CN V (Trigeminal Nerve) Flashcards
The caudal part of the brain is referred to as the brainstem and includes three parts. What are they?
medulla oblongata, pons, and midbrain
A ___ is a cluster of functionally-related neuronal cell bodies in the CNS
nucleus
note: Trigeminal nerve is linked to four
This trigeminal nerve nucleus is located slightly lateral to the 3rd ventricle in the midbrain
mesencephalic nucleus
This trigeminal nerve nucleus is located slightly lateral to the 3rd ventricle in the pons
principle sensory nucleus
This trigeminal nerve nucleus is located slightly lateral to the 4th ventricle in the medulla oblongata
spinal nucleus
The caudal end of the spinal nucleus is continued into the spinal cord as the _____ tract
spinotrigeminal
Immediately medial to the principle sensory nucleus of the trigeminal nerve is the much smaller _____ nucleus of the trigeminal nerve
motor
The trigeminal nerve extends from the lateral surface of the pons as a filamentous ____ ____ which connects to the medial surface of the trigeminal ganglion
sensory root
On the inferior surface of the filamentous sensory stalk is the much smaller _____ root
motor
The motor root of the trigeminal nerve courses parallel to, and merges with, the ____ branch
mandibular (V3)
The roots of the trigeminal nerve, the trigeminal ganglion, and the proximal ends of the three trigeminal branches are all enclosed within a dural evagination termed the ____ ____
trigeminal cave
The two layers of dura matter which form the trigeminal cave are expansions form the ____ ____
tentorium cerebelli
The trigeminal cave abuts the caudal surface of the venous expansion termed the ____ sinus
cavernous
The two branches of the trigeminal nerve that course through the cavernous sinus are?
ophthalmic (V1) and maxillary (V2)
note: within the sinus, these two branches are inferior to oculomotor (CN III) and trochlear (CN IV) nerves
All three branches of the trigeminal give off sensory nerves to the meninges. The largest of these is the ____ ___ nerve which arises from the maxillary (V2) immediately before it enters the foramen rotundum
Middle Meningeal
The ____ nerve arises from the mandibular branch (V3) immediately after it passes through foramen ovale and then curls back around to enter the skull through the foramen spinosum
Meningeal
The ophthalmic (V1) is the smallest of the trigeminal branches. It almost immediatlely subdivides into three nerves. What are they?
Frontal, Lacrimal, and Nasociliary
The frontal and lacrimal nerves enter the orbit through the superior tip of the ____ ____ ____; the nasociliary nerve enters more inferiorly within the _____ ____ of the supraocular muscles
superior orbital fissure; tendinous ring
This nerve is a branch from the frontal nerve and exits the orbit near the medial corner, extends superiorly along the forehead, and provides sensory to the scalp, frontal sinus, conjunctiva, and upper eyelid
supratrochlear nerve
This nerve is a branch from the frontal nerve and exits the orbit through the supraorbital foramen, extends superiorly along the forehead and posteriorly near the vertex. It provides sensory to the scalp of the head and forehead and the upper eyelid.
supraorbital nerve
The lacrimal nerve courses along the superior surface of ____ ____ to reach the lateral corner of the orbit.
rectus lacrimal
The lacrimal nerve does not give off any named branches but does supply the ____ gland before exiting the lateral corner of the orbit where it gives sensory to the conjuctiva and upper eyelid
lacrimal
The lacrimal nerve includes sympathetic and parasympathetic axons and is connected to the _____ nerve of the maxillary branch (V2)
zygomaticotemporal
The nasociliary nerve is the most inferior of the three nerves, a portion courses along the superior surface of the ___ nerve, while the remainder courses near the medial border of the orbit between the ____ ____ and the superior oblique muscles
optic; medial rectus
These nerves carry sensory information from the eyeball through the ciliary ganglion and into the nasociliary nerve
short ciliary nerves
These nerves carry sensory information from the eyeball but bypass the ciliary ganglion
long ciliary nerves
This nerve exits the orbit through the posterior ethmoidal foramen and provides sensory to the sphenoid sinus and the posterior ethmoid air cells
posterior ethmoid nerve
The anterior ethmoid nerve gives sensory to the middle and anterior ethmoid air cells before it passes through the margin of the cribriform plate to enter the cranial cavity where it gives off a ____ branch. It then passes inferiorly through the _____ _____ to enter the nasal cavity where it gives sensory to the anterior portion of the nasal septum
meningeal; nasal slit
This nerve is the nasociliary nerve distal to the branching of the anterior ethmoidal nerve.
