Anatomy-Trigeminal Nerve Flashcards
Name the three divisions of the trigeminal nerve?
Opthalmic
Maxillary
Mandibular
Where does the opthalmic divison of the trigeminal exit the Skull?
Supra-orbital notch
Where does the maxillary division of the trigeminal nerve exit the skull?
Infra-orbital foramen
Where does the mandibular divison of the trigeminal nerve leave the skull?
Mental foramen
Label A, B,C
A- supra-orbital notch
B- infra-orbital foramen
C- Mental foramen
Label these parts of the palate:
A- palatine process of the maxilla
B- Horizontal plate of the palatine bone
C- Incisive Foramen
D- greater palatine foramen
E- Lesser palatine foramen
Label the parts of the mandible
A- condylar process
B- Ramus
C- angle
E- mental foramen
F- Body
G- Head
H- Neck
J- coronoid process
K- mandibular foramen
L- lingula
What passes through the mandibular foramen?
Inferior alveolar nerve.
Where are teeth found in the jaw?
The alveolar process
Where does the trigeminal nerve originate from ?
Special visceral efferent nuclei
General somatic Afferent nuclei
Compare the motor and sensory nuclei of the trigeminal nerve.
There is 1 divison called the motor nucleus
There are 3 sensory divisons:
Mesencephalic nucleus
Chief sensory nucleus
Spinal nucleus.
Label this diagram:
A- motor
B- mesenchephalic
C- chief sensory
D- spinal nucleus.
WHat is the function & location of:
Motor nucleus?
LOCATION: pons
Function: muscles of mastication.
Compare the function and location of the Sensory nuclei?
Mesencephalic - midbrain - Proprioception
Chief sensory - Pons - discriminative touch
Spinal- medulla Oblongata - temperature and pain?
What is the terminal ganglion?
This is what the Sensory and motor nuceli exit the pons to become. This is before the trigeminal nerve divides into 3 divisons.
Where is the terminal ganglion found?
In meckle’s cave.
Explain the connection between the nuclei, the terminal ganglion and the Trigeminal nerve divisions.
the nuclei join together to become the terminal ganglion which then splits to become the divisions of the trigeminal nerve.
Where does CNV1 pass when it seperates from the trigeminal nerve?
Towards the superior orbital fissure.
Where does CNV2 pass when it seperates from the trigeminal nerve?
Through the foramen rotundum.
Where does CNV3 pass when it seperates from the trigeminal nerve?
Through the foramen ovale.
Label this image
A- trigeminal ganglion
B- CNV3 foramen ovale
C-CNV2 foramen rotundum
D- CNV1
Name the branches of the opthalmic division
A- nasociliary
B- lacrimal
C-Frontal
D- supraorbital
E- supratrochlear
F-anterior ethmoidal
G- infratrochlear
H- long ciliary
I- external nasal
Two of the branches of the opthalmic nerve are connected.
Which ones and discuss the connection?
The anterior ethmoidal continues to the tip of the nose as the external nasal nerve.
What is shingles ?
reactivation of the dormant chicken pox virus.
Name & Discuss this foramen?
Foramen rotundum-
This is where the maxillary divison of CNV exits.
This can only be identified on the inner aspect of the skull.
Where does the maxillary division divide?
Inferior orbital fissure.
Name the branches of the zygomatic divison of the trigeminal nerve?
Zygomaticotemporal
Zygomaticalfacial.
What is the function of the infra-orbital branches?
These supply the lower eyelid / cheeks/ upper lip & nose
Describe the pathway of the nasopalatine nerve?
- Nasopalatine nerve
- Sphenopalatine foramen
- Passes incisive canal to the hard palate.
Compare the 3 branches of the Superior alveolar nerve.
Anterior superior Alveolar nerve-comes from the infra orbital branch
Middle superior alveolar nerve - comes from the infra orbital branch.
Posterior superior alveolar nerve (its own seperate branch)
What does the alveolar nerve do?
It provides a nerve supply to the teeth and gums.
Label the alveolar nerves.
A- anterior superior alveolar nerve
B- Middle superior alveolar nerve
C- posterior superior alevolar nerve
Discuss the palatine branches?
The palatine branch goes down the palatine canal before spliting into the greater and lesser palatine nerve.
These supply the palate.
Label these nerve branches in the palate:
A- lesser palatine nerve
B- greater palatine nerve
C- Nasopalatine nerve
What is the relevance of the maxillary branch of trigeminal nerve to local anaesthetic?
The maxillary branch of the trigeminal nerve supplies the teeth and the gums.
Label the branches of the Maxillary of the trigeminal
A-Infra-orbital
B- zygomaticofacial
C- Zygomaticotemporal
D-Zygomatic
E- Anterior superior alveolar
F- middle superior alveolar
G- posterior superior alveolar
H- greater palatine nerve
I- lesser palatine nerve
J- posterior superior alveolar
K- palatine nerves
L- infra-orbital nerve
M-zygomatic nerve
N- nasal nerve
What are the boundaries of the Infra-temporal fossa?
Anterior- Posterior aspect of Maxilla
lateral - Ramus of mandible
inferior- angle of mandible
Superior- Infratemporal crest of sphenoid bone
Posterior - Styloid process, mastoid process & tympanic plate
Medial- Lateral Pterygoid plate of the sphenoid bone.
What are the branches of the mandibular division of the trigeminal nerve?
- Inferior alveolar
- Auriculotemporal
- Buccal
- Lingual
- Mental
- Muscular
Label the branches of the mandibular main trunk
A- meningeal branch
B- posterior branch
C- Anterior branch
D-Medial pterygoid
E- tensor tempani
F- Tensor Veli palatini
Label this diagram of the anterior trunk of the trigeminal nerve
A- Masseteric
B- Deep temporal nerves
C-Lateral pterygoid
D- Buccal nerve
Label this diagram of the posterior trunk of the mandibular
A- lingual
B- auriculotemporal
C- inferior alveolar
Compare the divisions that come from the main branch of the mandibular?
Meningeal- sensory
Medial pterygoid -motor
Tensor Tempani -motor
Tensor Veli Palatini-motor
Compare the divisions that come from the anterior trunk.
Deep temporal branches- motor
Buccal - sensory
Masseteric- motor
Lateral pterygoid- motor
Compare the divisions that come from the posterior trunk
Lingual- Sensory
auriculotemporal- Sensory
Inferior alveolar- mixed
How is the inferior alveolar “mixed”
Superior to the mandible the inferior alveolar is mixed sensory and motor.
The nerves then split into a sensory part (becomes mental branch and incisive branch) and a motor branch to the mylohyoid
Discuss the lower oral cavity sensory supply:
Cheeks and gums- buccal
Posterior lower teeth- main branch of inferior alveolar
Anterior lower teeth- incisive branch of inferior alveolar.
Lower lip and skin of the chin- mental
Why can a LA cause the tip of the tongue to go numb?
The lingual nerve is located very near the Inferior alveolar nerve.
So the lingual nerve can also be blocked.
Discuss the sensory innervation of the anterior 2/3 of tongue.
General sensory- temperature and pain - lingual nerve of Mandibular divison of trigeminal.
Special sensory- taste - Chordae tympani of the facial nerve.
What anatomical relations are there to an inferior alveolar block & what happens if they are touched?
- Blood vessels- parotid plexus
- Medial pterygoid - hitting this can cause trismus- muscle spasm- patient cannot open mouth.
- Parotid gland- if you inject deep enough you hit facial nerve
- Facial nerve- if hit causes palsy & loss of taste. This should wear off within a day- but need to appologise to patient.
