THE FACE 



1343 



and zygoma— can be readily traced. The last mentioned and the glabella are 

 alluded to on pp. 1331 and 1332; and the canine fossa should be identified as one 

 of the antral routes. The delicacy, laxity, and vascularity of the skin are of great 

 importance in all operations, while the abundance of large gland orifices accounts 

 for the frequency of lupus here. 



Arteries. — The supraorbital artery can be felt beating just above its notch 

 (junction of medial with lateral two-thirds of supraorbital margin); the little 

 frontal artery is of importance, as it nourishes the flap when a new nose is taken 

 from the forehead; the superficial temporal, accompanied by the auriculo-temporal 

 nerve, can be felt where it crosses the root of the zygoma just in front of the tragus, 

 its anterior branch about 3.1 cm. (1^ in.) above and behind the zygomatic process 

 of the frontal; the occipital, accompanied by the great occipital nerve (fig. 450), 

 pulsates to the medial side of the centre of a line drawn from the occipital protu- 

 berance to the mastoid process; the posterior auricular, rather deeply, between the 

 auricle and the mastoid process. The external carotid lies behind the ascending 



Fig. 1092. — Surface Relations of Vessels and Nerves in Lateral View of the Face 



AND Neck. 



Supraorbital n. 



Supratrochlear n. 



Infratrochlear n. 



External nasal n. 

 Infraorbital n. 



Buccal n. 



Ext. maxillary art. 



Mental n. 



Post, belly of 



digastric 



Ant. belly of 



digastric 



Thjrreoid cartilage 



Common carotid 



art. 



Thyreoid gland 



Auriculo-temporal 

 nerve 



Externa! auditory 



meatus 

 Facial nerve (in red) 



Parotid gland (yellow) 

 Sternomastoid 



Accessory nerve 

 Ext. jugular vein 



Trapezius 



ramus of the jaw. The external maxillary (fig. 1093) crosses the jaw just in front 

 of the masseter; if divided, both ends must be secured here. It can be felt again 

 a httle behind the angle of the mouth, just beneath the mucous membrane (it 

 here gives off the labial branches, which can also be felt, lying deeply, if the lip 

 is taken between the finger and thumb) ; and again by the side of the nose, as it 

 runs up to [the angulusoculi. The small angular branch is, from its position, 

 always troulalesome to secure. To trace the course of the external maxillary 

 artery a line should be drawn from a point a little above and lateral to the tip of 

 the great cornu of the hyoid to the lower part of the anterior border of the masse- 

 ter, and thence to one lateral to and above the angle of the mouth, and so onward, 

 lateral to the angle of the nose, up to the medial angle. The anterior facial vein 

 takes a straight course behind the tortuous external maxillary artery. The 

 absence of valves and its communication by the angular and ophthalmic veins 

 with the cavernous sinus, and, by the deep facial, with the pterygoid plexus, are 

 of grave importance in infective thrombosis. The external jugular vein will be 

 mentioned later. 



Parotid region. — A line drawn from the lower border of the meatus to a point 

 midway between the nose and upper lip gives the level of the parotid duct, which 



