INTRODUCTION

THIS IS THE LARGEST BRANCH OF THREE DIVISION OF THE TRIGEMINAL NERVE. HAS BOTH SENSORY & MOTOR FIBERS. NERVE OF FIRST BRACHIAL ARCH. SUPPLIES TO ALL STRUCTURES DERIVED FROM FIRST BRACHIAL ARCH. STARTS IN MIDDLE CRANIAL FOSSA AND LEAVES CRANIAL CAVITY THROUGH FORAMEN OVALE .

BRANCHES
MAIN TRUNK MENINGIAL BRANCH
NERVE TO MEDIAL PTERYGOID ANTERIOR BRANCH BUCCAL NERVE (S) MASSETERIC (M) DEEP TEMPORAL NERVE (M) NERVE TO LATERAL PTERYGOID (M) P OSTERIOR BRANCH AURICULO TEMPORAL LINGUAL INFERIOR ALVEOLAR

Meningeal Branch OR Nervous Spinosus

ENTERS THE SKULL THROUGH FORAMEN SPINOSUM SUPPLIES THE DURA MATER OF THE MIDDLE CRANIAL FOSSA

NERVE TO MEDIAL PTERYGOID

ARISES CLOSE TO OTIC GANGLION SUPPLIES TO MEDIAL PTERYGOID GIVES A MOTOR ROOT TO OTIC GANGLION WHICH DOES NOT RELAY THERE AND SUPPLIES TO TENSOR VELI PALATINI & TENSOR TYMPANI MUSCLES

BUCCAL NERVE

THE ONLY SENSORY BRANCH OF ANTERIOR DIVISION PASSES BETWEEN THE TWO HEADS OF LATERAL PTERYGOID , RUNS DOWNWARD AND FORWARD.. SUPPLIES SKIN AND MUCOUS MEMBRANE RELATED TO BUCCINATOR AND ALSO TO THE LABIAL ASPECT OF GUMS OF MOLAR & PREMOLAR TEETH

MASSeTERIC NERVE

EMERGES AT UPPER BORDER OF LATERAL PTERYGOID IN FRONT OF TMJ PASSES LATERALLY THROUGH THE MANDIBULAR NOTCH & ENTERS SURFACE OF MASSETER . ALSO SUPPLIES TO TMJ .

DEEP TEMPORAL NERVE

TWO IN NUMBER ANTERIOR & POSTERIOR . PASS BETWEEN SKULL AND LATERAL PTERYGOID AND ENTERS DEEP SURFACE OF TEMPORALIS. THE ANTERIOR ONE IS OFTEN A BRANCH OF BUCCAL NERVE. POSTERIOR MAY ARISE IN COMMON WITH MASSETERIC NERVE.

NERVE TO LATERAL PTERYGOID

ENTERS THE DEEP SURFACE OF MUSCLE. IT MAY BE AN INDEPENDENT BRANCH OR MAY ARISE IN COMMON WITH BUCCAL NERVE .

AURICULO TEMPORAL NERVE

ARISES BY 2 ROOTS WHICH ENCIRCLE THE MIDDLE MENINGEAL ARTERY TO FORM A SINGLE TRUNK. BEHIND THE NECK OF MANDIBLE , IT TURNS UPWARD AND ASCENDS ON TEMPLE BEHIND THE SUPERFICIAL TEMPORAL VESSELS. HAS TWO PART AURICULAR & TEMPORAL AURICULAR PART SUPPLIES SKIN OF TRAGUS , UPPER PART OF PINNA , EXT. ACOUSTIC MEATUS & TYMPANIC MEMBRANE. TEMPORAL PART SUPPLIES THE SKIN OF TEMPLE. IN ADDITION TO THESE , NERVE ALSO SUPPLIES PAROTID GLAND & TMJ.

LINGUAL NERVE
SENSORY TO ANTERIOR 2/3RD OF TONGUE & FLOOR OF MOUTH. FIBERS OF CORDA TYMPANI ARE SECRETOMOTOR TO SUBMANDIBULAR & SUBLINGUAL GLAND AND GUSTATORY TO ANTERIOR 2/3RD OF TONGUE.
COURSE

IT STARTS 1 CM BELOW SKULL AND ENDS ON THE SURFACE OF GENIOGLOSSUS . HERE IT WINDS ROUND SUBMANDIBULAR DUCT & DIVIDES INTO TERMINAL
BRANCHES

. WHILE IN ITS COURSE IT PASSES FROM LOWER BORDER OF LATERAL

PTERYGOID, RAMUS OF MANDIBLE, ATTACHES TO MANDIBLE MEDIAL TO MOLAR TOOTH, RUNS OVER HYOGLOSSUS THEN FINALLY TO GENIOGLOSSUS.

INFERIOR ALVEOLAR NERVE

IT

ENTERS MANDIBULAR FORAMEN & RUNS IN MANDIBULAR CANAL ACCOMPANIED BY INFERIOR ALVEOLAR ARTERY.

BRANCHES :
MYLOHYOID BRANCH CONTAINS ALL THE MOTOR FIBERS OF POSTERIOR DIVISION . IT PIERCES SPHENOMANDIBULAR LIGAMENT , RUNS IN MYLOHYOID GROOVE AND THEN SUPPLIES MYLOHYOID MUSCLE AND ANTERIOR BELLY OF DIGASTRIC. WHILE RUNNING IN MANDIBULAR CANAL IT GIVES OFF BRANCHES TO SUPPLY LOWER TEETH AND GUMS. MENTAL NERVE EMERGES FROM MENTAL FORAMEN AND SUPPLIES TO SKIN OF CHIN AND MUCOUS MEMBRANE OF LOWER LIP.

CLINICAL ANATOMY REFFERED PAIN : IN CASE WITH CANCER OF TONGUE , PAIN RADIATES TO THE EAR & TO TEMPORAL FOSSA , OVER DISTRIBUTION OF AURICULOTEMPORAL NERVE . SOMETIMES LINGUAL NERVE IS DIVIDED TO RELIEVE INTRACTABLE PAIN OF THIS KIND . IN EXTRACTION OF MALPLACED WISDOM TOOTH , CARE MUST BE TAKEN NOT TO INJURE THE LINGUAL NERVE .