24 SURGICAL ANATOMY OF THE FACE. 



the supra-orbital and supra-trochlear, which escape by 

 the supra-orbital and supra-trochlear notches. Large 

 inosculating vessels escape through several foramina in 

 the bones of the face, from deep branches of the external 

 carotid viz., the infra-orbital, passing out of the infra- 

 orbital foramen ; from the mental foramen, and a large 

 branch from the same source is found on the substance 

 of the buccinator. The free inosculation of the arteries 

 of the face renders ligature of both ends of a divided 

 facial artery necessary, as the return circulation is very 

 quickly re-established ; and, in wounds, whether the re- 

 sults of accident or surgical interference, very accurate 

 approximation of the edges must be obtained, for union 

 takes place very rapidly, and distortion is not so easily 

 remedied. The bloodvessels of the face are frequently 

 subject to a na3void condition. 



The nerves of the face are derived from the three di- 

 visions of the 5th, and from the portio dura or facial 

 part of the 7th cerebral nerve. The branches from the 

 1st division of the 5th are the supra-orbital, supra- 

 trochlear, infra-trochlear, lachrymal, and nasal. From 

 the 2d the infra-orbital, passing out of the infra-orbital 

 foramen, and the subcutaneous malse. The buccal from 

 the same source emerges just in front of the anterior 

 border of the masseter. From the 3d division the 

 masseteric, and the inferior dental from the foramen 

 mentale. The facial forms a plexus in the parotid gland, 

 after which it passes into a great many branches, and is 

 supplied to the muscles of the face, having free inoscula- 

 tions with the branches of the 5th nerve. The infra- 

 orbital nerve is peculiarly liable to neuralgic affections. 

 Twitchings of the muscles of the face are connected with 



