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BDS2 - Anatomy > Trigeminal Nerve 1 [CN1/2] > Flashcards

Trigeminal Nerve 1 [CN1/2] Flashcards

1
Q

what is cranial nerve V called

A

trigeminal nerve

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2
Q

what does the sensory root of CN V supply

A

skin of face
oral nasal and sinus mucosa
teeth

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3
Q

what does the motor root of CN V supply

A 
muscles of mastication
tensor-tympani muscle
tensor palati
mylohyoid
anterior belly of digastric
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4
Q

how many divisions does CN V have

A

3

  • ophthalmic
  • maxillary
  • mandibular
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5
Q

what are the 3 exit points where the branches of CN V exits the skull

A
  • supra-orbital notch / foramen
  • infra-orbital foramen
  • mental foramen
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6
Q

what is the hard palate made up of

A

palatine process of maxilla
and
horizontal plate of palatine bone

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7
Q

name the foramen found in the palatine process of maxilla

A

incisive foramen

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8
Q

name the 2 foramen found in the horizontal plate of palatine bone

A

greater palatine foramen

lesser palatine foramen

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9
Q

why is the foramina in the mandible

A

for the passage of neurovascular structures

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10
Q

name the parts of the mandible from the external view

A 
condylar process
ramus 
angle of mandible
inferior border
mental foramen
body
oblique line 
anterior border
superior border
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11
Q

name the parts of the mandible from the internal view

A 
head
neck 
pterygoid bone
mandibular notch 
coronoid process
mandibular foramen 
lingula
mylohyoid groove
mylohyoid bone
sublingual fossa
roughening for attachment of medial pterygoid muscle
angle
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12
Q

what is the condylar process part of

A

TMJ

can feel it when opening and closing the mouth

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13
Q

what is the temporalis muscle attached to

A

coronoid process

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14
Q

what passes through the mandibular foramen

A

inferior alveolar nerve

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15
Q

what is CN V covered by when on the base of the brain and skull

A

dura

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16
Q

where does the special visceral efferent axon come from and go to

A

comes from the motor nucleus in the pons to the muscles of mastication

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17
Q

where does the general somatic afferent go

A

to the

  • mesencephalic in the midbrain
  • chief sensory in the pons
  • spinal nuclei in the medulla oblongata
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18
Q

what does the CN V mesencephalic nucleus do

A

its for proprioception
tells you where your head is in space
not overly important dentally

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19
Q

what does the CN V cheif sensory nucleus do

A

for discriminative touch

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20
Q

what does the CN V spinal nucleus do

A

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

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21
Q

when assessing CN V, what is it important to do when testing this nerve

A

to test the regions of CN V individually (3 branches)

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22
Q

where does CN V supply general somatic sensation to

A

face
head
associated orbital, nasal and oral cavities

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23
Q

which branch of CN V contains the motor root

A

CN V3 / mandibular division

for the muscles of mastication

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24
Q

where does the ophthalmic division exit

A

supraorbital notch / foramen

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25
Q

where does the maxillary division exit

A

infraorbital foramen

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26
Q

where does the mandibular division exit

A

mental foramen

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27
Q

where is the trigeminal ganglion found

A

in meckel’s cave which is part of the dura
creates a protective cave

all the fibres of the trigeminal nerve are still together - this is before they divide into branches

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28
Q

where does the nerve roots of CN V emerge from and go

A

emerge from the mid-pons

pass forwards onto the apex of the petrous temporal bone where the trigeminal ganglion lies in a cave of dura mater

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29
Q

where does CN V1 go when it leaves the trigeminal ganglion

A

passes anteriorly in the lateral wall of the cavernous sinus to reach the superior orbital fissure

passes inside the human orbit
passes laterally
divides into branches inside the orbit

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30
Q

where does CN V2 go when it leaves the trigeminal ganglion

A

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

31
Q

what is the trigeminal ganglion close to

A

neurovascular sites

the cavernous sinus in particular

32
Q

if all 3 CN V divisions are affected, where must the lesion be?

A

must be in the pons (ie stroke)

or at the cranial base (ie trauma or tumour)

33
Q

where does CN V3 go when it leaves the trigeminal ganglion

A

foramen ovale

34
Q

what artery is close to CN V1 and V2 and the cavernous sinus

A

internal carotid artery and its sympathetic plexus

35
Q

if the divisions of CN V are affected in the cavernous sinus, what other nerves can evidence of an effect be seen too?

A

CN III

CN IV

36
Q

do we ever block the branches of CN V1 for dental treatment

A

no

37
Q

where does CN V1 supply sensory

A

scalp
eye
upper face
sinuses

38
Q

what does CN V1 carry

A

○ Parasympathetic
§ Via ciliary ganglion to eye for accommodation and pupil constriction (10 short ciliary nerves) via pterygopalatine ganglion for the lacrimal gland
§ CN V carries all parasympathetic to their end organs
§ Don’t worry about this part as much

○ Sympathetic
§ Via cavernous sinus to pulp for dilation (2 long ciliary nerves)
§ Main focus on this part

39
Q

what are the main branches of CN V1

A 
lacrimal 
supratrochlear
supraorbital
infratrochlear
external nasal
40
Q

what does the frontal nerve divide into and what does it supply

A

supraorbital
supratrochlear

sensory sensation to the skin of vertex and upper eyelid and forehead

41
Q

what does the lacrimal nerve supply

A

sensory sensation the lacrimal gland and skin of lateral upper eyelid and forehead
important for cryiing

