MYONET - Atlas Musculature Orofacial System

Atlas Musculature: INTRODUCTION

Erhard Thiele     001

Atlas Musculature Inventory

MYONET.TOTAL PROGR CONTENTS

Philosophy of the  Myofunctional Therapy

1 Anatomy and Physiology of the Extended Orofacial Systems

– Anatomical and Physiological Basics of the  Myofunctional Therapy

 Diagnosing myofunctional disorders as here in the orofacial region requires to be able to "look beyond the surface" of the action. In the word's sense and in a transferred way of meaning, to be able to imagine the musculature acting behind the particular procedure. To give us a synopsis of the anatomy of our working field we should make use of the familiar scheme for this musculature.

In regard of our  perception about the function of the orofacial musculature on our special field the negative effect shows up of a dissecting scheme being, never the less, necessary  methodologically necessary for the understanding.  If we are content with the common splitting up into of the external, the facial musculature this will too easily lead to a picture of mechanistic single functions of about thirteen single muscle tracks which mainly are located around the oral fissure.

From our present notion about the anatomy of the orofacial musculature besides perceptions for traumatology, rehabilitation and jaw and face surgery more over indispensable conclusions may be drawn for our myofunctional training, The consequences, though, for our special field are of some more special nature.

Primarily we find differences in the anatomical description of the muscle course what may give a notion about the difficulties to define certain muscles diagnostically. For example some muscles are splitting up into fibre tracks which partially are inserting on their own but partially associate or running on with neighbouring muscles or even crossing over. This whether makes it possible to get conclusions neither from the feasible single innervation of one muscle about an obvious movement nor from an observed motion the conclusion towards a responsible single muscle.

An aggravation in respect of the a correlation is given through the innervation -- three different systems and synaptogen4esis -- and last not least there will show up the frequently occurring variations of muscle anatomy and course

In the first place we may find an explanation from the genetic development. The embryonic planar skin muscle differentiates into the single muscle tracks. This differentiation may be quite different individually.

Likewise with a genetic background runs the programming of the muscle regulation. The physiognomy for example is individual characteristic inherited; The well trained motion patterns do not demand all muscles are able to bestow. Patients often do not know how to move the muscles coincidently the motion patterns are gone through involuntarily.. At lat through our training methods the patient experiences the scale of movements his musculature is able to run through.

This statement does not only fit for the external and genuine orofacial musculature but as well for example for the muscles that lend the tongue its movability. As for the extrinsic musculature its motion potential is clearly cut through an identifiable muscle origin respectively insertion (with exceptions like the m. Buccinator which is connected into the action field of the m. constrictor pharynx is by a raphe) in contrary to the tongue itself or still more with the muscles of the oral diaphragm, and especially with the hyoid or thyroid muscles where it becomes difficult to localise the very source of activity to a specific matching field. With the diaphragm and tongue muscles playing a crucial role for the functioning of the tongue we increasingly get out of our claim and into the fauces region  -  Neck, nape and shoulder girdle. Watch somebody who practised breath-holding for some while and now gasps for breath. You will see the muscle tensioning right from the m. Nasalis over mouth, chin, m.  Platysma down into the m. Pectoralis.)

This is one of the reasons why work groups who deal with those special disorders have changed the name for this area into craniofacial and finally craniocervical region. If we, then, call in mind that we do not follow single muscle actions but reflex course which run through different and in various regions sited, differently innervated muscle groups, one might rather tend to give up the task to create a plausible survey.

Having these rather general facts in mind we recognise that we will not generate our therapy concept merely from the anatomy of the single muscle. Do we want to influence function complexes of the musculature it is advisable to think in function complexes as well. (In this connection we are reminded at the nomenclature muscle-"function"-therapy whereas "function" is, as well, referring to the kind of disorder as to the methodology of the therapy and further more it should influence the categorisation as is done in the complex Diagnostic Exercises .).

Within the discussion about some basics the question might be put whether there principally are too long or too short lips or whether this phenomenon in many cases just is the result of a long-term existing dystonia within a special synergistic constellation of the musculature. Or, whether the "too big tongue" simply embodies an over trained mass of muscle.

Especially with the musculature around the mouth slit (rima oris) , the perioral mm. it is getting quite complex. In a coarse chart we would find the ring muscle (which, more precisely,  forms a ring of muscle fibres and tendons "inscriptions“ consisting of two upper quarters and one lower half)  (and which is functionally composed of an inner, a medial and an outer ring - in this connection see the chain of exercises ,O’, CHERRYMOUTH, TRUNK ).  If we try to fine-analyze the ultrafine motor functions of the mouth slit the conception of the muscle functions is getting somewhat complex. The finer the motor function is to be reigned the higher differentiated is the interaction of synergist/antagonist which we see in the whole orofacial musculature. When taking the mouth slit as an example we firstly recognise agonists being anatomically twirled up into each other but as well the clear cut pull and counter traction: The circular ring muscle contracts the mouth slit  centripetally 7 the radial fibre tracks pull it apart centrifugally. The latter, though, happens in ultrafine motor function as, here, fibre tracks are running crosswise or work antagonistically laying at the same site (M. Depressor labii inferioris and Musculus Mentalis).

These facts sometimes might raise an impression of inconsistency in a description about muscle tracks and their functions. At a closer look, though, it shows that only the grouping or the function complex is seen differently.   Generally the author attempts in the description presented to draw the reader a picture of the functional structuring of the musculature.

But it is just this last point that is supposed to help us on with our contemplations. Practical use can only derive from this schematically picture of the single muscles from watching the reflex paths. In the utilization "Therapy", finally, the exercises are shaped to effect on visibly disturbed relax courses.

We should keep these considerations in our minds when we try to define the effect of a single muscle without forgetting its effect to the whole organism. Complications might still arise from the fact that the function of some muscles effects more than just moving body parts. Some muscle accomplish "under cover" tasks as, for example the m. Veli palatini which is co-responsible for keeping open the Tuba eustachica, or the m. Omohyoideus leading in into the carotis sheath practically controlling the blood supply of the head.

Summing up:

From the view upon the whole individual and for the perception of the reflex courses and synergisms we must not only know and understand our own field but our observations will have to go farther. This requires a well-structured classification for a better perception. We will choose the borders of our areas in the well known classification discussing it group by group

To illustrate the site of the muscle a respective sketch will be added. Within the main area on one half of the face the single muscle is depicted while on the other an arrow points out the pulling direction puff the muscle with contraction. After this map-kind part of each chapter a descriptive part follows structured in general for each area as follows: