Muscles of facial expression; masticatory muscles; TMJ joint

Ivo Klepáček Guillaume Benjamin Amand Duchenne born. September 17, 1806, Boulogne, France death 15. September 15, 1875, Paris, Francie Pictures from his book titled Mécanisme de la Physionomie Humaine 1862

Using electric stimulation he tried to determinate which muscles can be acting in various facial expression. Following his findings, Charles Darwin had published some from his photos in own paper, comparising expressions of the man and animals

BRANCHIAL Motor areas V3., VII., STRUCTURES IX.,X.,XI. (their myogenic material probably originate from the occipital myotomes):

• Muscles of the I. Branchial arch (V. trigeminus) • Muscles of the II. Branchial arch (VII. V1 facialis) • Muscles of the III. V3 Branchial arch ( IX. X. XI., glossopharyngeus, vagus, accesorius) V2

III. arch: Cranial part: participate in forming of the laryngeal and pharyngeal muscles Distal part: forming of the trapezius and sternocleidomastoid muscles Head muscles Mm. capitis

Mimic (faciales) and Masticatory (masticatorii)

Kraissl´s and Langer´s cleavage lines 3D plexiform SMAS superficial (subcutaneous )musculoaponeurotic system net of collagenous Blow out fracture and muscular fibers containing fat cells

SMAS type I - thin septal layer containing fat SMAS lobules type I SMAS type deep located II - SMAS with intermingling type II muscular and collagenous fibers Mimické svaly Blow out fracture Mimic muscles Superficial spindle-like or strip-like or round

Deep flat • Inside subcutis •No or very thin fascia •No or very thin tendons •Interstitial fibrous tissue •Incorporated into subcutaneous fat •Nervous fibers enter muscle bellies in more than one point (gate) Motor innervation from the facial nervus facialis VII. Mimic head muscles Derivates of the 2. branchial mm. faciales arch Innervation: from n. facialis (nervus cranialis septimus; VII.) Muscles:  Vault (cover skull cap)  Muscles of the facial expression  MM. around eye  MM. around nose  MM. around oral cavity (mouth)

Epicranial (vault, skull cap) muscles

M. epicranius From two parts m. occipito-frontalis Venter frontalis et occipitalis skin, and above superior nuchal line to galea aponeurotica M. temporoparietalis  skin above pinna (auricularlobe)  to galea aponeurotica S C A L P

Regio frontalis, temporalis, parietalis, occipitalis Kůže Skin Podkožní vazivo s hustými svazky Connective tissue kolagenu (epicranial membrane) Aponeurosis (galea aponeurotica Řídké vazivo Loose areolar tissue Periost perikranium Pericranium Leží v subaponeurotickém prostoru

Venae are opened into v.jugularis ext., v. supraorbitalis, v. occipitalis Arteriae are come from the aa. supraorbitales, superficiales temporales, auriculares posteriores, occipitales Nerveas are branches of the cervical

segments V1,V2 Muscles around external nose

 M. nasalis  From the ventral surface of the maxilla to nasal dorsum Nasal muscle units importantant for plastic surgery: elevators, depressors, compressors, dilatators 10 1

? 3 2

6

8 7 4 “Rhinoplasty dissection manual“ by Toriumi and 5 Becker 2007

9 Internet message Muscles around eye (orbit)

 M. orbicularis oculi Palpebral and orbital part  Attached to periost covering inner medial orbital angle  M. procerus  Above nose root (subcutis)  Attached frontal muscle  M. corrugator supercilii  From the nosel root (craniolaterallly)  To skin on the medial one halves of supraorbital margines  M. alaeque nasi  From the medial orbital angle!  To skin groove called sulcus nasolabialis  M. levator labii superioris  Below orbital margine  To the skin following nasolabial groove  M. zygomaticus minor  Os zygomaticum  To the distal area of the nasolabial groove  M. zygomaticus major  From the proc. zygomaticus ossis temporalis  To skin of the oral angle or to the  M.  From the fascial covering  To the skin around angulus oris (mouth corner)  M.  From maxilla above canine root  To the angulus oris, m. orbicularis oris  M. depressor anguli oris  From below premolars  Angulus oris  M. depressor labii inferioris  The same as above  To the skin of the lower (labium inferius) above mentolabial groove  M.  Ventral mandible surface  skin (caudally) chin depression (fovea)  M. platysma  See neck muscles  Subcutaneous tissue podkožním vazivu from shoulder and thorax to clavicle  To skin above mandible (or to lower lip muscles)  N. facialis (its collar branch - br. colli)

Regio labialis et mentalis Lip Chin

Platysma

Pouting vivacity laugh

disgusting derogation rage

cry attention screwing up eyes Mimic muscles and skull openings

Mimicé svaly cévy obličeje Mimic muscles face vessels

trigonum mortis Mortal triangle Fat pad

Bichat cushion

Corpus adiposum Bichati Masticatory muscles

Musculi masticatorii

V3 – MANDIBULARIS Derivates of the 1. branchial arch Masticatory muscles n. mandibularis - 3rd branch of the n. V.  M. masseter  From the outer surface of the ; deep part of the muscle run from the internal bone surface, too  Superficial part runs mandibular angle; deep to the „fovea zygomaticomandibularis“  M. temporalis  From inferior temporal line (+adjacent bone)  Proc. coronoideus mandibulae (coronoid process)  Fascia temporalis and fascia parotideomasseterica Spatium interfasciale; Interfascial space

