N.V

The Motor Portion

• Jaras UMN dari scra primer korteks motorik kontralateral, meskipun bgitu, nucl N.V mnrima bilateral.

• Muskulus mastikasi: masseter, temporalis, medial dan lateral pterygoids

• the masseter may be the most powerful muscle in the body

• Radiks motornya jg the mylohyoid, anterior belly of the digastric, tensor veli palatini, and tensor tympani muscles

The Sensory Portion

• the largest ganglion in the peripheral nervous system ganglion gaseri (unit sensorik)

• The sensory root can be compressed by vascular loops, causing trigeminal neuralgia (TN).

• Neuron sensori pd ggl gaseri terbagi dua – fine discriminative touch– primarily pain and temperature

• 3 nukleus sensori– Nucl mesencephalik– Nucl principalis raba ringan dan tekanan – nucl spinal track pain dan suhu

• Onion skin (balaclava helmet distribution) perioral to periaurikular region– Sering pd neurosipilis, siringobulbi

Examination of the Motor Functions

• Otot mastikasi– Buka mulut deviasi atau tidak– Gerak kiri kanan? parese: tdk bisadigerakan

kontralateral– Gigit tongue spatel dgn molar dibandingkan

kedua sisi(saat spatel ditarik keluar)• Parese bilateral (dangling jaw) mgkin pd

motor neuron disease, neuromuscular transmission disorder or a myopathy.

Examination of the Sensory Functions

• Raba, nyeri dan terkadan suhu diperiksa dgn cara yg sama seperti di tubuh lain

• Dibandingkan di setiap divisi trigeminal, and the perioral region compared to the posterior face

• Proprioception cannot be adequately tested, but one can test for extinction and the ability to identify figures written on the skin

• 3 kegiatan saat evaluasi: – determining whether sensory loss is organic or

nonorganic– determining which modalities are involved– defining the distribution

• Cont non organik – Batas area abnormal adalah batas rambut– Rahan bawah ikut dikatakan abnormal– The corneal and sternutatory reflexes (see below)

should be normal – Splitting of vibration along the midline is reputedly a

nonorganic sign

Examination of the Reflexes• The corneal, sternutatory, and jaw reflexes– The Jaw, Masseter, or Mandibular Reflex (dgn

index or thumb, ketok pake hamer)• Bedain hiperreflek pd cervical lesi dgn hiperreflek

general pseudobulbar palsy (UMN n.V) ato ALS

– The Corneal Reflex (N.V1) with a wisp of cotton or tissue• Upper kornea, arah dari bawah ato blind spot (bukan ke

sklera !)• Kalo ada luka, kudu diganti kapas/tisu nya• Stroke supratentorial kotralateral, lesi di lesi batang

otak hingga cervical (C3-4) ipsilateral, atau kontak lens

– The Sternutatory (Nasal, Sneeze) Reflex (N.V1)• Stimulation of the nasal mucous membrane with

cotton, a spear of tissue, or similar objects • wrinkling of the nose, eye closure and often a forceful

exhalation• cross-check on the corneal reflex• Photosternutatory ?