03b: Trigeminal Flashcards
The trigeminal ganglion is located in (X), where it divides into its major divisions.
X = Meckel’s cave
The first, (X), division of trigeminal n exits the (Y) cranial fossa via the (Z). Which space does it enter?
X = opthalmic Y = middle Z = superior orbital fissue
Enters posterior orbit
The second, (X), division of trigeminal n exits the (Y) cranial fossa via the (Z). Which space does it enter?
X = maxillary Y = middle Z = foramen rotundum
Enters pterygopalatine fossa
The third, (X), division of trigeminal n exits the (Y) cranial fossa via the (Z). Which space does it enter?
X = mandibular Y = middle Z = foramen ovale
Enters infratemporal fossa
List the different CN V nuclei in brainstem that receive sensory information.
- Mesencephalic
- Chief sensory
- Spinal (descending)
(X) CN V nucleus is responsible for controlling the force of the masticatory bite by receiving sensation from (Y) structures.
X = Mesencephalic Y = muscle spindles
(X) CN V nucleus receives signals of pain and temperature.
X = Spinal (descending)
(X) CN V receives the signals of fine touch and pressure
X = Chief sensory
General sensory territory for opthalmic division of CN V.
Skin and mucous membranes of superior aspect of face (including cornea of eye)
List the main branches off opthalmic division of CN V.
- Tentorial
- Frontal (supratrochlear and supraorbital)
- Lacrimal
- Nasociliary
Nasociliary branch of (X) has which branches?
X = opthalmic division of CN V
- Ant/Post ethmoidal
- Short/long ciliary
- Infratrochlear
Sensation to skin of the anteriomedial forehead and medial superior eyelid by (X). (Be specific)
X = Supratrochlear nerve (of V1)
Sensation to middle superior eyelid, anterolateral forehead/scalp, and mucosa of frontal sinus by (X). (Be specific)
X = Supraorbital nerve (of V1)
Supraorbital nerve exits orbit via:
Supraorbital foramen
Lacrimal nerve, a branch of (X), supplies:
X = V1 (opthalmic)
Sensation to lateral superior eyelid and lacrimal gland
Anterior/posterior ethmoidal nerves off of (X) supply:
X = nasociliary branch of V1
Sensation to:
- Ethmoidal air cells
- Sphenoid sinus
- Dura of anterior cranial fossa
External nasal nerve is branch of (X), which is a branch of (Y).
X = anterior ethmoidal nerve Y = Nasociliary nerve (of V1)
Sensation from the iris, cornea and ciliary body by (X) nerve.
X = short and long ciliary (off nasociliary branch of V1)
General sensory territory for maxillary division of CN V.
- Skin/mucous membranes between the corner of the eye and corner of the mouth
- Nasal cavities, midface paranasal sinuses
- Roof of the mouth and maxillary teeth
The maxillary nerve (V2) branches that leave (X) anteriorly via (Y) then emerge into (Z).
X = pterygopalatine fossa Y = inferior orbital fissure Z = the orbit
List the maxillary nerve branches that branch anteriorly.
- Zygomatic
- Orbital
- Infraorbital
Zygomatic branch of V2 further branches into:
Zygomaticofacial and zygomaticotemporal nerves
(X) passes through bone of lateral orbit to emerge via similarly named foramen to supply skin over zygomatic arch.
X = zygomaticofacial (off zygomatic branch of V2)
(X) passes through bone of lateral orbit to emerge via similarly named foramen into the temporal fossa to supply the temporal area.
X = zygomaticotemporal (off zygomatic branch of V2)
The (X) nerve is the primary continuation of V2. It passes through (Y) canal and emerges through (Z) foramen. List its branches. Star those that are given within the canal.
X = Y = Z = infraorbital
- Middle and anterior superior alveolar*
- Palpebral
- Nasal
- Superior labial
The maxillary nerve (V2) branches that leave (X) laterally via (Y) then emerge into (Z).
X = pterygopalatine fossa Y = sphenopalatine foramen Z = lateral aspect of posterior nasal cavity
List the maxillary nerve branches that branch laterally.
- Nasopalatine
2. Medial and lateral posterior superior nasal
Nasopalatine branch of (X) nerve supplies:
X = V2 (maxillary division)
- Posterior inferior nasal septum
- Anterior hard palate
List maxillary (V2) branches that continue descent from PPF into (X) by passing through (Y).
X = oral cavity Y = palatine canal
Greater and lesser palatine nerves
Sensation to soft palate via (X). Sensation to hard palate via (Y).
X = lesser palatine nerve (V2) Y = greater palatine nerve (V2)
List maxillary (V2) branches that continue leave PPF through their own personal routes.
- Superior posterior alveolar (pterygomaxillary fissure)
2. Pharyngeal (palatovaginal canal)
(X) division of CN V carries (Y) nerve modalities to which muscles?
