Nervous System Pt 3 (Detailed Version)

FULL TRIGEMINAL NERVE FLASHCARDS (V1, V2, V3)

V1 — Ophthalmic Nerve

Trigeminal nerve smallest division

Ophthalmic nerve (V1)

Ophthalmic nerve type

Afferent (sensory)

Ophthalmic nerve supplies sensory innervation to

Conjunctiva, cornea, eyeball, orbit, forehead, ethmoidal and frontal sinuses, part of dura mater, part of nasal cavity and nose

Pathway of ophthalmic nerve to brain

Superior orbital fissure of sphenoid bone

Three major nerves that form ophthalmic nerve

Frontal nerve, lacrimal nerve, nasociliary nerve

The frontal nerve is located

In the orbit

The frontal nerve is composed of a merger of

Supraorbital nerve and supratrochlear nerve

Supraorbital nerve supplies

Forehead and anterior scalp

Supratrochlear nerve supplies

Bridge of nose and medial upper eyelid and forehead

Course of frontal nerve

Along roof of orbit toward superior orbital fissure

Where frontal nerve joins V1

Near the superior orbital fissure with lacrimal and nasociliary nerves

The lacrimal nerve supplies

Lateral upper eyelid, conjunctiva, lacrimal gland

The lacrimal nerve carries

Postganglionic parasympathetic fibers to lacrimal gland

Function of parasympathetic fibers via lacrimal nerve

Production of lacrimal fluid (tears)

Course of lacrimal nerve

Runs posteriorly along lateral roof of orbit

Where lacrimal nerve joins V1

Near superior orbital fissure with frontal and nasociliary nerves

The nasociliary nerve provides

Sensation to eyeball, cornea, nasal cavity, medial eyelids

The nasociliary nerve is a branch of

Ophthalmic nerve (V1)

The nasociliary nerve travels

Across the orbit medially toward nose

The nasociliary nerve gives rise to

Long ciliary nerves, ethmoidal nerves, infratrochlear nerve

The nasociliary nerve passes through

Superior orbital fissure

Long ciliary nerves supply

Sensory to cornea, iris, ciliary body

Long ciliary nerves carry

Sympathetic fibers to dilator pupillae

Corneal reflex afferent limb is carried by

Nasociliary nerve (via long ciliary)

Damage to long ciliary nerves results in

Loss of corneal sensation

Posterior ethmoidal nerve supplies

Ethmoid sinus (posterior cells), sphenoid sinus

Posterior ethmoidal nerve enters

Posterior ethmoidal foramen

Anterior ethmoidal nerve supplies

Anterior ethmoidal air cells, nasal septum (anterior/superior), lateral wall of nasal cavity

Anterior ethmoidal nerve exits

Anterior ethmoidal foramen

Anterior ethmoidal nerve continues as

External nasal nerve

External nasal nerve supplies

Skin of nose (bridge to tip)

Infratrochlear nerve supplies

Medial eyelid skin, side of nose, lacrimal sac, caruncle, medial conjunctiva

Infratrochlear nerve travels

Beneath trochlea of superior oblique

Shingles commonly affects

Ophthalmic nerve (V1)

Shingles symptom pattern

Painful vesicles and/or ulcers follow nerve pathway

V2 — Maxillary Nerve

Maxillary nerve type

Afferent (sensory)

Maxillary nerve carries sensation from

Maxilla, overlying skin, oral mucosa, maxillary sinuses, nasal cavity, palate, nasopharynx, part of dura mater

