introduction to the trigeminal nerve dental surgery
DESCRIPTION
Introduction to the trigeminal nerve dental surgery Ophthalmic nerve dental surgery Maxillary nerve Mandibular nerveTRANSCRIPT
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Introduction to The Trigeminal Nerve
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What are cranial nerves?
• Cranial nerves are nerves that emerge directly
from the brain
• There are 12 pairs of cranial nerves
• Only the first 2 originate from the cerebrum,
the others originate from the brain stem
• Trigeminal nerve is the FIFTH cranial nerve
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The cranial nerves• Ⅰ Olfactory nerve • Ⅱ Optic nerve • Ⅲ Oculomotor nerve • Ⅳ Trochlear nerve
• Ⅴ Trigeminal nerve • Ⅵ Abducent nerve • Ⅶ Facial nerve • Ⅷ Acoustic nerve • Ⅸ Glossopharyngeal nerve• Ⅹ Vagus nerve • Ⅺ Accessory nerve • Ⅻ Hypoglossal nerve
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Classification of cranial nerves• Sensory cranial nerves:
– contain only afferent (sensory) fibers
• Motor cranial nerves:
– contain only efferent (motor) fibers
• Mixed nerves:
– contain both sensory and motor fibers
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TRIGEMINAL NERVE
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Trigeminal nerve
• 5th cranial nerve (CN5)
• Largest cranial nerve
• MIXED CRANIAL NERVE
• Sensory to face – 3 dermatomes
• Motor to muscles of mastication
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View of brain from below showing trigeminal ganglion and trigeminal nerves
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Nuclei
• Sensory nuclei – largest cranial nerve nuclei• Sensory nuclei –mid-brain, pons and medulla• Sensory nuclei – 3 parts– Mesencephalic nucleus– Primary/Main sensory (pontine) nucleus– Spinal trigeminal nucleus
• Motor nucleus – mid-pons
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Trigeminal ganglion(semilunar/gasserian /gasser’s ganglion)
• Semilunar in shape • Situated in Meckel’s cavity /cave on ‘Trigeminal
depression’ present on petrous temporal bone• Contains the cell bodies of incoming sensory
nerve fibers• Convex surface below to which the 3 nerve roots
converge: – Opthalmic division– Maxillary division– Mandibular division
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Trigeminal ganglion - shape
5
Semi lunar
Ganglion
3 2
1
Motor root
Superior orbital fissure
Foramen rotundumForamen
ovale
To sensory nuclei
To muscles of mastication/ swallowing
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Trigeminal dermatomes
• Areas of cutaneous sensory innervation• Show very little overlap• Injection of local anesthesia shows loss of
sensation from very well defined areas• Knowledge of dermatomes helps in– Locating site of nerve injury– Testing result of nerve block
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V1- OPTHALMIC DIVISION
V2 – MAXILLARY DIVISION
V3 – MANDIBULAR DIVISION
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Applied anatomy• Knowledge of dermatomes and their nerve
supply helps locate site of nerve injury• Also helps in demonstrating effect of nerve
block• Intracranial causes of trigeminal neuralgia• Pain control and modulation
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Stimulus – pin prick
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THANK YOU