BRANCHES OF TRIGEMINAL NERVE

Julius King Kwedhi

3 BRANCHES OF N. TRIGEMINUS

• Nervus OphthalmicusSensory

• Nervus MaxillarisSensory

• Nervus MandibularisSensory & Motor

Nervus Ophtalmicus

Nervus Maxillaris

Nervus Mandibularis

Nervus Ophthalamicus

• Passes through lateral wall of sinus cavernosus through fissura orbitalis superior (together with n. abducens, trochlearis and occulomotorius)

• Before entering orbit, at level of sella turcica, it receives communicating branches from parietal sympathetic plexus of internal carotid artery, and gives off tentorial nerve.

• Recurrent tentorial branch supplies the tentorium cerebelli and supratentorial flax cerebri

Structures Near To N. Ophthalmicus

• Medially: N. Trochlearis• Laterally: N. Abducens• Superior-lateral: N. Occulomotor

Nervus Ophtalmicus

Branches of N. Ophthalmicus

o Inside orbit N. Frontalis

N. Supraorbitalis rami lateralis et medialis N. Supratrochlearis

N. Lacrimalis Communicates with n. zygomaticus (from n. maxillaris)

N. Nasociliaris To ganglion ciliare N. Ciliaris longus N. Ethmoidale posteriores N. Ethmoidale anteriores N. Ethmoidale posteriores & N. Ethmoidale anteriores N. nasalis

distalis latetrale et mediale N. Infratrochlearis N. Tentorii

Nervus Frontalis• Course: It runs through margo supraorbitalis, on upper

surface of musculus levator palpabrae superiores, & divides:a) N. Supraorbitalis rami lateralis et medialis

Innervates skin of forehead (frontal region) Arises from orbital through supraorbital notch & ends

in skin of forehead

b) N. Supratrochlearis Innervates skin of root of the nose, lower part of

forehead, medially of the eye & skin of conjunctiva Musculus Frontalis (proprios=ceptor)

N. Lacrimalis

Course: Passes between lateral and superior rectus muscles, & lies next to lateral angle of eye (outside muscular comb) glandular lacrimalis

Communicates with n. zygomaticus a branch of N. Maxillaris

Nervus Nasociliaris

• Course: Passes inside orbit above nervus opticus, between the nervus rectus superior and superior rectus muscle, & goes further between oblique & medial rectus muscle.

• Passes into muscular comb, crosses n. opticus medially of the eyes, and then gives off 6 branches

6 Branches of N. Nasociliaris1. Branch(es) to ganglion ciliare2. N. Ciliaris longus

Posterior surface of eyes: Passes along upper surface of n. as 2/3rd of its branches to posterior

surface of eyes

3. N. Ethmoidale posterior4. N. Ethmoidale anterior

the two nerves gothrough canalis orbitoethmoidale anterior and posterior to cellulae ethmoidale n. nasalis distalis (laterallis et medialis)

Innervates cellular ethmoidale ant et post,medial menengeal into fossa cranii and anterior region of nasal cavity

N. Nasociliaris (cont)

5. N. Infratrochlearis : Couse: Beneath m. oblique superior bridge of

nose, lacrimal sac, upper eyelid6. Rami tentorii

Nervus Maxillaris

3 Braches of Nervus Maxillaris

• Exists through foramen rotundum fossa pterygopalatina, and divides into:1. N. Infraorbitalis

Enters through fissura orbitalis inferior sulcus infraorbitalis canalis infraorbitalis foramen infraorbitalis and branches into:

a) N. Alveolaris superior posterior (molar) through fissura pterygopalatina

b) N. alveolaris superior anterior (in cisivus) Canalis alveolaris sup. Post, ant, & medial

c) N. Alveolaris superior medius (premolar) In tuber maxillare

a, b & c nerves branch off at level of sulcus infraorbitale

d) At infraorbitalis foramen: Infraorbital nerve palpebral inferiores, nasal

extensor, labialis superiores Infraorbital nerge gives branch to:

i. lower eyelids, ii. nasal branches, iii. Superior labial branches

Course: Pass through nasal muscle to skin of nostril in form of olfactory nasal branches