M. temporalis et fascia temporalis M. masseter

Fascia parotideomasseterica, Parotideomasseteric fascia

 Mm. pterygoidei  Medialis From the pterygoid fossa and from the tuber maxillae Tuberositas pterygoidea  Lateralis From the processus pterygoideus (lamina lateralis) and from the infratemporal face of the greater wing of the sphenoid bone below mandibular head, pterygoid fossa and onto the joint capsule

a – lig. pterygospinosum

b – n. alveolaris inferior

c, d – n. lingualis e – lig. pterygomandibulare (raphe buccopharyngea)

f – sulcus mylohyoideus g – angulus mandibulae et lig. stylomandibulare h – lig. sphenomandibulare

Innervation:

CN V3

Additional (assisting) muscles (masticatory muscles from the orthotics point of view)

venter anterior of the m. digastrici m. mylohyoideus Innervation:

CN V3

m. geniohyoideus

Temporomandibular Articulatio temporo- (craniomandibular) joint mandibularis ATM lat. TM , TMJ engl.

Morphological findings:

• The great variability of all the articular structures • The absence of hyaline cartilage •The two separate compartments, allowing a wider range of mandibular movements • The mared weakness of the articular ligaments, allowing hypertranslation and dislocation without tearing the capsule Compound joint Similar to hinge joint type

Basis cranii externa –

semiview on the

tympanic bone Condylus occipitalis

Processus styloideus Os tympanicum zvýrazníte dalším Foramen jugulare kliknutím

For. stylomastoideum Tuberc. pharyngicum

Processus mastoideus Foramen lacerum Spina sphenoidalis Foramen spinosum Fissura Foramen ovale tympanomastoidea Fis.tympanopetrosa Fis.petrosquamosa Fis.tympanosquamosa

Porus acusticus ext.

Fossa mandibularis

Tuberculum articulare

Arcus zygomaticus

END

bundle of cartilaginous cels – Meckel derivate ? Articular Capsule is a sac that encloses TMJ. Gray´s anatomy, The classic collector´s edition Borders: Superior: Capsule is positioned underneath inferior side of Articular Eminence. Inferior: Capsule wraps around condyle's neck (Collum Mandibulae) It is a fibro-cartilageus disc. It divides synovial cavity of TMJ into: 1. Superior synovial cavity 2. Inferior synovial cavity Both cavities are filled with synovial fluid, secreted by inner side of articular capsule (clear, viscous fluid). Attachments of articular disc: 1.Anterior: a. Anterio-Superior: indirectly to articular eminence through capsule b.Anterio-inferior: to condyl's neck 2.Posterior: a.Posterio-superior: to post-glenoid process spina supra meatum ? b. Posterio-inferior: to condyl's neck

Salentijn, L. Biology of Mineralized Tissues: Prenatal Skull Development, Columbia University College of Dental Medicine post-graduate dental lecture series, 2007 Moss, ML. The non-existent hinge axis, Am. Inst, Oral Biol. 1972, 59-66 Rodríguez-Vázquez JF, et al., JF; Mérida-Velasco, JR; Mérida-Velasco, JA; Jiménez-Collado, J (1998). "Anatomical considerations on the discomalleolar ligament". J Anat.. 192 (Pt 4): 617–621. PMC 1467815. PMID 9723988. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1467815/. Rodríguez-Vázquez JF, et al. (1993). "Relationships between the and the middle in human fetuses.". J Dent Res.. 72 (1): 62–66. T Rowicki, J Zakrzewska. (2006). "A study of the discomalleolar ligament in the adult human.". Folia Morphol. (Warsz).. 65 (2): 121–125. S Zhang, N Gersdorff, J Frahm (2011) Real-Time Magnetic Resonance Imaging of Temporomandibular Joint Dynamics. The Open Medical Imaging Journal, 2011, 5, 1-7, [1] Zadik, Yehuda; Aktaş Alper; Drucker Scott; Nitzan W Dorrit (2012). "Aneurysmal bone cyst of mandibular condyle: A case report and review of the literature". J Craniomaxillofac Surg 40.

•J. Chen, U. Akyuz, L. Xu, R.M.V. Pidaparti : Stress analysis of the human temporomandibular joint •Medical Engineering & Physics 20/8/: 565-572, October 1998 Upper space - cavitas discosquamosa – 581 mm2 Lower space - cavitas discocondylaris – 396 mm2 Condylar atrophy follows age fibroelastic lamina

!

Retroarticular hydroelastic cushion Zenker (contains vessels)

Thin elastic lamina

N. facialis:

• lateral surface of the joint capsule N. auriculotemporalis nerve is branched into four :

• lateral branch •Medial branch • branch from the middle nerve segment • branch from the area where nerve crosses n. temporalis superficialis m. temporalis profundus:

• supplies rostromedial part of the disc and capsule n. massetericus send four branches:

• branch below oval foramen • branch from the first nervous segment closely below skull base • two branches from the first segment below Ganglion oticum ():

• supplies dorsal part (pars discosquamalis) of the joint capsule

Adjacent nerves:

Auriculotemporal nerve Chorda tympani (pars intermedialis from CN VII.)

Literature R. Čihák: Anatomie 1, 2, 3 Grada Publishing 2003 M. Dykes : Anatomy 2th edition, Mosby 2002

S.Snell: Clinical anatomy for Medical Students 6th edition, Lippincott, Williams & Wilkins I.Klepáček, J.Mazánek et al.: Klinická anatomie ve stomatologii Grada Publishing 2001 G.J.Tortora : Principles of Human Anatomy 4th edition, Williams & Wilkins K.L.Moore, A.F.Dalley: Clinically Oriented Anatomy 4th edition, Williams & Wilkins F.H.Netter: anatomický atlas člověka Vlastní archív