The large goose foot ( lat. Pes anserinus major ) is a radially diverging branching of the facial nerve (VII pair of cranial nerves ) located in the parotid salivary gland and innervating the facial muscles of the face .
Anatomy
After leaving the styloid opening of the temporal bone and penetrating the thickness of the parotid salivary gland, the facial nerve is divided into two main branches, namely the temporal-facial and cervical-facial. Further, these branches are divided into branches of the second order, which diverge radially: up, forward and down to the muscles of the face. Between these branches in the thickness of the parotid gland, compounds are formed that make up the parotid plexus ( lat. Plexus parotideus ). Five groups of branches depart from the latter, diverging radially from the tragus of the outer ear to the facial muscles [1] :
- Temporal branches ( Latin Rami temporales ) - two to four branches, usually the back, middle and front. They are directed up and forward to the upper edge of the orbit and innervate the upper and front auricular muscles, frontal abdomen of the cranial muscle , circular muscle of the eye, muscle, wrinkling eyebrow.
- Zygomatic branches ( Latin Rami zygomatici ) - two, sometimes three or four, are directed obliquely through the middle of the zygomatic bone to the outer edge of the orbit and approach the zygomatic muscles and the circular muscle of the eye.
- Buccal branches ( Latin Rami buccales ) are three to five fairly powerful nerves. Depart from the upper main branch of the facial nerve across the cheek and below the zygomatic bone to the wings of the nose and upper lip. The following muscles innervate: the large zygomatic, laughter muscle, buccal, raising and lowering the angle of the mouth, circular muscle of the mouth and nasal. Occasionally, there may be connecting branches between the symmetrical nerve branches of the circular muscle of the eye and the circular muscle of the mouth.
- The marginal branch of the lower jaw ( lat. Ramus marginalis mandibulae ), moving forward, runs along the edge of the lower jaw and innervates the muscles that lower the corner of the mouth and lower lip, the chin muscle.
- The cervical branch ( lat. Ramus colli ) in the form of 2-3 nerves goes down behind the corner of the lower jaw to the neck, approaches the subcutaneous muscle, innervates it and gives off a number of branches connecting to the upper (sensitive) branch of the cervical plexus.
The listed branches of the facial nerve, forming a large goose paw, pass in the deep layer of subcutaneous tissue and are inherently extremely motor [2] .
Topography and variant anatomy
The branches forming the large goose foot diverge in the form of rays from one point located approximately 0.5 cm in front of the auricle [3] [4] .
It should be noted that the peripheral branching of the facial nerve is quite variable [5] . So, in 25% of people the main branches depart, which branch little and form small connections between themselves. In other cases, there is a dense network formed by both secondary branches and anastomoses between the main nerve trunks. Despite numerous studies aimed at establishing universal types of branching of nerves of the large goose paw, their branching options depend on the individual anatomy of each individual individual [6] . According to Davis and Anson et al, there are 6 types of branching and plexus nerve formation [7] . According to I. A. Ponomareva [8] and L. O. Tsakadze, there are basically two types of branching: the main branch with a small number of secondary branches and individual connections between them and loose - with a large number of secondary branches and connections between them [6] . In 80% of cases, the zygomatic and buccal branches mutually anastomose, while the marginal branch of the lower jaw anastomoses with the buccal branches in only 12% of cases [6] .
For better orientation in the location of the branches of the goose foot, you can imagine a hand, while the thumb should vertically cross the zygomatic arch (projection of the temporal branches), the index finger should be directed to the outer edge of the eye (zygomatic branches), the middle finger should be placed above the upper lip (buccal branches), ring finger - along the edge of the lower jaw (marginal mandibular branch), and the little finger - to be directed downward (cervical branch) [4] .
Notes
- ↑ Sinelnikov R. D. , Sinelnikov Y. R. Atlas of human anatomy: Textbook. allowance. - 2nd ed., Stereotyped - In 4 volumes. T.4. - M .: Medicine, 1996
- ↑ Facial Nerve Anatomy (Extratemporal Portion) . Emedicine. Date of treatment May 3, 2017. Archived July 11, 2013. (eng.)
- ↑ Richard S. Snell Clinical Anatomy by Regions. - 9th. - New York: Lippincott Williams & Wilkins, 2011 .-- 768 p. - ISBN 978-1609134464 .
- ↑ 1 2 Kovanov V.V. Operative surgery and topographic anatomy. - 4th. - Moscow: Medicine, 2001 .-- 408 p. - ISBN 5-225-04710-6 .
- ↑ Bernstein L, Nelson RH (1984) Surgical anatomy of the extraparotid distribution of the facial nerve. Arch Otolaryngol 110: 177-183.
- ↑ 1 2 3 Kalina V.O., Shuster M.A. Peripheral facial paralysis.- M .: Medicine, 1970.- 208 p.
- ↑ Davis RA, Anson BJ, Budinger JM, Kurth RE (1956) Surgical anatomy of the facial nerve and parotid gland based upon a study of 350 cervicofacial halves. Surg Gynecol Obstet 102: 385-412.
- ↑ Ponomareva I.A. Extracranial section of the facial nerve: author. dis. Cand. honey. sciences. L., 1951.