CRANIAL NERVES

OLFACTORY SENSORY II OPTIC SENSORY III OCULOMOTOR MOTOR IV TROCHLEAR MOTOR V TRIGEMINAL MIXED VI ABDUCENS MOTOR VII FACIAL MOTOR VIII VESTIBULOCOCHLEAR - SENSORY

Cranial nerves
IX

GLOSSOPHARYNGEAL MIXED X VAGUS MIXED XI ACCESSORY MOTOR XII HYPOGLOSSAL MOTOR

Cranial nerves

TRIGEMINAL NERVE

TRIGEMINAL NERVE
Largest cranial nerve. Nerve of 1st brachial arch. Large sensory component. Small motor component. Branches provide sensory fibres to 4 parasympathetic

ganglia ciliary, pterygopalatine, otic, submandibular. Possesses a special feature of proprioception.

Trigeminal nerve
V1 OPHTHALMIC DIV - SENSORY V2 MAXILLARY DIV

- SENSORY V3 MANDIBULAR DIV - SENSORY, MOTOR

Branches

TRIGEMINAL NERVE NUCLEUS

Motor nucleus
Upper pons. BE. Aids in movement of

the mastication mandibular nerve.

mandible. Innervates muscles of through

Mesencephalic nucleus
Midbrain. GSA. Propriception impulses from

muscles of mastication, & teeth.

f TMJ

Superior sensory nucleus

Upper pons GSA Touch and pressure from skin

mucous membrane region

and of facial

Spinal nucleus
Upper pons to C2 segment

of

spinal cord GSA Pain and temperature of face

TRIGEMINAL GANGLION
Sensory ganglion.
Homologous with dorsal nerve root ganglia of spinal

nerve. Made of pseudo unipolar nerve cells. Cresentric or semilunar in shape with its convexity directed anterolaterally. Lies in trigeminal impression on the anterior surface of the petrous temporal bone. Occupies trigeminal or Meckels cave in duramater.

Pseudo unipolar neuron

Ganglion

Ganglion

Ganglion - Relations
Medial

Internal carotid artery Post part of cavernous sinus Lateral Middle meningeal artery Superior Parahippocampal gyrus Inferior Motor root of Trigeminal N Greater petrosal N Apex of petrous temporal bone F.Lacerum

Ganglion Roots & Branches

Central processes of the ganglion cells form the sensory

root the trigeminal N.

Peripheral process of the ganglion cells form the 3

divisions of trigeminal N namely ophthalmic, maxillary & mandibular.

Small motor root is attached to the pons superomedial to

the sensory root. It passes under the ganglion from its medial to the lateral side & joins the mandibular N at F.Ovale.

Ganglion Blood supply

Internal carotid artery Middle meningeal artery Accessory meningeal artery Meningeal branch of Ascending pharyngeal artery

Trigeminal N Motor root

Small motor root arises separately from the sensory root

originating in the motor nucleus within the pons. It passes under the ganglion from its medial to the lateral side & joins the Mandibular N at F.Ovale.
Motor root unites with the sensory root of the

Mandibular div to form a single nerve trunk just after this exit from the skull.

Motor root innervates

Muscles of mastication Mylohyoid Anterior belly of digastric Tensor tympani Tensor vali palatini

Trigeminal N Sensory root

Composed of central processes of ganglion cells. Sensory root fibres enter the concave portion of the

crescent & the 3 sensory divisions of the trigeminal N exit from the convexity of the ganglion.

Sensory root - Branches

V1 Ophthalmic div travels anteriorly in the lateral

wall of the cavernous sinus to the medial part of SOF through which it exits the skull through the orbit.

V2 Maxillary div travels anteriorly & downward to

exit the cranium through the F.rotundum into the upper portion of the pterygopalatine fossa.

V3 Mandibular div travels almost directly downward

to exit the skull along with the motor root through F.ovale. These two roots intermingle forming one trunk as it enters the infratemporal fossa.

DIVISIONS

Divisions

OPHTHALMIC BRANCH V1
First division of trigeminal nerve
Exclusively sensory Smallest of three divisions Leaves cranium and enters orbit through SOF. Nerve trunk app 2.5 cm long Supplies bulb of the eye, conjunctiva, lacrimal gland,

parts of the mucous membrane of the nose & paranasal sinus & skin of the forehead, eyelids & nose.

V1

Branches of V1
Nasociliary Frontal Lacrimal

Branches of V1

Branches of V1

V1 scheme

V1

Nasociliary N
Travels along the medial border of the orbital roof giving

off branches to the nasal cavity & ending in the skin at the root of the nose. Branches Posterior Ethmoidal - Long Ciliary - Infratrochlear - Comm Br to Ciliary ganglion - Anterior Ethmoidal (PLICA)

Nasociliary N

Nasociliary N

Nasociliary N

Ciliary Ganglion
Peripheral parasympathetic ganglion present in the orbit

between the Optic N and the tendon of the lateral rectus muscle. Topographically related to Nasociliary N but functionally related to Oculomotor N. Does not have secretomotor fibres. Roots sensory, sympathetic & motor. Only motor root fibres relay to supply the intra ocular muscles.

Ciliary Ganglion

Ciliary ganglion - Roots

Sensory root from long ciliary n. Sympathetic root is by the long ciliary n from plexus

around ophthalmic artery. Supplies dilator pupillae & blood vessels of the eyeball. Motor root contains pre ganglionic fibres that begin in the Edinger Westphal nucleus. Post ganglionic fibres pass through the short ciliary nerves & supply the sphincter pupillae & ciliaris muscle.

Ciliary Ganglion

Ciliary Ganglion

Ciliary ganglion
The ganglion gives 10 12 short ciliary nerves

containing post ganglionic fibres which pierce the sclera around the entrance of the optic n to supply the sphincter pupillae for narrowing the size of the pupil & ciliaris muscle for increasing the curvature of anterior surface of the lens required during accomodation of the eye.

Ciliary Ganglion

Ciliary Ganglion

Frontal N
Largest branch of ophthalmic division. Travels anterior in the orbit dividing into 2 branches

Supraorbital sensory to the upper eyelid to the scalp as far back as the parietal bone to the lambdoid suture.

Supratrochlear supplies conjunctiva & skin of the medial aspect of upper eyelid & the skin over the lower & mesial aspects of the forehead.

Frontal N

Frontal N

Frontal N

Lacrimal N
Smallest branch of ophthalmic division. Supplies the lacrimal gland, lateral part of the upper

eyelid & a small adjacent area of skin.

Lacrimal N

Lacrimal N

TRIGEMINAL NEURALGIA

HERPES ZOSTER

Herpes Zoster