Trigeminal Nerve 1 Flashcards
1
Q
What cranial nerve is the trigeminal
A
5
2
Q
Does the trigeminal nerve have sensory or motor routes
A
both
3
Q
What are the 3 divisions of the trigeminal nerve
A
ophthalmic nerve
maxillary nerve
mandibular nerve
4
Q
What divisions of the trigmeninal are targeted by the local anesthesia
A
maxillary and mandibular
5
Q
What is the osteology that needs to be known when looking at the skull anteriorly
A
supraorbital notch (foramen)
zygomatic bone
mental foramen
6
Q
What exits through the supra orbital notch/foramen
A
the supra orbital nerve
7
Q
What is the supra orbital nerve
A
a continuation of the frontal nerve (ophthalmic)
8
Q
What passes through the infraorbital foramen
A
the infra orbital nerve
9
Q
What is the infra orbital nerve
A
a branch of the maxillary nerve
10
Q
What passes through the mental foramen
A
it transmits the terminal branches of the inferior alveolar nerve (and the mental artery)
11
Q
When looking at the osteology of the hard palate what should you be able to identify
A
should be able to differentiate between the maxilla and the palatine bone
incisive foramen
greater palatine foramen
lesser palatine foramen
12
Q
What passes through the incisive foramen
A
the nasopalatine nerve
13
Q
What passes through the greater palatine foramen
A
greater palatine nerve
14
Q
What passes through the lesser palatine foramen
A
lesser palatine nerve
15
Q
What are the key features of the mandible
A
it is the site of attachment for several muscles
it has foramina for the passage of neuromuscular structures
it has teeth in the alveolar processes
16
Q
What do you need to be able to identify on the mandible
A
condylar process
coronoid process
mental foramen
17
Q
What is the condylar process
A
forms part of the TMJ
can be felt when asking patient to open and close their mouth
18
Q
What is the coronoid process
A
site of attachment for the temporals
19
Q
What should you be able to identify on the medial site of the mandible
A
lingula
mandibular foramen
20
Q
Why is the lingula significant
A
it can be felt easily
21
Q
What is the mandibular foramen for
A
it allows the passage of the inferior alveolar nerve
22
Q
Where does the trigeminal nerve exit
A
at the mid pons
23
Q
What are the 2 components in terms of information that the trigeminal transmits from the periphery to the brainstem
A
special visceral efferent
general somatic afferent
24
Q
What is the special visceral efferent
A
it is efferent because it is motor information comes from the motor nucleus
25
Where is the motor nucleus of the trigeminal
at the level of the pons
26
What is the special visceral efferent information to
predominantly the muscles of mastication
27
What are the 3 different brainstem nuclei that information that general somatic afferent info is sent to
mesencephalic nuclei
chief sensory nuclei
spinal nuclei
28
Where is the mesencephalic nuclei found
in the mid brain
29
What is the mesencephalic nuclei for
proprioception
30
What is the chief sensory nuclei found
in the pons
31
What is the chief sensory nuclei for
discriminative touch
32
Where is the spinal nucleus found
founding the medulla oblongata
33
What is the spinal nucleus for
For pain and temperature for structures supplied by the trigeminal as well as general conscious sensation for the viscera supplied by cranial nerves 9 and 10
34
What is a ganglion
w A ganglion is when all the fibres of the trigeminal nerve are together and before the trigeminal nerve divides into it's 3 divisions
35
What is the cavity in the dura mater that the trigeminal ganglion occupies called
MECKELS CAVE
36
Describe the course of the trigeminal nerve as it approaches the ganglion
The nerve roots of CN V emerge from the mid pons and pass forwards onto the apex of the petrous temporal bone where the trigeminal ganglion lies in a cave of dura mater (Meckel's cave)
37
What does the first division of the trigeminal nerve pass through
superior orbital fissure
38
What does the second division of the trigeminal nerve pass through
foramen rotundum
39
What does the third division of the trigeminal nerve pass through
foramen ovale
40
What is the trigeminal ganglion close to
the cavernous sinus
41
What branches of the trigeminal nerve pass through the cavernous sinus
V1 and V2 pass anteriorly in the lateral wall fo the cavernous sinus to reach the superior orbital fissure and foramen rotunda respectively
42
If a patient has an injury that effects all 3 divisions of the trigeminal nerve what is it likely to be
injury somewhere in the pons e.g stroke
| injury at the cranial base e.g trauma or tumor
43
In the cavernous sinus, what is the trigeminal nerve close to
the internal carotid artery and its sympathetic plexus
44
What is the significance of the trigeminal nerves close proximity to the internal carotid artery
a clot forming in this artery can result in compression of the nerve
45
If the divisions of the trigeminal nerve are affected in the cavernous sinus then what is usually also effected
the other nerves present
Cn3, 4 and 6
usually severe issues seen in the eye
46
What is the course of the ophthalmic nerve
passes anteriorly in the lateral wall of the cavernous sinus to reach the superior orbital fissure
once inside the orbit it divides into the different divisions
47
What does the ophthalmic division provide sensorial innervation to
scalp, eye, upper face and sinuses
48
What are the main branches of the ophthalmic branch
frontal
lacrimal
nasociliary
49
What does the frontal nerve branch into
supraorbital
| supratrochlear
50
What does the terminal branches nasociliary nerve branch into
infratrochlear
| external nasal
51
What are the TERMINAL branches of the ophthalmic nerve
```
supraorbital
supratrochlear
