Head and Face

Forward Head Posture Fix

Forward Head Posture Fix

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CONTENTS

Introduction 121

Section I: Innervation

Cranial Nerves and Deep Facial Muscles 122

Cervical Nerves and Superficial Facial and Neck Muscles 123

Temporomandibular Joint Movement 124

Cranial Nerve and Muscle Chart 125

Section II: Facial and Eye Muscles 12 6

Facial and Eye Muscles, Charts 126-127

Facial and Eye Muscle Tests 128-133

Section III: Facial Paralysis 13 4

Case #1 134-135

Case #2 136-137

Section IV: Muscles of Deglutition

Chart 138-139

References 140

INTRODUCTION

The illustration on the following page portrays a sagittal section of the skull at approximately the center of the left orbit, except that the complete eyeball is shown. The muscles illustrated are the deep facial and head muscles, mainly those of the tongue, the pharyngeal area, and the eyeball.

The left hemisphere of the brain has been reflected upward to show its inferior surface and the cranial nerve roots. Lines, numbered according to the respective cranial nerves, connect the nerve roots to the corresponding nerve trunks in the lower part of the drawing. Nerve roots I, II and VIII are sensory and shown in white. The motor and mixed nerves are shown in yellow with one exception: Because the motor part of cranial nerve V is such a tiny branch, it is shown in yellow; the rest of cranial nerve V is shown in white.

A side view of the superficial muscles of the head and neck is illustrated on page 123. Cranial nerves and the muscles they innervate are listed on pages 122 and 123.

Facial muscles are called the muscles of expression. The facial nerve, through its many branches, innervates most of the facial muscles. Numerous muscles may act together to create movement (e.g., as in a grimace), or movement may occur in a single area (e.g., as in raising an eyebrow). Loss of function of the facial muscles interferes with the ability to communicate feelings through facial expressions and with the ability to speak clearly.

A smile, a frown, a look of surprise—expressions such as these are created by the actions of muscles that insert directly into the skin. Because of the unique insertions of facial muscles, tests of these muscles differ from other manual muscle tests that require test position and fixation for the subject and pressure or resistance by the examiner. Instead, the subject is asked to imitate facial expressions while looking at photographs of a person performing the test movements or while watching the examiner perform them. Grading the strength of muscles is essentially a subjective estimate by the examiner of how well the muscle functions on a scale of zero, trace, poor, fair, good and normal. (Facial and eye muscle tests are illustrated on pp. 128-133, and test results for two cases appear on pp. 134-137.)

CRANIAL NERVES AND DEEP FACIAL MUSCLES

Bottom Tooth Nerves

I Olfactory nerve (sensory)

II Optic nerve (sensory)

III Oculomotor nerve

Levator palpebrae superioris Rectus superior Rectus medialis Rectus inferior Obliquus inferior

IV Trochlear nerve Obliquus superior

V Trigeminal nerve, mandibular branch Masse ter Temporalis

Anterior digastric

VI Abducens nerve

Rectus lateralis

VII Facial nerve

Occipitalis Auricularis posterior Posterior digastric Stylohyoid Auricularis superior Auricularis anterior Frontalis

Corrugator supercilii

Orbicularis oculi

Levator labii superioris

Zygomaticus major and minor

Buccinator

Risorius

Orbicularis oris

Levator Anguli Oris Muscles

Levator anguli oris (34)

Procerus (35)

Nasalis (36)

Depressor septi nasi (37)

Mentalis (38)

Depressor labii inferioris (39)

Depressor anguli oris (40)

Piatysma (41) VIII Vestibulocochlearis nerve (sensory) IX Glossopharyngeal nerve

Stylopharyngeus (8) X Vagus nerve (see p. 125) XI Accessory nerve (spinal portion)

Sternocleidomastoid (44)

Trapezius (48)

IX, X, and XI Pharyngeal plexus

Palatoglossus (9)

Constrictor pharyngis superior (10)

Constrictor pharyngis medius (11)

Constrictor pharyngis inferior (12) XII Hypoglossal nerve

Styloglossus (13)

Hyoglossus (14)

Genioglossus (15)

Tongue intrinsics (16) Miscellaneous from cervical nerves

Sternohyoid (42)

Omohyoid (43)

Scalenus medius (45)

Levator scapulae (46)

Splenitis capitis (47)

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