Muscles of the Face

The facial muscles (also called mimetic muscles) control facial expression and are supplied by the facial nerve. Most of them originate from the skull and attach to the skin around the facial openings, which serve as a method to group or classify them. Also located within the face are the masticatory muscles, which move the temporomandibular joint, allowing for mastication and the initial stages of digestion.

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Muscles of the Cranium

The muscles of the cranium assist with actions of facial expression. These muscles receive nerve supply from the facial nerve (cranial nerve (CN) VII).

Table: Muscles of the cranium
MuscleOriginInsertionNerve supplyFunction
OccipitofrontalisFrontal belly (frontalis): galea aponeurotica (epicranial aponeurosis)Skin of the eyebrowTemporal branch of the facial nerveLifts eyebrows, wrinkling the forehead
Occipital belly (occipitalis): superior nuchal lineGalea aponeuroticaOccipital belly: posterior auricular nerve from facial nerveMoves the scalp posteriorly
TemporoparietalisAponeurosis above auriculares musclesGalea aponeurosisTemporal branch of the facial nervePulls the ears cranially and dorsally
Occipitofrontalis and Temporoparietalis

Lateral view of the face featuring both bellies of the occipitofrontalis muscle and the temporoparietalis muscle

Image by BioDigital, edited by Lecturio

Muscles of the Mouth

The muscles of the mouth assist with facial expression, chewing, and communication. These muscles are supplied by the facial nerve (CN VII).

Orbicularis oris and buccinator

Table: Muscles of the mouth: orbicularis oris and buccinator
MuscleOriginInsertionNerve supplyFunction
Orbicularis orisDeep surface of the perioral skin, angle of the mouth (modiolus)Mucous membrane of the lipsBuccal branch of the facial nerveCloses mouth, purses lips
BuccinatorAlveolar processes of the maxilla and mandible (at the 1st–2nd molars)Angle of the mouth radiating into the orbicularis orisBuccal branch of the facial nerve
  • Pulls cheeks inward against the molars while chewing
  • Works with the tongue to keep food between occlusal surfaces of the teeth and out of the oral vestibule
  • Resist distention when blowing
Anterior view of the orbicularis oris muscle fibers

Anterior view of the orbicularis oris muscle fibers

Image by BioDigital, edited by Lecturio
3D rendering of a lateral view of the buccinator and orbicularis oris

Lateral view of the buccinator and orbicularis oris muscles

Image by BioDigital, edited by Lecturio

Upper group

Table: Muscles of the mouth: upper group
MuscleOriginInsertionNerve supplyFunction
RisoriusMasseteric fasciaSkin of angle of the mouthBuccal branch of the facial nervePulls angle of the mouth laterally
Zygomaticus majorLateral surface of the anterior aspect of the zygomatic boneSkin of angle of the mouth, blending with levator anguli/orbicularis orisZygomatic and buccal branches of the facial nerve
  • Elevates sides of mouth to smile
  • Elevates unilateral side of mouth to sneer
Zygomaticus minorFront of the zygomatic archSkin of lateral part of upper lip, extends to nasolabial sulcusBuccal branch of the facial nerve
  • Elevates upper lip
  • Can also evert upper lip
Levator labii superiorisInfraorbital margin of the maxillaSkin of the upper lipBuccal branch of the facial nerve
  • Retracts upper lip
  • Can also evert upper lip
Levator labii superioris alaeque nasiFrontal process of the maxillaSkin of lateral part of the nostril and skin of upper lipZygomatic branches of the facial nerve
  • Dilates nostril
  • Elevates wing of the nose and upper lip
Levator anguli orisCanine fossa (maxillary fossa) on anterior surface of the maxillaSkin of angle of the mouthBuccal branch of the facial nerveRaises the angle of the mouth while smiling
Muscles of the mouth (Upper group)

Oblique view of the muscles of the mouth (upper group)

