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TRIGEMINAL NERVE
Largest cranial nerve
Both motor & sensory
4 nuclei
-main sensory
-spinal
-mesencephalic
-Motor- only for mandibular division
Main sensory-posterior part of pons
-lateral to the motor nucleus
-continues with spinal nucleus
-touch & pressure
Spinal-continues -superiorly with main sensory nucleus
-inferiorly with substantia gelatinosa of the spinal cord
-extent: whole length of medulla oblongata and inferiorly to the C2
segment of spinal cord
-pain & temperature
Mesencephalic-midbrain
-proprioception
Motor-pons,medial to main sensory nucleus
-Supply:- muscles of mastication
-anterior belly of Digastric
-mylohyoid
-tensor veli palatini & tensor tympani

CourseLeaves the posterior aspect of the pons as a small motor root & a large sensory
root
Pass forward out of the posterior cranial fossa
Upper surface of the apex of the petrous temporal bone
In the middle cranial fossa
Sensory root expands to form a trigeminal ganglion in meckels cave
(a pouch of dura mater)
Ophthalmic

maxillary

mandibular

Repeat campaign 2007 A/L

Ophthalmic
Trigeminal ganglion
Lateral wall of cavernous sinus, inferior to Trochlear nerve & superior to maxillary
nerve
Lacrimal
Lateral part of superior

frontal

nasocilliary

lateral part of SOF

middle part of

SOF
orbital fissure(SOF)
divisions
parasym.
sensory
nerve
zygomatico
lacrimal gland
sensory root to
temporal
ganglion

between 2
of occulomotor
supratrochlear

supraorbital
cilliary

Upper eye lid

frontal air sinus

long

cilliary nerves
upper eye lid

-sensory-

cornea,iris
skin up to vertex

-sym-

dilator papillae
post.ethmoidal
infratrochlear ant.ethmoidal

Repeat campaign 2007 A/L

Maxillary
Lateral wall of cavernous sinus most inferiorly
foramen rotundam
pterygopalatine fossa
zygomaticofacial
post.sup.alveolar
zygomatic

IOF

zygomaticotemporal
inferior orbital fissure(IOF)
infraorbital nerve

ant.sup.alveolar

infraorbital foramen
face
sensory root to
pterygopalatine ganglion
greater palatine
pharyngeal branches
lesser palatine
greater
palatine
palatovaginal
canal
canal

lesser palatine
canal

hard palate
nasopharynx
lateral wall of
nose

nasal branches

soft palate

sphenopalatine
foramen

orbital branches

inferior orbital
fissure

lateral wall &

septum of nose

Repeat campaign 2007 A/L

Mandibular
Sensory to buccinator
Nerve of 1st branchial arch.

masseteric

Deep
temporal

TMJ

Motor & sensory roots pass through foramen ovale Tensor veli palatini & Tensor
buccal
Fuse to form main trunk which lies in infratemporal fossa on the tensor veli
palatini,
deep to lateral pterygoid
Meningeal
medial
ANTERIOR
Otic
POSTERIOR
Inf.alveolar
pterygoid ganglion
Lateral
Pterygoid branch

temporalis

Auriculo nerve to medial pterygoid

lingual
temporal
Chorda
otic
tympani

Mandibular foram

2 roots to hyoglossus,deep to myelohyod &

Superficial
Mental nerve

Encircle MM artery

Myelohyiod
branch
winds around the submandibular
duct
Sensory to pinna,EAM & tympanic
parotid
mem.
Secretomotor & sensory

Myelohyoid & post.belly of digas

Sensory &gustatory to ant.2/3 of tongue, Secretomotor to the sublingual & submand

Repeat campaign 2007 A/L

CLINICALS
Clinical testing-Sensory div. by using a cotton & pin
Very little overlap of dermatomes
Motor div. by asking the patient to clench his teeth & feeling for the contracting
masseter.
& asking the patient to move the jaw from side to side
TRIGEMINAL NEURALGIA
Severe stabbing pain of unknown cause involving mainly of V2 & V3
Sensory root is divided preserving fibres of the ophthalmic div. to avoid damage
to the cornea.

Repeat campaign 2007 A/L

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Lingual nerve can be damaged in extracting the malplaced wisdom tooth as the
nerve lies in contact with the medial surface of the 3 rd molar tooth.
OLFACTORY NERVE
Central processes of olfactory hair cells in the olfactory mucosa pass through the
cribriform plate to synapse with mitral cells in olfactory bulb.
Axons of mitral cells pass as olfactory tract to uncus ( 1ry auditory cortex)
FIBRES DO NOT RELAY IN THALAMUS
Bilateral anosmia due to fracture of anterior cranial fossa associated with CSF
rhinorrhoea .

Repeat campaign 2007 A/L