infratrochlear nerve
The infratrochlear nerve exits the orbit at the ___ corner and is sensory to the soft tissue at the corner of the orbit, the conjunctiva, and the upper eyelid
medial
The maxillary (V2) exits the foramen rotundum as a single nerve, within the pterygopalatine fossa it gives rise to branches and communicates with the pterygopalatine ganglion, then divides into the ____ and ____ nerves
zygomatic and infraorbital
The zygomatic and infraorbital nerves enter what?
inferior orbital fissure
In regards to the maxillary nerve (V2), this nerve branches off distal to the pterygopalatine galngion, courses inferiorly over the tuberosity of the maxilla to enter the alveolar canal
posterior superior alveolar nerve
The posterior superior alveolar nerve provides sensory to what?
upper premolars and molars
note: forms plexus with the anterior superior alveolar nerve
In regards to the maxillary nerve (V2), this nerve exits near the lateral border of the inferior orbital fissure. Courses for a relatively short distance along the lateral margin of the orbit
zygomatic nerve
The communicating branch of the zygomatic nerve courses superiorly to merge with the ____ nerve
lacrimal
This branch of the maxillary nerve (V2) exits near the middle of the inferior orbital fissure, only courses in the orbit for a short distance then enters the infraorbital canal. It gives off one branch within the infraorbital canal then passes through the infraorbital foramen
infraorbital nerve
This branch of the infraorbital nerve provides sensory to the upper incisors and canines, courses within the alveolar canal and forms a plexus with the posterior counterpart
anterior superior alveolar nerve
This branch of the infraorbital nerve courses superiorly from the infraorbital foramen; gives sensory to the lower eyelid and conjunctiva
inferior palpebral nerve
This branch of the infraorbital nerve courses medially from the infraorbital foramen and gives sensory to the septum and floor of the nasal cavity
lateral nasal nerve
This branch of the infraorbital nerve courses inferiorly from the infraorbital foramen; gives sensory to the skin between the nose and upper lip
superior labial nerve
This branch of the mandibular nerve (V3) is a muscular branch which supports the otic ganglion but has no synaptic connections there. It courses over the deep surface of the medial pterygoid and gives off named branches to the tensor tympani and the tensor veil palatini
nerve to medial pterygoid
This branch of the mandibular nerve (V3) supplies muscular innervation to the lateral pterygoid
nerve to lateral pterygoid
This branch of the mandibular nerve (V3) courses posterior to the tendon of temporalis and anterior to the TMJ. It crosses the mandible and the mandibular notch with the masseteric artery. It gives muscular innervation to the masseter.
masseteric nerve
This branch of the mandibular nerve (V3) courses superior to the lateral pterygoid then radiates along the deep surface of the temporalis. It typically splits into anterior and posterior branches, but both the number and origin of the branches is highly variable. Muscular innervation to the temporalis.
Deep temporal nerve
This branch of the mandibular nerve (V3) courses deep to the temporalis and master. Sensory to the cheek region, may also carry sensory impulses from the molars.
buccal nerve
What three nerves are found in the posterior division of the mandibular nerve (V3)?
