterygoid
Muscle has two origin points (or heads) Lateral surface of lateral pterygoid plate and greater wing of sphenoid Fibers course backwards to insert into pterygoid fossa

Depression on anterior neck of condyle

Action protrudes jaw by pulling condyle down and forward Alternating contractions of pterygoids allows jaw to move in grinding motions Innervation: CN V

Geniohyoid
Arises from inferior mental spine on inside mandible Insert onto anterior surface of hyoid Actions either elevate hyoid or depress jaw Innervation: CN XII

Mylohyoid
Arises just below geniohyoid Forms muscular floor of mouth Fibers emerge from entire mylohoid line and insert with contralateral fibers at midline raphe Posterior fibers insert into hyoid Has minor role in tensing base of mouth and opening jaw CN V

Jaw Closing Muscles

Masseter
Most powerful muscle of mastication Thick, flat quadrilateral muscle Peripheral muscle covering most of ramus External fibers arise from zygomatic arch and insert into angle and lateral surface of ramus

Forms bulk of muscle

Masseter
Internal fibers more sparse Run from zygomatic arch slightly forwards to insert on upper half of ramus Masseter pulls jaw upward and slightly backwards This angle optimizes power of muscle allowing molars to crush food Masseter may have the most rapid stretch reflex of all muscles May have a minimal role in speech unnecessary closing power Innervation: CN V

Temporalis
Broad, thin fan shaped muscle

Arises from broad section of temporal bone Fibers converse during course under zygomatic arch Insert at anterior border of ramus along coronoid process Anterior and middle fibers are more vertical and elevate mandible Posterior fibers have an angle and aid in retracting mandible

Temporalis
Muscle allows more rapid contractions of jaw, perhaps for snapping Faster speed may be more useful for closing mouth during speech Innervation: CN V

Medial Pterygoid
Arises from pterygoid fossa and medial pterygoid plate (or medial surface of lateral plate)
Recall sphenoid bone a second slip arises from maxilla and palatine bone Fibers course downward, laterally and backward to insert on medial surface of ramus and angle

Medial Pterygoid
Sometimes called the internal masseter

Describes its course and action

Together with masseter, these muscles cradle the mandible, in the mandibular sling Innervation: CN V

dont spend much time on it know types of teeth, orientation of teeth to idling

Dentition

SHS 300

The Teeth
Critical for life and speech articulation

Mastication, aesthetics and articulatory surfaces Types of teeth and basic internal anatomy (Figure 623a & 6-24) Relationship of teeth to midline (figure 6-25) Surfaces of teeth and roots of teeth (figure 6-25 & 626) Dental development (pp 313-316) Types of occlusion and malocclusion (pp 316-320) Innervation of the teeth

What to know:

Dentition
Housed in alveoli of maxilla and mandible
Upper and lower arches Actually half arches on each side House equal numbers of teeth of the same type

Types of teeth
Types
HALF i

Central incisors 1 per arch 6 front teeth upper and lower HALF Lateral incisors 1 per arch HALF Cuspid or canines 1 per arch (8 all together) Premolars: first and second bicuspids 2 per arch Molars: first, second and third molars 2-3 per arch

Adults have 32 teeth normally but many have third molars removed (wisdom teeth)
children have fewer

could be questions on idenitfying teeth

Functions of teeth in mastication

Incisors cutting Canines ripping Premolars and molars crushing and grinding Very effective set of slicers and mashers for omnivores

Surfaces of teeth
Midline is the space between central incisors

Motion along arch is medial if moving toward midline Distal if moving away from midline Medial surface faces toward midline Distal surface faces away from midline Buccal surface faces cheeks Lingual surface faces tongue Occlusal surface is contact surface between upper and lower teeth

distal

Five surfaces

medial

ony 4-5 questions on ALL of teeth

Internal anatomy
Each tooth has a root hidden in gum line

Crown is the visible top third Juncture of crown and root is neck Crown is covered with enamel

Hard surface overlying the anatomy of the teeth

Below crown is ivory that overlies pulp Pulp is the nerve ending that provides sensation and maintain tooth vitality Teeth are held in alveolar socket by thin layer of bone called cementum

Dental development
Humans go through 2 sets of teeth

Infants grow temporary teeth

Deciduous or milk teeth

Early buds of teeth present at birth Begin to erupt through bone and gums at 6-9 months of age

Interosseous and clinical eruption

Teeth are smaller and fewer than adults (10 teeth per arch in children)

tells you age at which baby teeth are coming in..and contrasts age at which adult teeth come in

look at in great detail

I-Clicker Question
How many teeth are there per arch in a 3 year old child?
A) 8 B) 10 C) 16

Dental development
General sequence of development

Central incisors 6-10 mts

lower before upper upper before lower

Lateral incisors - 8-10 mts

Canines 10-20 mts Molars 20-24 mts Premolars are not present in baby teeth

Review general ages at which permanent teeth grow in

Innervation of teeth
Teeth obviously have rich sensory innervation

Accurate sensing of pressures and loads against teeth

Essential for control chewing and other oral forces

Exquisite pain sensation (and thermal sensation?)

All innervation originates in trigeminal nerve (CN V)

Upper teeth supplied by maxillary branch Lower teeth supplied by mandibular branch

Innervation of teeth
Maxillary branch (V2) splits into different branches

Eventually gives rise to anterior and posterior superior alveolar nerves

Anterior branch innervates incisors and canines Posterior branch innervates molars and premolars

Mandibular branch (V3) splits into anterior and posterior divisions

Posterior branch gives rise to inferior alveolar nerve that supplies all mandibular dentition

Occlusal Patterns
Learn occlusal patterns in text

chapter 6....read those over