THE FACE. 



affect them are among the most distressing and disfiguring of any in the body, 

 wounds of the face producing paralysis of the muscles of expression. 



The relatively small size of the face in relation to the cranium in the child as 

 compared to that of the adult has already been alluded to (see page 8). The 

 reasons for this are evident: dentition must be complete to insure the proper 

 development of the jaws; the use of the special senses and the expression of the 

 emotions cause the facial muscles to develop, and this in turn causes the bones to 

 which they are attached to become more rugged in outline and larger in size. In 

 old age, as the teeth are lost, the jaws are diminished in size by absorption of their 

 alveolar processes. 



THE FRONTAL REGION. 



The frontal region embraces that part of the face above the eyes and nose in 

 front and anterior to the temples at the sides. 



The Frontal Suture. The frontal bone develops from two centres of ossifi- 

 cation, one on each side. These unite in the median line to form the frontal suture 

 which joins the anterior fontanelle and 

 is closed about the same time, within the 

 age of two years. The suture occa- 

 sionally persists through life and some- 

 times the line of junction can be felt in 

 the living; it should not be mistaken 

 for fracture. 



The frontal eminences in the 

 child are particularly prominent, the 

 forehead projecting beyond the edge of 

 the orbit. This makes it difficult to 

 apply a bandage securely to the head 

 in children unless it is twisted to draw 

 in its sides. 



The superciliary ridges are 

 about a centimetre above the edge of 

 the orbit over its inner half. Aided by 

 the hair of the eyebrows they serve 

 to divert the sweat to the sides, as 

 pointed out by Humphry. They are 

 best developed in the adult male. 

 Directly between them in the median 



line on a level with the upper edge of the orbit is a depression called the glabella. 

 It is the anterior point from which measurements are taken in cerebral topography. 



Frontal Sinuses. Beneath the superciliary ridges are the frontal air-sinuses, 

 but the size of the sinuses is not necessarily proportional to that of the ridges; they 

 may extend quite far back over the orbit. Fractures of the outer wall of these 

 sinuses not infrequently occur without the inner table being injured. A septum 

 separates one sinus from the other, not always in the median line. The lining 

 membrane of these sinuses is often inflamed and suppurates, discharging pus into the 

 nose. Tumors also grow in them. 



Margins of the Orbit. At the upper and outer margin of the orbit is the 

 external angular process of the frontal bone. The line of junction or suture between 

 it and the malar bone can be distinctly felt in the living both on the side of the orbit 

 and on the side toward the temple. This is an important landmark in cerebral 

 topography, as it is used to locate the fissure of Sylvius and also the middle menin- 

 geal artery. On the upper margin of the orbit at about the junction of its middle 

 and inner thirds is the supra-orbital notch. This can usually be readily felt through 

 the skin. Sometimes it is a complete foramen instead of simply a notch. It is then 

 to be located by feeling on the orbital surface just behind the edge. It transmits 

 the supra-orbital nerve and artery. 



The supra-orbital nerve, a branch of the ophthalmic division of the fifth nerve, 

 is sometimes the seat of neuralgia, for which resection of the nerve is performed. 



FIG. 54. Frontal region of a child's skull. 