X = Mandibular (V3) Y = SVE
- 4 mastication (temporalis, masseter, pterygoids)
- Tensor veli palatini (soft palate)
- Tensor tympani (middle ear)
- Anterior digastric and mylohyoid (floor of mouth)
List sensory nerves off V3 (mandibular). Star the two that follow roughly parallel paths.
- Meningeal
- Buccal
- Auriculotemporal
- Lingual*
- Inferior alveolar*
Meningeal branch of (X) immediately returns to (Y) fossa via (Z) to supply innervation to:
X = V3 (mandibular) Y = middle cranial Z = foramen spinosum
Sensory to dura of anterior and middle cranial fossae
Buccal nerve of V3 supplies:
Sensation to:
- Skin over buccinator
- Buccal mucosa and gingiva tissue
Auriculotemporal nerve of (X) supplies:
X = V3 (mandibular)
- Skin over temporal region and anterior external ear
- TMJ
- External auditory meatus; tympanic membrane (outer surface)
Lingual nerve passes (superficial/deep) to lateral pterygoid and travels on (X) aspect of the tongue. What does it innervate?
Deep;
X = lateral
Sensation to floor of mouth and anterior 2/3 of tongue
(X) nerve enters a bony tunnel in the mandible called the (Y). Along its route, it gives off the (Z) nerve, which supplies the skin of the chin and lower lip after emerging through:
X = inferior alveolar Y = mandibular canal Z = mental
Emerges through mental foramen
As well as the mental nerve, (X) gives off (Y) nerve to supply which muscle?
X = inferior alveolar Y = nerve to mylohyoid
Mylohyoid and anterior digastric
List the nerves off CN V (V1/V2/V3) that carry (X) nerve modalities to muscles. Star those that supply/give off additional branches to more than one muscles.
V3;
X = SVE
- Nerve to medial pterygoid*
- Nerve to lateral pterygoid
- Nerve to mylohyoid*
- Masseteric nerve
- Deep temporal nerves
In dental nerve block, the aim is to numb (X) nerve at which landmark?
X = inferior alveolar;
Before enters bony canal
(X) nerve particularly susceptible to injury during (Y) molar tooth extraction. What are the symptoms?
X = lingual; Y = 3rd
Loss of sensation to anterior 2/3 tongue; loss of taste and innervation to submandibular and sublingual glands
List the parasympathetic ganglia in head and the respective location.
- Ciliary (suspended from short ciliary nerve; posterior to globe in orbit)
- Pterygopalatine (suspended from main root of V2; pterygopalatine fossa)
- Submandibular (suspended from lingual; floor of mouth)
- Otic (suspended from auriculotemporal nerve; infratremporal fossa)
List the parasympathetic ganglia in head and the respective CNs that jump onto their track.
- Ciliary (CN III)
- Pterygopalatine (CN VII)
- Submandibular (CN VII)
- Otic (CN IX)
Autonomics associated with V1: do sympathetic fibers reach targets via same tracks (nerve branches) as parasympathetics?
No
Autonomics associated with V2: do sympathetic fibers reach targets via same tracks (nerve branches) as parasympathetics?
Yes
Parasympathetic innervation that travels via Otic ganglion is supplied by (X) nerve and going to (Y) structure.
X = CN IX Y = parotid gland
Parasympathetic innervation that travels via Submandibular ganglion is supplied by (X) nerve and going to (Y) structure.
X = CN VII Y = submandibular and sublingual glands; mucosa to floor of mouth and surface of tongue
List the paranasal sinuses.
- Frontal
- Sphenoid
- Ethmoid air cells
- Maxillary
Frontal sinus innervation via:
Supraorbital nerve (V1)
Sphenoid sinus innervated via:
- Posterior ethmoidal nerve (V1)
2. Orbital branches of V2
Ethmoidal air cells innervated via:
- Anterior and posterior ethmoidal nerves (V1)
2. Orbital branches of V2
Maxillary sinus innervated via:
- Alveolar branches of Infraorbital nerve (V2)
2. Posterior superior alveolar nerve
Anterior 2/3 tongue sensation via which nerve?
Lingual nerve (V3)
Posterior 1/3 tongue sensation via which nerve?
CN IX
Infratrochlear nerve, a branch of (X), innervates:
X = V1 (opthalmic)
Skin of superior nose, superior medial eyelid, and lacrimal sac
(Short/long) ciliary nerve important for (sympathetic/parasympathetic) NS. It acts as conduit for nerves that arrive on internal carotid artery.
Long; Sympathetic
(Parasymp/symp/somatic) nerves from CN (X) via (Y) ganglion jump from branches of V(1/2/3) and onto (Z) branch of V1 to reach the lacrimal gland.
Parasympathetic; X = VII Y = pterygopalatine V2; Z = lacrimal nerve
Pharyngeal nerve of V2 leaves pterygopalatine fossa via (X). This is located where, wrt (Y), through which V2 entered PPF originally.
X = palatovaginal canal
Superior;
Y = foramen rotundum