Examination of Trigeminal nerve Video

Trigeminal Nerve

Examination of Trigeminal nerve Video

Trigeminal Nerve—Sensory Components

Trigeminal Nerve—Sensory Components
Modality	Nerve Branch(es)	Associated Parasympathetic Ganglion/Nerve	Sensory Region Served
Ophthalmic (V1) Division of Trigeminal Nerve
GSA	Lacrimal	Zygomaticotemporal of V2, delivers post. para. from pterygopalatine ganglion (VII) for lacrimal gland (GVE)	Lacrimal gland, adjacent conjunctiva, lateralaspect of skin of upper eyelid
	Frontal
	Supratrochlear		Conjunctiva and skin of the medial portion of the eye and skin over the forehead
	Supraorbital		Filament to frontal sinus, upper eyelid, forehead, and scalp
	Nasociliary	Ciliary ganglion (III) & possibly post. sym. from carotid plexus (GVE) (Postganglionic sympathetic to dilatator pupillae)
	Long ciliary Posterior ethmoidal		Orb, cornea P.E. foramen—ethmoidal, sphenoidal, frontal sinuses
	Anterior ethmoidal		A.E. foramen—ethmoidal, sphenoidal, frontal sinuses
	Internal nasal		Mucous membranes
	External nasal		Ala and globus of nose
	Infratrochlear		Conjunctiva, eyelid, caruncula, lacrimal sac, side of nose
Maxillary (V2) Division of Trigeminal Nerve
GSA	Zygomatic	Pterygopalatine ganglion (VII) delivers post. para. secretomotor fibers to zyygomatico-temporal nerve for distribution to lacrimal nerve to lacrimal gland (GVE)
	Zygomaticofacial		Skin of the cheek
	Zygomaticotemporal	Delivers secretomotor fibers to lacrimal nerve for lacrimal gland	Skin of temporal region
	Pterygopalatine	These nerves serve as a functional connection to the pterygopalatine ganglion permitting passage of post. para. to zygomatic nerve and sensory fibers from maxillary through ganglion to become other named branches of the maxillary nerve
	Orbital		Periorbita, ethmoid, and sphenoid sinuses
	Greater palatine	Pterygopalatine ganglion (VII) delivers post. para. secretomotor fibers to glands of the nasal cavity, pharynx, and palate (GVE)	Adjacent soft palate, hard palate, gingiva, mucous membranes anteriorly to incisor teeth (communismall cates with nasopalatine)
	Lesser palatine	Delivers secretomotor fibers to glands of soft palate	Soft palate, tonsil, and uvula. (Many of the afferents were communicated from facial nerve)
	Posterior superior nasal branches	Delivers secretomotor fibers to glands of nasal cavity	Nasal cavity supplying mucous memb. of sup. and middle conchae, median nasal septum and ethmoid sinus. Major trunk is nasopalatine
	Nasopalatine	Delivers secretomotor fibers to glands of nasal cavity	Between septum and mucous memb. to incisive canal. Serves anterior palate as far laterally as cuspid. (Communicates with greater palatine nerve)
	Pharyngeal br.	Delivers secretomotor fibers to glands of nasopharynx and spheniod sinus	Enters pharyngeal canal. Serves m. memb. and nasopharynx to auditory tube
	Posterior superior alveolara		Sometimes branched. Passes over max. tuberosity to serve m. memb. of cheek and adjacent gingiva. Enters P.S.A.F to distribute to max. sinus and to roots of 3 max. molars (except mesial buccal root of 1st molar)
	Infraorbital	This nerve is a continuation of the maxillary nerve into the floor of the orbit via the inferior orbital fissure and exiting the skull at the infraorbital foramen
	Middle superior alveolara		Lateral wall of max.sinus, enters mesial buccal root of 1st molar and all roots of premolars
	Anterior superior alveolara		Anterior max. sinus, and roots of anterior teeth, and twigs to floor of nasal cavity serving inferior meatus, and adjacent m. membrane
	Inferior palpebral brs.		Skin and conjunctiva of the lower eyelid
	External nasal brs		Skin about the lateral aspect of the nose
	Superior labial brs		Skin and mucous memb. of the upper lip
Mandibular (V3) Division of Trigeminal Nerve
GSA	Sensory root	Sensory and motor roots join outside the skull (F. ovale) to form a mixed nerve. Some branches are sensory, some motor, whereas some are mixed
	From trunk		Dura and mastoid air cells
	Recurrent meningeal From anterior division Buccal Articular br. to TMJ From: masseteric nerveb From posterior division Lingual	Joined by chorda tympani (VII) delivering taste fibers (SVA) to ant. 2/3 of tongue, and pre. para to submandibular ganglion (VII) delivers post.para from ganglion to sublingual and minor salivary glands of the floor of the mouth (GVE)	Skin of cheek over buccinator muscle passes through buccinator muscle to serve buccal mucosa and adjacent gingiva. (May communi cate with facial nerve for distribution purposes) TMJ Anterior 2/3 of tongue with GSA and delivers SVA (taste) from facial nerve to taste buds in anterior 2/3 of tongue. Post.para from submandibular ganglion pass directly to submandibular gland. Those destined for sublingual gland and other minor glands reenter the lingual and get distributed to the glands.
	Inferior alveolar		Mandibular teeth and supporting tissues via a dental plexus, two terminals—main trunk continues to incisor teeth, other terminal is mental nerve
	Mental		Skin of chin, lower lip including mucous membrane
	Auriculotemporal	Otic ganglion (IX) communicates post. para fibers for distribution to the parotid gland (GVE)	Distribute superficial temporal nerves over skin of temple. Articular brs. to TMJ secretomotor fibers from otic ganglion to parotid gland
GSA indicates general somatic afferent; GVE, general visceral efferent; TMJ, temporomandibular joint. a Posterior, middle, and anterior superior alveolar nerves communicate, forming a dental plexus before innervating the teeth. b The masseteric nerve from the anterior division is a mixed nerve. Its sensory fibers are the articular branches to the TMJ.

Trigeminal Nerve—Motor Components

Trigeminal Nerve—Motor Components
Division of Trigeminal Nerve	Modality	Nerve Branch	Motor to Muscles
Mandibular (V3)	SVE	Sensory and motor roots of the trigeminal nerve exit the foramen ovale and then join to form the trunk of the nerve, which then divides into anterior and posterior divisions. Some nerves are sensory, some motor, and some mixed. Only motor components are presented.
		From Trunk
		Nerve to medial pterygoid	Medial pterygoid
		Nerve to tensor tympani	Tensor tympani
		Nerve to tensor veli palatini	Tensor veli palatini
		From Anterior Division
		Deep temporal nerves (anterior and posterior)	Temporalis
		Lateral pterygoid nerve	Lateral pterygoid
		Masseteric nerve	Masseter
		From Posterior Division
		Mylohyoid nerve	Mylohyoid
		Nerve to anterior digastric	Anterior diagastric
SVE indicates special visceral efferent.

Examination of cranial nerves....ppt