Maxillary nerve exits skull through

Foramen rotundum

Maxillary nerve is formed in

Pterygopalatine fossa

Largest contributor to maxillary nerve trunk

Infraorbital nerve

Maxillary nerve tributaries include

Zygomatic, ASA, MSA, PSA, greater palatine, lesser palatine, nasopalatine nerves

Zygomatic nerve is formed from

Zygomaticofacial nerve + zygomaticotemporal nerve

Zygomaticofacial nerve supplies

Skin of cheek

Zygomaticofacial nerve pathway

Pierces frontal process of zygomatic bone at zygomaticofacial foramen

Zygomaticotemporal nerve supplies

Skin of temporal region

Zygomaticotemporal nerve pathway

Pierces temporal surface of zygomatic bone at zygomaticotemporal foramen

Infraorbital nerve is formed from

Cutaneous branches of upper lip, medial cheek, lateral nose, lower eyelid

Infraorbital nerve exits

Infraorbital foramen

Location of infraorbital foramen

Inferior to midpoint of infraorbital rim

Anterior superior alveolar (ASA) nerve supplies

Maxillary central incisors, lateral incisors, canines, labial periodontium and gingiva

ASA nerve origin

Dental branches in pulp exiting apical foramina

ASA nerve plexus association

Superior dental plexus

Middle superior alveolar (MSA) nerve supplies

Maxillary premolars, mesiobuccal root of first molar, buccal periodontium and gingiva

MSA nerve origin

Dental, interdental, interradicular branches

MSA nerve plexus association

Superior dental plexus

MSA nerve presence

Sometimes absent

Posterior superior alveolar (PSA) nerve supplies

Maxillary molars, buccal periodontium and gingiva, maxillary sinus mucosa

PSA nerve origin

Dental, interdental, interradicular branches

PSA nerve plexus association

Superior dental plexus

PSA nerve foramina location

Posterior superior on maxillary tuberosity, superior to apex of maxillary second molar

Greater palatine nerve supplies

Posterior hard palate, palatal gingiva of ipsilateral maxillary posterior teeth

Greater palatine nerve exits

Greater palatine foramen

Greater palatine nerve travels

Pterygopalatine canal with greater palatine blood vessels

Lesser palatine nerve supplies

Soft palate, palatine tonsils

Lesser palatine nerve exits

Lesser palatine foramen

Lesser palatine nerve joins

Greater palatine nerve in pterygopalatine canal

Nasopalatine nerve supplies

Anterior hard palate and palatal gingiva canine to canine, nasal septum

Nasopalatine nerve origin

Mucosa palatal to maxillary central incisors

Nasopalatine nerve exits

Sphenopalatine foramen into pterygopalatine fossa

V3 — Mandibular Nerve

Mandibular nerve is a branch of

Trigeminal nerve (CN V)

Mandibular nerve function

Mixed (afferent and efferent)

Mandibular nerve contains

All efferent fibers of trigeminal nerve

Largest trigeminal division

Mandibular nerve (V3)

Mandibular nerve formed from

Small anterior trunk + large posterior trunk

Mandibular nerve forms in

Infratemporal fossa

Mandibular nerve exits skull through

Foramen ovale

Mandibular nerve joins with

V1 and V2 to form trigeminal ganglion

Auriculotemporal Nerve

Supplies

Anterior auricle, external acoustic meatus, temporal scalp

Carries

Postganglionic parasympathetic fibers to parotid gland

Function

Sensory + secretomotor fibers

Path

Posterior to TMJ, wraps around middle meningeal artery

Buccal Nerve

Supplies

Buccal mucosa and gingiva of mandibular molars, cheek skin

Function

Sensory

Path

Between heads of lateral pterygoid

Lingual Nerve

Supplies

Anterior 2/3 of tongue (general sensation), floor of mouth

Carries

Chorda tympani fibers (taste anterior 2/3), parasympathetic fibers to submandibular & sublingual glands

Function

Sensory + taste + parasympathetic

Path

Medial to mandible, inferior to lateral pterygoid

Inferior Alveolar Nerve (IAN)

Supplies

Mandibular teeth, buccal gingiva anterior to mental foramen, chin, lower lip

Gives off

Mylohyoid nerve (motor)

Plexus

Inferior dental plexus

Travels

Mandibular canal