lacrimal
infratrochlear
external nasal
```
52
What do the supraorbital and supratrochlear nerve provide sensation to
different parts of the forehead
| provide sensation to the skin of the vertex (the scalp) and the upper eyelid/forehead
53
What does the lacrimal nerve supply
Lacrimal nerve innervates the lacrimal gland and skin of the lateral and upper eyelid and forehead
54
What is the external nasal nerve a continuation of
the external nasal nerve is a CONTINUATION of the anterior ethmoidal nerve which comes off the nasociliary nerve
55
What does the external nasal nerve supply
tip of the nose
56
What does the infratrochlear nerve supply
the skin at the medial angle of the eye and adjacent root of nose
57
What is the significance of the nasociliary supplying both the tip of the nose and the cornea
Should the shingles appear at the tip of the nose then this may be a warning that the disease will also develop on the cornea which could result in loss of sight
58
What is shingles
Shingles is due to the virus that causes chickenpox (varicella-zoster virus) which sits dormant on the trigeminal ganglion but when it reactivates it is known as shingles which can present on any division of the trigeminal nerve
59
What does CN V1 supply in relation to the eye
the skin of the upper eyelid, underlying conjuctiva both on the eyelid and over the cornea
60
What part does Cn V1 play in the corneal reflex
the sensorial part of the reflex is the nasociliary nerve
| motor part is the facial nerve
61
What do the ethmoidal nerves (anterior and posterior) supply
ethmoidal sinuses, lateral wall of the nasal cavity and nasal septum)
62
What is the course of the maxillary division
N V2 passes anteriorly in the lateral wall of the cavernous sinus and reaches the PTERYGOPALATINE FOSSA via the foramen rotundum
63
What is the foramen rotunda also called
the middle cranial fossa
64
What is the foramen rotundum hidden in
the pterygopalatine fossa
65
Where does the pterygopalatine fossa lie
just lateral to the upper aspect of the nasal cavity & nasopharynx behind the orbit and above the hard/soft palate
66
What does the pterygomaxillary fissure do
w The pterygomaxillary fissure gives entry to the pterygopalatine fossa
67
Where can the sphenopalatine foramen be found
in the medial wall of the pterygopalatine fossa
68
What are the 2 main branches of the maxillary division
zygomatic
| infra orbital
69
What are the other important branches of the maxillary division
nasopalatine
greater and lesser palatine to the palate
alveolar to the upper teeth
70
What does the zygomatic nerve branch into
○ Zygomaticotemporal (to the temple)
| Zygomaticofacial (further down the face)
71
What does the infraorbital go down to
upper lip
72
What do the anterior superior alveolar nerve and middle superior alveolar nerves branch from
the infraorbital
73
Does the posterior superior alveolar branch from the infraorbital?
No
| it is its own branch
74
What does the palatine nerve go through
the palatine canal
| gives off the greater and lesser palatine nerves
75
Where does the nasal nerve go
disappears in the sphenopalatine foramen
76
What does CNV2 send the zygomatic and infraorbital branches
into the orbit via the INFERIOR ORBITAL FISSURE
77
Where does the infraorbital branch exit
through the intra orbital foramen
78
Where does the zygomatic branch exit
The zygomatic branch divides into the zygomaticotemporal and zygomaticofacial nerve which then exit the orbit using identically named foramina.
79
What does CNV2 supply
parts of the nasal cavity, nasopharynx, maxillary sinus, hard and soft palate, upper teeth and gums
80
Describe the course of the nasopalatine nerve
Trigeminal nerve exits at the pons > second division exits through the foramen rotundum > goes through the pterygopalatine fossa > goes through the sphenopalatine foramen (foramen in the pterygopalatine fossa) to reach the nasal cavity, into the septum and passes inferiorly to reach the anterior hard palate and exits through the incisive foramen
81
What does the nasopalatine nerve enter the hard palate through
INCISIVE CANAL
82
What are the 3 alveolar branches
anterior superior alveolar
middle superior alveolar
posterior superior alveolar
83
What is the course of the posterior superior alveolar
The pterygomaxillary fissure connects the infratemporal fossa with the pterygopalatine fossa which transmits the posterior superior alveolar nerve. It exits through the fissure into the temporal fossa
84
What are the 2 palatine branches
○ Greater palatine
| Lesser palatine
85
What is the course of the palatine nerves
They pass through the palatine fossa, go through the palatine canal and exit through the corresponding foramen (greater palatine foramen and lesser palatine foramen) that are found on the hard palate
86
Where are the palatine nerves found
They are found on the lateral wall of the nasal cavity unlike the nasopalatine
87
What are the upper teeth innervated by
Anterior superior alveolar nerve
Middle superior alveolar nerve
Posterior superior alveolar nerve
88
What is the upper labial gingiva innervated by
by the same nerve that supplies the tooth
89
What does the nasopalatine nerve innervate regarding the gingiva
innervates the mucosa surrounding the incisive papilla and the palatal gingival margins of the anterior teeth
90
What does the greater palatine nerve innervate regarding the gingiva
innervates the palatal tissues and the palatal gingiva posterior to the canines after passing through the greater palatine foramen
91
What do the greater palatine nerve and nasopalatine supply in regards to the hard palate
they overlap in their innervation of it
92
What does the lesser palatine nerve supply
the soft palate and uvula
