ACTIVITY 4
This is patient AM, 28-year-old male who came in the ER because of drooping of his left face. He said he woke up and he could not move his left face.
He has no other muscle weakness. He is conscious and coherent although he had a little difficulty speaking because the left side of his lips drooped. He had normal blood pressure, and he had no other comorbidities. He was diagnosed to have Bell’s palsy. Name 5 muscles which are affected and list its actions. Describe the mechanism of his muscle weakness. What other symptoms could the patient exhibit as a result of facial muscle weakness?
Image from: http://www.microbiologynutsandbolts.co.uk/the-bug-blog/ringing-the-infection-bell-about-facial-nerve-palsy
Innervated by the facial nerve, there are several facial muscles that may be affected by Bell’s palsy. Some of these muscles are as follows:
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Occipitofrontalis (Frontal belly)
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Action: Draws scalp anteriorly, raises eyebrows, and wrinkles skin of forehead horizontally as in look of surprise
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Orbicularis oculi
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Action: Closes eyes
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Zygomaticus major
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Action: Draws angle of mouth superiorly and laterally, as in smiling
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Buccinator
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Action: Presses cheeks against teeth and lips, as in whistling, blowing, and sucking; draws corner of mouth laterally; and assists in mastication (chewing) by keeping food between the teeth (and not between teeth and cheeks)
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Orbicularis oris
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Action: Closes and protrudes lips, as in kissing; compresses lips against teeth; and shapes lips during speech
In addition, the mechanism of his muscle weakness is attributed to Bell’s palsy. The direct nature of this episode of facial weakness or paralysis remains unexplained; it begins suddenly and worsens over the period of 48 hours. It results from damage to the facial nerve (7th cranial nerve) and is often accompanied by pain or discomfort on one side of the face and/or head (Bell’s Palsy, 2021).
Consequently, aside from drooping of the face and difficulty in speaking, other symptoms of Bell’s palsy include the following: disordered movement of the muscles that control facial expressions, such as smiling, squinting, blinking, or closing the eyelid; loss of feeling in the face; headache; tearing; drooling; loss of the sense of taste on the front two-thirds of the tongue; hypersensitivity to sound in the affected ear; inability to close the eye on the affected side of the face; and many others.
References
Bell’s Palsy. (2021, August 8). Johns Hopkins Medicine. Retrieved September 23, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/bells-palsy
Tortora, G. J., & Derrickson, B. (2014). Principles of Anatomy and Physiology (14th ed.). Wiley.