42
Q

what does the nasociliary nerve divide into

and what do they supply

A
  • long ciliary nerve
  • anterior ethmoidal
  • posterior ethmoidal
  • infratrochlear
    skin of medial upper eyelid and root of nose

and the continuation of the anterior ethmoidal nerve into a branch called the external nasal nerve
supplies tip of the nose

43
Q

what does the supratrochlear, supra orbital and lacrimal nerves supply

A

vertex
forehead
upper eye lids

44
Q

what does the infratrochlear nerve supply

A

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

45
Q

how is CN V1 important in detection of shingles

A

shingles is a virus you get when you have chicken pox but the virus lies dormant inside the trigeminal ganglion

if virus is reactivated = shingles, can be got in any division of the trigeminal nerve

if there is a painful tingy rash at the tip of the nose this is indication that shingles is in the external nasal nerve which is supplied by the anterior ethmoidal nerve which comes from the nasociliary nerve

this rash on the tip of the nose is an warning that the cornea will develop shingles which can cause loss of eye sight

dentist in good position to clinically recognise shingles

46
Q

what nerves are involved in the corneal reflex

A

• CN V1 is the first limb of the corneal reflex (nasociliary nerve)
○ Stimulate the cornea to blink
§ First part of reflex is the nasociliary nerve (sensory)
§ The closing of the eye (blink) is mediated by the facial nerve (CN VII) (motor)

47
Q

what do the ethmoidal nerves supply

A

ethmoidal sinuses
lateral wall of nasal cavity
nasal septum

48
Q

what does CN V2 supply

A

substantial sensory supply to the maxilla, upper teeth and gingiva

49
Q

what does CN V2 pass through to enter the pterygopalatine fossa

A

foramen rotundum

50
Q

where is the pterygopalatine fossa found

A

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

51
Q

what is in the medial wal of the pterygopalatine fossa

A

sphenopalatine foramen

52
Q

where is the pterygomaxillary fissure found

A

leads to the pterygopalatine fossa

with spehnopalatine foramen medial to this fossa

53
Q

diagrams

A

some havent got Qs about them so make sure to look at them so you can label them

54
Q

where does CN V2 give sensory supply

A 
middle face
palate
sinuses
nasopharynx
nose
55
Q

what does CN V2 carry

A

○ Parasympathetic

Via pterygopalatine ganglion to lacrimal gland, mucous glands of nose, palate, nasopharynx

56
Q

where does CN V2 supply taste sensation

A

hard and soft palate

57
Q

name branches of CN V2

A 
zygomaticotemporal
zygomaticalfacial
infraorbital
anterior superior alveolar
middle superior alveolar
posterior superior alveolar 
lesser palatine
greater palatine
58
Q

what does the nasopalatine nerve supply

A

nasal cavity

59
Q

what does the greater and lesser palatine nerves supply

A

palate

60
Q

what does the pharyngeal nerve supply

A

nasopharynx

61
Q

what does the alveolar nerve supply

A

upper teeth

62
Q

what does the zygomatic nerve divide into

A

zygomaticotemporal

zygomaticofacial

63
Q

the CN V2 divides to send zygomatic and infraorbital branches where

A

into the orbit
via the inferior orbital fissure
that then emergy through bony foramine to supply the skin
also supplies parts of the nasal cavity, nasopharynz, maxillary sinus, hard and soft palate, upper teeth and gums

64
Q

describe the course and innervation of infraorbital nerve

A

emerges from the infraorbital foramen to supply the lower eyelid, cheek, nose and upper lip

65
Q

describe the course and innervation of the nasopalatine nerve

A

enters the nasal cavity via the sphenopalatine foramen to reach the nasal septum
it then travels inferiorly and passes via the incisive canal to reach the anterior hard palate

66
Q

what can be found on the lateral side of the pterygopalatine fossa

A

think of it as a box

there is an opening inside the nasal cavity on the lateral size of the box called the sphenopalatine foramen and the nasal nerve enters this opening to reach the nasal cavity

67
Q

where does the anterior superior and middle superior nerve come from

A

infraorbital branch

68
Q

where does the posterior superior nerve come from

A

maxilla division

nothing to do with infraorbitla branch

69
Q

where does the palatine branch travel

A 
palatine fossa
palatine canal
separates into greater and lesser
then exit through corresponding foramen 
- greater palatine foramen
- lesser palatine foramen
70
Q

where is the palatine canal found

A

roof of oral cavity (palate)

71
Q

explain the general sensory supply of the upper teeth

A

anterior superior alveolar nerve (CN V2) supplies anteriors = canines and incisors

middle superior alveolar nerve supplies premolars

posterior superior alveolar supplies molars

72
Q

explain the general sensory supply of the upper gingiva

A

nasopalatine nerve supplies palatal gingiva

anterior superior alveolar supplies anterior labial gingiva

middlle superior alveolar supplies the (posterior / premolar) buccal gingival

posterior superior alveolar supplies the buccal gingiva of the molars

greater palatine nerve supplies palatine gingiva from premolars to molars

73
Q

what is the lesser palatine nerve important for

A

sensory supply to the soft palate and uvula

BDS2 - Anatomy (4 decks)

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