auriculotemporal, lingual, and inferior alveolar nerves
note: this is confusing but the posterior division is actually inferior, not posterior
This branch from the posterior division of the mandibular nerve (V3) courses posteriorly with an inferior arch to course around the neck of the mandible - along this course it is pierced by the MMA, then passes between TMJ and the external auditory meatus before coursing superiorly along the head. Gives sensory to the temporal region, TMJ, auditory canal; autonomics to the parotid gland
auriculotemporal nerve
This branch from the posterior division of the mandibular nerve (V3) courses inferior to the lateral pterygoid and medial to the inferior alveolar nerve, then between the medial pterygoid and the ramus of the mandible. Here it gives rise to two communicating branches connecting it to the submandibular ganglion. At the hypoglossus it bifurcates to form the smaller nerve to sublingual gland and larger sublingual nerve which is general sensory to the anterior 2/3 of the tongue
lingual nerve
This branch from the posterior division of the mandibular nerve (V3) courses inferiorly along the posterior margin of the lateral pterygoid. Gives rise to a muscular branch, the nerve to mylohyoid, then passes through the mandibular foramen to enter the mandibular canal. Within the canal, it sends sensory branches to the lower molars and premolars. Anteriorly it bifurcates to form the incisive nerve and the mental nerve
inferior alveolar nerve
The ciliary ganglion is located on the superior surface of the optic nerve. What are its inputs?
postsynaptic sympathetic axons: from superior cervical ganglion
presynaptic parasympathetic axons: from occulomotor nerve (CN III)
sensory fibers: from nasociliary nerve
The ciliary ganglion is located on the superior surface of the optic nerve. What are its outputs?
short ciliary nerves
What is the functional significance of the ciliary ganglion?
autonomics passing through the ciliary ganglion regulate both accommodation of the lens and pupillary aperture
The pterygopalatine ganglion is located in the pterygopalatine fossa. What are its inputs?
postsynaptic sympathetic axons: from superior cervical ganglion
presynaptic parasympathetic axons: from greater petrosal nerve (from Facial nerve)
sensory fibers: from maxillary nerve (V2)
The pterygopalatine ganglion is located in the pterygopalatine fossa. What are its outputs?
posterior superior nasal nerve posterior inferior nasal nerve nasopalatine nerve greater palatine nerve lesser palatine nerve orbital nerves pharyngeal nerves
This nerve gives sensory to the lateral wall of the nasal cavity including the inferior concha
posterior inferior nasal nerve
this nerve gives sensory to the palatal mucosa around the upper incisors and canines
nasopaltine nerve
This nerve gives sensory to the palatal mucosa and gingiva anteriorly as far as the first premolar
greater palatine nerve
This nerve gives sensory to the mucosa of the soft palate
lesser palatine nerve
This nerve gives sensory to the medial wall of the orbit
orbital nerve(s)
These nerve gives sensory to the nasopharynx
pharyngeal nerve
Autonomics passing through the pterygopalatine ganglion regulate _____
lacrimation
The submandibular ganglion is located in the floor of the mouth, superior to the submandibular gland. What are its inputs?
postsynaptic sympathetic axons: from superior cervical ganglion
presynaptic parasympathetic axons: from chorda tympani
sensory fibers: from lingual nerve
The submandibular ganglion is located in the floor of the mouth, superior to the submandibular gland. What are its outputs?
the outputs course in the lingual nerve
Autonomics passing through the submandibular ganglion regulate what?
saliva expression in the sublingual and submandibular glands
The otic ganglion is located on the medial surface of the mandibular nerve (V3) at the level of the divergence of the anterior division of the mandibular nerve. What are its inputs?
post synaptic sympathetic axons: from superior cervical ganglion
presynaptic parasympathetic axons: from glossopharyngeal nerve coursing in the lesser petrosal nerve
sensory and muscular axons: from medial pterygoid nerve and chorda tympani
The otic ganglion is located on the medial surface of the mandibular nerve (V3) at the level of the divergence of the anterior division of the mandibular nerve. What are its outputs?
auriculotemporal nerve to the parotid gland
Autonomics passing through the otic ganglion regulate what?
salivation at the parotid gland
What is the function of the mesocephalic nucleus?
proprioception from muscles, teeth, TMJ
What is the function of the principle nucleus
touch sensation from the head and face
What is the function of the spinal nucleus?
tactile sensation from oral cavity, dental pain, pain and temp sensation from face
What is the function of the motor nucleus?
muscular branches of mandibular nerve (V3)
This is paralysis of the muscles of mastication (innervated by the anterior division of the mandibular nerve (V3))
trigeminal palsy
This is described as one of the most painful medical conditions - causes suicidal depression. There is no effective treatment.
trigeminal neuralgia
