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BDS2 BAMS - Anatomy > Trigeminal nerve 1 > Flashcards

Trigeminal nerve 1 Flashcards

1
Q

What are the sensory functions of the trigeminal nerve

A
  • skin of face
  • oral mucosa
  • nasal mucosa
  • sinus mucosa
  • teeth
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2
Q

what are the motor functions of the trigeminal nerve

A
  • muscles of mastication

- 4 others

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3
Q

what functions of the trigeminal nerve are we particularly interested in

A

sensory functions (motor is more to be aware of incase of damage)

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4
Q

what cranial nerve is the trigeminal nerve

A

CNV

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5
Q

what are the 3 main branches of the trigeminal nerve

A

CNV1 - opthalmic
CNV2 - maxillary
CNV3 - mandibular

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6
Q

which main branches of the trigeminal nerve do we delivery anaesthesia to

A

maxillary and mandibular (opthalmic to be aware of as could affect others)

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7
Q

what are the 3 exit points of the trigeminal nerve

A
  1. supra-orbital notch (foramen)
  2. infra-orbital foramen
  3. mental foramen
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8
Q

what is the difference between a notch and a foramen

A

notch - semi-circular opening

foramen - hole

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9
Q

exit point of opthalmic branch

A

supra-orbital notch

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10
Q

exit point of maxillary branch

A

infra-orbital foramen

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11
Q

exit point of mandibular branch

A

mental foramen

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12
Q

what bones make up the hard palate

A
  • palatine process of maxilla

- horizontal plate of palatine bone

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13
Q

what foramens are in the hard palate (know positions)

A
  • incisive foramen (in between central incisors)
  • greater palatine foramen (x2) (near posterior molars)
  • lesser palatine foramen (x2) (near posterior molars)
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14
Q

what nerve passes through the mandibular foramen

A

inferior alveolar nerve

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15
Q

what foramen does the inferior alveolar nerve pass through

A

mandibular foramen

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16
Q

What landmarks on the mandible should I definitely know

body

A
  • angle
  • ramus
  • condylar process
  • head
  • neck
  • lingula
  • mandibular foramen
  • coronoid process
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17
Q

Where does the trigeminal nerve exit on the base of the brain and skull

A

the pons of the brainstem

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18
Q

What are the different nuclei and modalities of the trigeminal nerve

A

Special visceral efferent from the motor nucleus in the pons to the muscles of mastication

General somatic afferent to the mesencephalic (midbrain), chief sensory (pons) and spinal nuclei (medulla)

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19
Q

where does general somatic afferent (sensory) information come from regarding the trigeminal nerve

A

3 different brainstem nuclei (midbrain, pons and medulla). Spans the human brainstem. Fibres come together and exit at the pons. Different sensory info is processed at different points in the brain

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20
Q

What does the trigeminal motor nucleus control

A

muscles of mastication

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21
Q

What does the CNV mesencephalic nucleus control

A

proprioception

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22
Q

What does the CNV chief sensory nucleus control

A

discriminative touch

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23
Q

What does the CNV spinal nucleus control

A

pain and temperature for structures supplied by CNV as well as general conscious sensation for the viscera supplied by CN IX and X

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24
Q

what brainstem nuclei are we most interested in

A
  • chief sensory nucleus (discriminative touch)
  • spinal nucleus (pain and temperature)

(exit half way through pons)

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25
Q

When assessing the trigeminal nerve what must you do

A

test CNV1,2 and 3 individually

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26
Q

Where do the trigeminal nerve roots emerge from and go to

A

emerge from mid pons

pass forwards onto the apex of the petrous temporal bone where the trigeminal ganglion lies in a cave of dura mater (Meckel’s cave)

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27
Q

where does the trigeminal ganglion lie

A

Meckel’s cave (cave of dura mater)

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28
Q

where is Meckel’s cave

A

on the apex of the petrous temporal bone

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29
Q

After dividing from the trigeminal ganglion where does CNV1 pass

A

towards the superior orbital fissure

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30
Q

After dividing from the trigeminal ganglion where does CNV2 pass

A

through the foramen rotundum

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31
Q

After dividing from the trigeminal ganglion where does CNV3 pass

A

through the foramen ovale

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32
Q

If all 3 CNV divisions are affected, where must the lesion be

A

in the pons (i.e. a stroke) or at the cranial base (i.e. trauma or tumour)

33
Q

What are the 3 main and 5 sensory branches of the opthalmic branch

A
  • Frontal (supratrochlear, supra-orbital)
  • Lacrimal
  • Nasociliary (infratrochlear, external nasal)
34
Q

What does the opthalmic divison carry

A

Parasympathetics via ciliary ganglion to eye for accomodation and pupil constriction, via pterygopalatine ganglion for lacrimal gland

Sympathetics via cavernous sinus to pupil for dilation

35
Q

Where does the frontal nerve go

A
  • divides into supra-orbital and supra trochlear
  • skin of vertex
  • upper eyelid/forehead
36
Q

Where does the lacrimal nerve go

A
  • lacrimal gland

- skin of lateral upper eyelid and forehead

37
Q

Where does the nasociliary nerve go

A
  • gives off long ciliary nerve(s), anterior and posterior ethmoidal nerves
  • then continues as the infratrochlear nerve to skin of medial upper eyelid and root of nose (external nasal nerve)
38
Q

What does the supratrochlear, supraorbital and lacrimal nerves supply

A
  • the vertex
  • forehead
  • upper eyelids
39
Q

What does the anterior ethmoidal nerve continue as

A

external nasal nerve to the skin at the tip of the nose

40
Q

What does the infratrochlear nerve supply

A

the skin at the medial angle of the eye and adjacent root of the nose

41
Q

What division of the trigeminal nerve can shingles affect

A

any!

