TRIGEMINAL

NERVE

PRESENTED BY DR. MOHIT DHAWANMDS 1ST YEARDEPTT OF PROSTHODONTICSB.R.S DENTAL COLLEGESULTANPUR(PANCHKULA)

CONTENTS

INTRODUCTION FUNCTION ORIGIN SEMILUNAR GANGLION THE OPTHALMIC NERVE THE CILIARY GANGLION THE MAXILLARY NERVE THE MANDIBULAR NERVE THE OTIC GANGLION THE SUBMANDIBULAR

GANGLION TRIGEMINAL NEURALGIA WALLENBERG SYNDROME REFERENCES

CRANIAL NERVES

CN 1 – OLFACTORY NERVECN2 – OPTIC NERVECN3 – OCULOMOTOR NERVECN4 – TROCHLEAR NERVECN5 – TRIGEMINAL NERVECN6 – ABDUCENS NERVECN7 – FACIAL NERVECN8 – VESTIBULOCOCHLEAR

NERVECN9 – GLOSSOPHYRNGEAL NERVECN10 – VAGUS NERVECN11 – ACCESSORY NERVECN12 – HYPOGLOSSAL NERVE

INTRODUCTION

TRIGEMINAL NERVE IS ALSO CALLED AS FIFTH NERVE OR SIMPLY CN5

IT IS PRIMARILY A SENSORY NERVE,BUT IT ALSO HAS CERTAIN MOTOR FUNCTIONS(BITING ,CHEWING AND SWALLOWING)

FUNCTIONS

SENSORY- TO PROVIDE TACTILE,PROPIOCEPTIVE AND NOCICEPTIVE AFFERENCE OF FACE AND MOUTH. IMP THE POSTERIOR SCALP AND THE NECK ARE INNERVATED BY C2-C3 , NOT BY THE TRIGEMINAL NERVE.

MOTOR – IT ACTIVATES THE MUSCLES OF MASTICATION,TENSOR TYMPANI,TENSOR VELI PALATINI, MYLOHYOID AND THE ANTERIOR BELLY OF DIGASTRIC.

ORIGIN

Word trigeminal means “triplet with common origin”.

MOTOR the fibers arise from 2 nuclei,a superior and an inferior nucleus in upper part of pons.

The fibers from superior nucleus constitute the mesencephalic root.

SENSORY the fibres of sensory root arise from the cells of semilunar ganglion which lies in a cavity of dura mater near the apex of the petrous part of temporal bone.

Spinal trigeminal nucleus--- pain/temperature

Main trigeminal nucleus--- touch/position

Mesencephalic trigeminal nucleus--- propioceptive and mechanoreceptor fibres from jaws and teeth.

Onion skin distribution of trigeminal nerve.

THE SEMILUNA

R GANGLION

THE SEMILUNAR GANGLION

ALSO KNOWN AS GASSERIAN GANGLION, GANGLION SEMILUNARE

LIES IN THE DURA MATER COVERING THE TRIGEMINAL IMPRESSION NEAR THE APEX OF THE PETROUS PART OF THE TEMPORAL BONE.

THE MOTOR ROOT RUNS IN FRONT OF AND MEDIAL TO THE SENSORY ROOT, AND PASSES BENEATH THE GANGLION.

TRIGEMINAL GANGLION

1• THE OPTHALMIC

NERVE

2• THE MAXILLARY

NERVE

3

• THE MANDIBULAR NERVE

SENSORY SUPPLY OF TRIGEMINAL NERVE

THE OPTHALMIC NERVE

OPTHALMIC NERVE

THE FRONTAL NERVE 1 SUPRATROCHLEAR 2 SUPRAORBITALTHE NASOCILIARY NERVE

1 BRANCH TO CILIARY

GANGLION. 2 2-3 LONG CILIARY

NERVES 3 POSTERIOR ETHMOIDAL 4 INFRATROCHLEAR 5 ANTERIOR ETHMOIDALLACRIMAL T

HE

NA

SO

CIL

IARY

NE

RV

E

THE LONG CILIARY NERVE

THE INFRATROCHLEAR

NERVE

THE ETHMOIDAL BRANCHES

THE OPTHALMIC NERVE

THE CILIARY GANGLION

THE CILIARY GANGLION

THE CILIARY GANGLION

IT IS A PERIPHERAL PARASYMAPATHETIC GANGLION PLACED IN THE COURSE OF OCCULOMOTOR NERVE

THE MOTOR ROOT ARISES FROM THE NERVE TO INFERIOR OBLIQUE.