Image by BioDigital, edited by Lecturio

Lower group

Table: Muscles of the mouth: lower group
MuscleOriginInsertionNerve supplyFunction
Depressor anguli orisOblique line of the base of the mandibleSkin of angle of the mouthMarginal mandibular branch of the facial nervePulls angle of the mouth downward
Depressor labii inferiorisOblique line of the base of the mandibleSkin of lower lipRetracts (depresses) and everts lower lip (pouting)
MentalisIncisive fossa on alveolar process of the mandibleSkin of the chin
  • Raises the lower lip, wrinkling the skin of the chin
  • Raises base of the lower lip and helps in protrusion and eversion of the lower lip
Muscles of the mouth (Lower group)

Oblique view of the muscles of the mouth (lower group)

Image by BioDigital, edited by Lecturio

Muscles of the Eyes

The muscles of the extraorbital eye assist with actions of blinking and facial expression. These muscles are primarily supplied by branches of the facial nerve.

Table: Muscles of the eyes
MuscleOriginInsertionNerve supplyFunction
Orbicularis oculiOrbital part:
  • Origin: nasal part of frontal bone, frontal process of maxilla, medial palpebral ligament
  • Insertion: around the orbit
Palpebral part:
  • Origin: medial palpebral ligament
  • Insertion: lateral palpebral raphe
Lacrimal part:
  • Origin: lateral surface and lacrimal crest (superior part) of lacrimal bone
  • Insertion: superior and inferior tarsi of eyelids and lateral palpebral ligament
Temporal and zygomatic branches of the facial nerve
  • Orbital: clenches eyelids
  • Palpebral: gently closes eyelids
  • Lacrimal: drains tears
Depressor superciliiMedial orbital rimSkin below the eyebrow and intercanthal regionTemporal branch of the facial nerveDepresses the eyebrow
Corrugator superciliiMedial part of superciliary archSkin over middle of the eyebrow (penetrates frontalis and orbicularis oculi)Temporal branch of the facial nervePulls skin of eyebrow downward and medially
Oblique view of the skull showing the superomedial extra-orbital muscles

Oblique view of the skull, showing the superomedial extraorbital muscles

Image by BioDigital, edited by Lecturio
Anterior view of the skull, showcasing the origin and insertion of the orbicularis oculi muscle

Anterior view of the skull, showcasing the origin and insertion of the orbicularis oculi muscle

Image by BioDigital, edited by Lecturio

Muscles of the Nose

The muscles of the nose assist in respiration and facial expression. These muscles are supplied by branches of the facial nerve. 

Table: Muscles of the nose
MuscleOriginInsertionNerve supplyFunction
NasalisTransverse nasalis (compressor naris): maxilla, lateral to incisive fossaAponeurosis of bridge of the noseBuccal branch of the facial nerveCompresses nostril
Alar nasalis (dilator naris): outer surface of maxilla, above lateral incisor toothSkin of ala, superior to lateral crus of major alar cartilageDilates nostril
ProcerusMidline of nasal bone and lateral nasal cartilageSkin of lower part of forehead between eyebrowsDraws the medial border of the eyebrows downward to produce transverse wrinkles over the bridge of the nose
Depressor septi nasiIncisive fossa of the maxillaNasal septum and posterior aspect of alar nasalisDepresses nasal septum and pulls wings of the nose downward
Oblique view of the skull showing the facial muscles of the nose

Oblique view of the skull showing the facial muscles of the nose

Image by BioDigital, edited by Lecturio

Muscles of the Ear

The muscles of the ear are more simple than the other muscle groups of the face. These muscles assist with moving the ear and are innervated by fibers of the facial nerve (CN VII).

Table: Muscles of the ear
MuscleOriginInsertionNerve supplyFunction
Anterior auricularLateral edge of the galea aponeuroticaProjection on the front of the helixTemporal branch of the facial nervePulls ear upward and forward
Posterior auricularMastoid portion of temporal boneLower part of the cranial surface of the conchaPosterior auricular nerve of facial nerveRetracts and elevates the ear
Superior auricularGalea aponeuroticaCranial surface of the auriculaPulls ear upward
Lateral view of the head, featuring the facial muscles around the ear

Lateral view of the head, featuring the facial muscles around the ear:
Note the posterior, superior, and anterior auricular muscles.

