Lecture 4: trigeminal nerver (CN5)

Question 1

resident fibers of CN 5

Answer 1

• general somatic afferent (GSA): general sensation from the face
• special visceral efferent (SVE): muscles of the 1st pharyngeal arch

Question 2

acquired fibers of CN 5

Answer 2

• special afferent (SA): taste

- general visceral efferent (GVE): parasympathetic fibers to smooth muscle

Question 3

CN 5 path

Answer 3

courses anteriorly to reach the middle cranial fossa

Question 4

location of the trigeminal ganglion

Answer 4

-trigeminal impression/ trigeminal cave/ meckel’s cave

Question 5

V1 exits the cranial cavity via the

Answer 5

superior orbital fissure

Question 6

V2 exits the cranial cavity via the

Answer 6

foramen rotundum

Question 7

V3 exits the cranial cavity via the

Answer 7

foramen ovale

Question 8

V1

Answer 8

ophthalmic nerve

Question 9

branches off V1

Answer 9

• meningeal branch
• lacrimal nerve
• frontal nerve
• nasociliary nerve

Question 10

meningeal branch (v1)

Answer 10

is a sensory branch that emerges from v1 before it transverses the superior orbital fissure

Question 11

before traversing the superior orbital fissure the ophthalmic nerve (v1)

Answer 11

branches into the lacrimal, frontal, and nasociliary nerves

Question 12

lacrimal nerve (v1)

Answer 12

travels along the lateral border of the orbit to reach the lacrimal gland and the lateral eye

Question 13

frontal nerve (v1)

Answer 13

branches into the supratrochlear and supraorbital nerves

Question 14

supratrochlear and supraorbital nerves

Answer 14

course anteriorly though the orbit and emerge superior to the eye with same named arteries

Question 15

nasocilliary nerve

Answer 15

travels in a plane deep to the lacrimal and frontal nerves

Question 16

nasocilliary nerve branches

Answer 16

• sensory root –> ciliary ganglion –> short ciliary nerves
• long ciliary nerves
• posterior ehtmoidal nerve
• anterior ethemoidal nerve
• infratrocheal nerve

Question 17

posterior ethmoidal nerve

Answer 17

exits the orbit via the posterior ethmoidal foramen

Question 18

anterior ethmoidal nerve

Answer 18

• exits the orbit via the anterior ethmoidal foramen

- gives rise to internal and external nasal branches

Question 19

v1 branches that carry sensory information from the face

Answer 19

• supraorbital
• supratrochlear
• infratrochlear
• external nasal
• lacrimal

Question 20

v2

Answer 20

maxillary nerve

Question 21

branches off v2

Answer 21

• meningeal branch
• zygomatic nerve
• communicating branches with pterygopalatine ganglion
• posterior superior alveolar nerve
• infraorbital nerve

Question 22

meningeal branch (v2)

Answer 22

branch before v2 courses through the foramen rotundum to enter the pterygopalatine fossa

Question 23

branches of v2 in the pterygopalatine fossa

Answer 23

• zygomatic nerve
• communicating roots to pterygopalatine ganglion
• posterior superior alveolar nerve
• infraorbital nerve

Question 24

zygomatic nerve (v2)

Answer 24

• enters the orbit via the inferior orbital fissure

- branches into the zygomaticofacial and zygomatictemporal nerves

Question 25

zygomaticofacial and zygomatictemporal nerves

Answer 25

leave the orbit and emerge on the face via same named foramen -communicating branch from the zygomaticotemporal nerve to the lacrimal nerve (v1)

Question 26

communicating roots to pterygopalatine ganglion

Answer 26

the ppterygopalatine ganglion is suspended from v2 by 2 communicating branches -fibers pass through the pterygopalatine ganglion without interruption and into branches

Question 27

communicating roots to pterygopalatine ganglion branches

Answer 27

- orbital branches - medial posterior superior nasal nerve - lateral posterior superior nasal nerve - nasopalatine nerve - greater palatine nerve - lesser palatine nerve - pharyngeal nerve

Question 28

orbital branches travel in

Answer 28

the inferior orbital fissure to reach the orbit

Question 29

-medial posterior superior nasal nerve, lateral posterior superior nasal nerve, and nasopalatine nerves travel in

Answer 29

the sphenopalatine foramen to enter the nasal cavity

Question 30

pharyngeal nerve travels in

Answer 30

the palatovaginal canal to reach the nasopharynx

Question 31

greater palatine and lesser palatine travel in

Answer 31

descend in the greater palatine canal to reach the palate

Question 32

posterior superior alveolar nerve (v2)

Answer 32

leave the pterygopalatine fossa through the pterygomaxillary fissure and enters the maxilla via the alveolar foramen

Question 33

infraorbital nerve (v2)

Answer 33

continuation of the maxillary nerve - name change occurs as it passes through the inferior orbital fissure - courses in the infraorbital canal before exiting in the infraorbital foramen

Question 34

infraorbital nerve (v2) gives rise to

Answer 34

- middle superior alveolar nerve | - anterior superior alveolar nerve

Question 35

infraorbital nerve (v2) terminates as

Answer 35

- palpebral branch - nasal branch - labial branch

Question 36

superior dental plexus

Answer 36

formed by nerves that carry sensory information to from maxillary teeth and adjacent gingival tissue - posterior superior alveolar nerve - middle superior alveolar nerve - anterior superior alveolar nerve

Question 37

dental pulp is innervated by

Answer 37

- a delta and c fibers from CN 5 (GSA) and postganglionic sympathetic nerve fibers from the superficial cervical ganglion

Question 38

v2 branches that carry sensory information from the face

Answer 38

- zygomaticotemporal - zygomaticofacial - infraorbital

Question 39

v3

Answer 39

mandibular nerve

Question 40

immediate branches off v3

Answer 40

- meningeal branch (nervus spinosus) | - nerve to the medial pterygoid

Question 41

branches off v3 anterior division

Answer 41

- nerve to the lateral pterygoid - deep temporal nerves (anterior and posterior) - massenteric nerve - long buccal nerve

Question 42

branches off v3 posterior division

Answer 42

- auriculotemporal nerve - lingual nerve - inferior alveolar nerve

Question 43

nervus spinosus v3

Answer 43

re-enters the cranial cavity via the foramen spinosum and caries GSA from the meninges of the anterior and middle cranial fossa

Question 44

nerve to the medial pterygoid (v3)

Answer 44

``` carries motor (SVE) and proprioceptive (GSA) fibers to the medial pterygoid muscle -also sends a small branch to the tensor tympani and tensor veli palatini muscle ```

Question 45

lingual erve (v3)

Answer 45

- receives chorda tympani (CN 7) | - has communicating fibers with the submandibular ganglion

Question 46

inferior alveolar nerve (v3)

Answer 46

- nerve to the mylohyoid | - terminates as the mental nerve and incisive nerve

Question 47

v3 branches that carry sensory information from the face

Answer 47

- auriculotemporal - mental - buccal