42
Q

what does shingles at the tip of the nose indicate, why?

A

a warning that the disease will also develop on the cornea

because the nasociliary nerve that innervates the tip of the nose also supplies the cornea and the conjunctiva (if you don’t treat could lose eyesight)

43
Q

What nerves supply blinking

A
  1. CNV1 (first limb of coneal reflex)

2. facial nerve (actual blink)

44
Q

Where does the maxillary division pass following the trigeminal ganglion

A

passes anteriorly in the lateral wall of the cavernous sinus and reaches pterygopalatine fossa via the foramen rotundum

45
Q

What division of the trigeminal nerve enters through the foramen rotundum

A

maxillary division (CNV2)

46
Q

what does the maxillary division reach after passing through the foramen rotundum

A

pterygopalatine fossa

47
Q

where is the pterygopalatine fossa

A

lies just lateral to the upper aspect of the nasal cavity and nasopharynx behind the orbit and above the hard/soft palate

48
Q

what is the opening of the pterygopalatine fossa called

A

pterygopalatine fissure

49
Q

where is the sphenopalatine foramen

A

in medial wall of pterygopalatine fossa

50
Q

what landmarks in the pterygopalatine fossa should we know

A
  • sphenopalatine foramen
  • foramen rotundum
  • palatine canal
51
Q

What are the main branches of the maxillary division

A
  • Zygomatic (zygomatico-temporal, zygomatico-facial)

- infra-orbital

52
Q

what sensory info does the maxillary division provide

A
  • middle face
  • palate
  • sinuses
  • nasopharynx
  • nose
53
Q

what does the maxillary division carry

A

Parasympathetics via pterygopalatine ganglion to lacrimal gland, mucous glands of nose, palate, nasopharnynx

taste - hard and soft palate

54
Q

other important features of maxillary branch other than main branches

A
  • nasopalatine to nasal cavity
  • greater and lesser palatine to palate
  • pharyngeal to nasopharnx
  • alveolar to upper teeth
55
Q

where does the infraorbital nerve emerge from

A

the infraorbital foramen

56
Q

what does the infraorbital nerve supply

A
  • the lower eyelid
  • cheek
  • nose
  • upper lip
57
Q

what does the zygomaticotemporal nerve supply

A

anterior temple

58
Q

what does the zygomaticofacial nerve supply

A

zygoma

59
Q

What happens to the nasopalatine nerve

A
  • enters the nasal cavity via the sphenopalatine foramen
  • to reach the nasal septum from where courses inferiorly and passes via the incisive canal to reach the anterior hard palate
60
Q

what are the alveolar branches of maxillary and what nerve do they come from

A

come from infraorbital branch of maxillary (anterior and middle)

  • anterior superior alveolar
  • middle superior alveolar
  • posterior superior alveolar (separate from infra-orbital)
61
Q

What are the palatine branches of maxillary

A
  • greater palatine

- lesser palatine

62
Q

where are the palatine branches found

A

lateral nasal wall

63
Q

What nerve supplies upper teeth 1-3

A

anterior superior alveolar nerve (from V2)

64
Q

What nerve supplies upper teeth 4-5

A

middle superior alveolar nerve (from V2)

65
Q

What nerve supplies upper teeth 6-8

A

posterior superior alveolar nerve (from V2)

66
Q

What teeth does the anterior superior alveolar nerve supply

A

maxillary 1-3

67
Q

What teeth does the middle superior alveolar nerve supply

A

maxillary 4-5

68
Q

What teeth does the posterior superior alveolar nerve supply

A

maxillary 6-8

69
Q

what part of the gingiva does the nasopalatine nerve supply

A

palatal side of maxillary 1-3

70
Q

what part of the gingiva does the greater palatine nerve nerve supply

A

palatal side of maxillary 4-8

71
Q

what does the lesser palatine nerve supply

A

soft palate and uvula

72
Q

what part of the gingiva does the anterior superior alveolar nerve supply

A

buccal aspect of maxillary 1-3

73
Q

what part of the gingiva does the middle superior alveolar nerve supply

A

buccal aspect of maxillary 4-5

74
Q

what part of the gingiva does the posterior superior alveolar nerve supply

A

buccal aspect of maxillary 6-8

75
Q

What nerve supplies upper palatal aspect of 1-3 gingiva

A

nasopalatine nerve

76
Q

What nerve supplies upper palatal aspect of 4-8 gingiva

A

greater palatine nerve

77
Q

What nerve supplies upper buccal aspect of 1-3 gingiva

A

anterior superior alveolar nerve

78
Q

What nerve supplies upper buccal aspect of 4-5 gingiva

A

middle superior alveolar nerve

79
Q

What nerve supplies upper buccal aspect of 6-8 gingiva

A

posterior superior alveolar nerve

BDS2 BAMS - Anatomy (2 decks)

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