Issue link: https://www.massageandbodyworkdigital.com/i/1234356
LOCATION HEAD AND FACE Structures of Note • Trigeminal nerve branches • Facial nerve • Styloid process of the temporal bone • Cervical lymph nodes • Greater occipital nerves Eyes Obviously, eyes are a local caution for massage, and special care must be taken with clients who wear contact lenses, who may prefer not to lie prone. Some practitioners keep a bottle of distilled water and a clean lens case available in case clients might want to remove their contacts. Trigeminal Nerve Branches Three pairs of foramina allow the mental (from the chin), infraorbital (from the cheek), and supraorbital (from the forehead) branches of the trigeminal nerve to exit from the skull to provide sensation for the face. Heavy pressure on these spots can elicit unnecessary pain, and may even bruise the nerves as they emerge (Image 1). Retromandibular Fossa If you put your index finger behind your earlobe, and press gently anteriorly, you will find the retromandibular fossa where the facial nerve exits. This area is close to the mastoid process where the sternocleidomastoid attaches, so it is not unusual for massage therapists to work in this neighborhood. But if our pressure strays, we are close enough to the facial nerve to cause a problem. The styloid processes of the temporal bone are located medial to the mastoid process. It is extremely unlikely that a massage therapist would encounter these very sharp, fang-like bony prominences, but sometimes they grow extra-long or the ligaments that attach to them become injured, so it's useful to have the styloid processes of the temporal bone on our radar (Image 2). Occipital Ridge The left and right greater occipital nerves (the occipital ridge) emerge from the deep fascia of the posterior neck, about an inch lateral to the spinous process of C2. Transient pressure at this site is unlikely to damage the nerves, but headache symptoms can occur if pressure is sustained (Image 6). Branches of the trigeminal nerve emerge from the mental, infraorbital, and supraorbital foramina. Illustrations by Emily Morgan. Supraorbital nerve Infraorbital nerve Mental nerve 1 2 The facial nerve emerges from the retromandibular fossa. Brachial plexus nerve roots Spinal accessory nerve External jugular vein Styloid process Facial nerve Mastoid process Retromandibular fossa