THE SENSORY ROOT COMES FROM THE NASOCILIARY NERVE.IT CONTAINS SENSORY FIBRES FROM THE EYEBALL.

THE MAXILLARY

NERVE

1 THE MIDDLE MENINGEAL 2 ZYGOMATIC NERVE3 SPHENOPALATINE4 POSTERIOR SUPERIOR ALVEOLAR5 ANTERIOR SUPERIOR ALVEOLAR6 INFERIOR PALPEBRAL7 EXTERNAL NASAL8 SUPERIOR LABIAL

THE MAXILLARY NERVE

COURSE OF MAXILLARY NERVE

IN THE CRANIUM--- MIDDLE MENINGEALIN THE PTERYGOPALATINE FOSSA--- ZYGOMATIC

SPHENOPALTAINE POSTERIOR SUPERIOR ALVEOLAR

IN THE INFRAORBITAL CANAL--- ANTERIOR SUPERIOR ALVEOLAR

MIDDLE SUPERIOR ALVEOLAR

ON THE FACE--- INFERIOR PALPEBRAL

EXTERNAL NASALSUPERIOR LABIAL

THE

MANDIBULAR NERVE

DISTRIBUTION OF MANDIBULAR NERVE

THE MANDIBULAR NERVE

FROM MAIN TRUNK--- MENINGEAL BRANCH

NERVE TO MEDIAL PTERYGOID FROM ANT TRUNK --- A SENSORY BRANCH – BUCCAL NERVE MOTOR BRANCHES – MASSETERIC DEEP TEMPORAL NERVE NERVE TO LATERAL PTERYGOIDFROM POSTERIOR TRUNK--- AURICULOTEMPORAL LINGUAL INFERIOR ALVEOLAR NERVE

THE OTIC GANGLION

THE OTIC GANGLION

IT IS A PERIPHERAL PARASYMPATHETIC GANGLION WHICH RELAYS SECRETOMOTOR FIBRES TO THE PAROTID GLAND.

IT IS TOPOGRAPHICALLY RELATED TO MANDIBULAR NERVE BUT FUNCTIONALLY IT IS A PART OF THE GLOSSOPHARYNGEAL NERVE.

THE SUB-MANDIBULAR GANGLION

THE SUBMANDIBULAR GANGLION

IT IS PERIPHERAL PARASYMPATHETIC GANGLION THAT RELAYS ITS SECRETOMOTOR FIBRES TO SUBMANDIBULAR AND SUBLINGUAL SALIVARY GLANDS.

TOPOGRAPHICALLY IT IS RELATED TO LINGUAL NERVE BUT FUNCTIONALLY IT IS CONNECTED TO CHORDA TYMPANI BRANCH OF FACIAL NERVE

THE SUBMANDIBULAR GANGLION

TRIGEMINA

L NEURALGI

A

TRIGEMINAL NEURALGIA

ALSO KNOWN AS TIC-DOLOUREUX.,IS A PAIN SYNDROME RECOGNIZABLE BY PATIENT HISTORY ALONE.

TRIGEMINAL NEURALGIA IN YOUNG PERSON SUGGESTS THE POSSIBILITY OF MULTIPLE SCLEROSIS.HOWEVER IDIOPATHIC NEURALGIA CAN OCCUR AT ANY AGE.

SENSORY SUPPLY OF TRIGEMINAL NERVE

WALLENBERG SYNDROME

ALSO CALLED AS LATERAL MEDULLARY SYNDROME.

IT IS THE CLASSICAL CLINICAL DEMONSTRATION OF THE ANATOMY OF THE FIFTH NERVE.

A STROKE USUALLY AFFECTS ONE SIDE OF BODY.HOWEVER IN WALLENBERG SYNDROME ONE SIDE OF FACE AND OPPOSITE SIDE OF BODY IS INVOLVED.

EXPLANATION ANATOMY OF BRAINSTEM.AS A RESULT PAIN/TEMPERATURE SENSATIONS ARE INVOLVED.

REFERENCES

B.D CHAURASIA’S HUMAN ANATOMY—4TH EDITION

BRODAL P. THE CENTRAL NERVOUS SYSTEM---2004

RAYMOND J FONESCA ET AL: ORAL AND MAXILLOFACIAL TRAUMA EDITION 3 VOL 1

JEFFREY OKESON: OROFACIAL PAIN ED 6

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