Innervates: o palpebra inferioreso Ala of nasus externuso Superior lipo Medial surface of bucca

2nd Branch of Nervus Maxillaris

2. Nervus Zygomaticus Pterygopalatina fossa enters fissura orbitalis superior Branches:

a. N. zygomaticolacrimalis (vegetative)• To lacrimal gland

b. N. Zygomaticus facialis (sensory)• From foramen zygomaticofacialis• Innervates:

upper part of cheek laterally lower eyelid (in foramen zygomaticoorbitalis)

c. N. Zygomaticotemporalis (sensory)• From lateral wall of orbit to anterior part of os zygomaticus, via foramen

zygomaticotemporalis, to skin of temporal & lateral of forehead)

3rd Branch of Nervus Maxillaris

3. Ganglion Pterygopalatinum Is a branch of N. Facialis (VII), not ANS nerve)

Found in pterygopalatine fossa medialis & below maxillary nerve

Enters as n. petrosus major, & it also receives from nerve of canalis pterygoideus

Has 3 branches:a. N. Nasalis posterior, superior, lateral & medial branches

o Goes through foramen sphenopalatinum cavum nasaleo Gives off superior, medial branches of sphenopalatine nerveo Innervates mucosa of nasal cavity, fornix of pharynx, wall of

choannae & sinus of sphenoid bone

Ganglion Pterygopalatinum Branches (Cont…)

b. N. Palatinus majoro Goes from canalis palatinum majoy palatum durum

c. N. Palatinus minoro Goes from foramen palatinum minor palatum molle

Nervus Mandibularis (mixed nerve)

Motor Branches of N. Mandibularis

• Project from nucleus motorius nervi trigemini and innervates:i. Masticatory muscle

Nerve projects to: pterygoid lateralis & medialis, temporalis profundus, & masseter

ii. 2 tensor muscles Musculus tensor vellu palatine Musculus tubarius Musculus tensor tympani

i. Musculus mylohyoideus & anterior belly of musculus digastricus

Sensory Branches of N. Mandibularis

i. N. buccalis Runs between n. pterygoideus medialis &

lateralis forms proprioceptor of m. buccinator and projects further to skin of mouth angle region

Innervates mucosa of bucca

Sensory Branches of N. Mandibularis

ii. N. lingualis (ganglion chorda tympani) Vegetative & sensory nerve Runs between pterygoid medialis & lateralis to:

o Glandula submadibular (superiorly), &o Glandula sublingualis (region sublingualis)

Also gives off ganglion branch to submandibular ganglion (parasympathetic)

Submandibular ganglion receives fibers from nervus lingualis in chorda tympani (n. facialis) & carry info from anterior 2/3rd of tongue, (responsible for sweet, sour & salty taste)

Sensory Branches of N. Mandibularis

iii. Nervus albeolaris inferior (sensory & motor neuron) Runs between m. pterygoid lateralis & medialis canalis

mandibularis (dental branch of teeth)o Innervates mylohyoideus muscle (motor)

Gives off branches to m. mylohyoideus & anterior belly of m. digastricus

Goes on to pass through foramen mentalis & gives off n. mentalis

o N. mentalis innervates skin of chin & lower lip In canal mandibularis, gives off branches that form

plexus dentalis inferior: Gives off inferior dental branch teeth (sensory branch) Gives off inferior gingival branch gums

iv. N. auriculotemporalis (sensory) 2 branches:

a. Auricular branchb. Temporal branch

Goes upward as a single trunk, & then passes through parotid salivary gland & then gives off 2 branches:

I. Auricular branches: goes to the mandibular joint & neck of mandibleII. Parotid branches: goes to glandula salivatorius paroticus

o Contain postganglionic parasympathetic brancho From ganglion oticum projects parasympathetic branches:

1. Nervus auricularis anterior meatus acousticus exterior• Innervates tympanic membrane & walls of external auditory

meatus2. Menengieus (part of auriculotemporalis)

• Enters beneath foramen oval, through foramen spinosum of arteria meningea media & divides:

a. Ramus anterior dura materb. Ramus posterior to fisura petrosquamousa to innervate

mucosa of processus masoideus os temporalis

The END

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