Image by BioDigital, edited by Lecturio

Muscles of Mastication

The muscles of mastication assist in the action of chewing via movement of the mandible. They are supplied by the mandibular branches (V3) of the trigeminal nerve (CN V). 

Table: Muscles of mastication
MuscleOriginInsertionNerve supplyFunction
TemporalisTemporal fossaCoronoid process of the mandibleBranches of mandibular division of trigeminal nerveElevates and retracts the mandible
MasseterZygomatic archMasseteric tuberosity of the mandibleElevates the mandible
Lateral pterygoidInfratemporal surface of the greater wing of sphenoid and lateral plate of pterygoid processPterygoid fossa of the mandible
  • Bilateral: protracts mandible
  • Unilateral: pushes mandible to the opposite side
Medial pterygoidPterygoid fossa of sphenoid bonePterygoid tuberosity of the mandible
  • Bilateral: pushes mandible forward
  • Unilateral: pushes mandible to the opposite side
  • Elevates the mandible
Muscles of mastication (1)

Lateral view of the lateral and medial pterygoid muscles

Image by Lecturio. License: CC BY-NC-SA 4.0

Clinical Relevance

  • Temporomandibular joint (TMJ) dysfunction: syndrome of pain and dysfunction of the TMJ and the muscles of mastication. The most significant feature of this disorder is pain, followed by restricted mandibular movement, and possibly “cracking” or “popping” noises from the TMJ. The etiology is multifactorial, being attributed to musculoskeletal, psychological, and/or neuromuscular factors. Symptomatology may be chronic and difficult to manage. Management includes analgesics, physical therapy, and CBT.
  • Trismus: also called lockjaw. Trismus is limited range of motion of the jaw. The disorder may be caused by a spasm of the muscles of mastication or by an inferior alveolar nerve block injection leading to hemorrhage within the medial pterygoid muscle. Trismus can significantly affect an individual’s quality of life by interfering with eating, speaking, and maintaining proper oral hygiene. Trismus can present with an altered facial appearance. The condition may be distressing and painful, but it is temporary in most cases.
  • Myasthenia gravis: autoimmune neuromuscular junction disorder characterized by varying degrees of muscle weakness. The condition commonly presents with weakness of the arms and legs, but individuals with myasthenia gravis will also have ptosis, resulting from weakness of the muscles around the eyes. Myasthenia gravis is managed medically with acetylcholinesterase inhibitors or immunosuppressants and surgically by thymectomy. 
  • Cosmetics: the muscles of the face are common targets for botulinum toxin injection, with the intent of temporary paralyzing the targeted muscles. Relaxation of the muscles leads to fewer wrinkles and a younger-appearing face. Common muscles for botulinum toxin injection include the frontalis, procerus, and corrugator supercilii.

References

  1. Park, J.K., Vernick, D.M. (2020). Vestibular schwannoma (acoustic neuroma). UpToDate. Retrieved May 23, 2021, from https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma?search=acoustic%20neuroma
  2. Martin, K.A. (n.d.). Patient education: vestibular schwannoma (acoustic neuroma). UpToDate. Retrieved May 23, 2021, from https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma-the-basics?search=acoustic%20neuroma
  3. Kutz, J.W. (2020). Acoustic neuroma: Practice essentials, history of the procedure, epidemiology. Medscape. Retrieved May 23, 2021, from https://emedicine.medscape.com/article/882876-overview
  4. Albrecht, M.A., and Levin, M.J. (2021). Epidemiology, clinical manifestations, and diagnosis of herpes zoster. UpToDate. Retrieved April 18, 2021, from https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-herpes-zoster
  5. Albrecht, M.A. (2020). Diagnosis of varicella zoster virus infection. UpToDate. Retrieved April 18, 2021, from https://www.uptodate.com/contents/diagnosis-of-varicella-zoster-virus-infection
  6. Albrecht, M.A. (2020). Treatment of herpes zoster in the immunocompetent host. UpToDate. Retrieved April 18, 2021, from https://www.uptodate.com/contents/treatment-of-herpes-zoster-in-the-immunocompetent-host

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