Download Trigeminal Nerve Worksheet #1

Trigeminal Nerve Worksheet #1 – Distribution by Nerve
Dr. Darren Hoffmann
Dental Gross Anatomy, Spring 2013
We have drawn out each of the branches of CN V in lecture and you have an idea now for their basic
pathways. The next step is to incorporate the details of the distribution of those nerves’ sensory
territories into the framework of the pathway. This worksheet is written as an incomplete outline. The
pathway components we’ve already discussed are provided and the distribution for each nerve is left
blank. Your textbook (Liebgott Anatomical Basis of Dentistry) has exactly the right level of detail for
each of the nerve branches, so you can use the textbook to fill in each of these blanks. Page numbers in
the third edition and second edition are provided for each nerve in parentheses (3rd ed., 2nd ed.).
To get you started, here is a condensed outline of the branches of CN V.
V1 (Ophthalmic n.)
1. Frontal n.
Supraorbital n.
Supratrochlear n.
2. Lacrimal n.
3. Nasociliary n.
Short and long ciliary nn.
Posterior ethmoidal n.
Anterior ethmoidal n.
External nasal n.
Infratrochlear n.
V2 (Maxillary n.)
1. Zygomatic n.
Zygomaticofacial n.
Zygomaticotemporal n.
2. Infraorbital n.
Middle superior alveolar n.
Anterior superior alveolar n.
Inferior palpebral n.
Lateral nasal n.
Superior labial n.
3. Posterior superior alveolar n.
4. Nasopalatine n.
5. Posterolateral nasal nn.
6. Pharyngeal n.
7. Greater palatine n.
8. Lesser palatine n.
V3 (Mandibular n.)
1. Buccal n.
2. Lingual n.
3. Inferior alveolar n.
Nerve to mylohyoid n. (motor)
Mental n.
4. Auriculotemporal n.
Articular branch to TMJ
5. Nervus spinosus
Other motor branches
N. to masseter
N. to temporalis
N. to medial pterygoid
N. to lateral pterygoid
N. to tensor tympani
N. to tensor veli palatini
Trigeminal Nerve Worksheets, Distributions – Page 1
V1 (Opthalmic nerve)
Modality:
Enters orbit through Superior orbital fissure of Sphenoid bone
1. Frontal nerve
Runs along roof of orbit (frontal bone)
Supraorbital n. (p. 259 3rd ed. Liebgott, pp. 282-283 2nd ed. Liebgott)
Passes through supraorbital foramen/notch
Supplies:
Supratrochlear n.
Exits orbit medial to supraorbital nerve (not through supraorbital foramen), superior to the
trochlea
Supplies:
2. Lacrimal nerve (p. 259, p. 283)
Runs along lateral orbit to Lacrimal gland
Supplies:
3. Nasociliary nerve
Crosses superior to optic nerve to run along medial orbit
3a. Short ciliary and long ciliary nerves (p. 260-261, p. 283)
Long ciliary branch from nasociliary and pass directly to eyeball
Short ciliary branch from ciliary ganglion to eyeball (also carry parasympathetics from CN IIII
and sympathetics from Superior cervical ganglion)
Both supply:
3b. Posterior ethmoidal nerve (p. 260, p. 283)
Pass through posterior ethmoidal foramen and enter ethmoid bone
Supplies:
3c. Anterior ethmoidal nerve (p. 260, p. 283)
Pass through anterior ethmoidal foramen, then continues to enter nasal cavity
Runs along roof of nasal cavity
Supplies:
*External nasal nerve (p. 260, p. 283)
Termination of Anterior ethmoidal nerve, exits the nasal cavity onto median strip of nose
Supplies:
3d. Infratrochlear nerve (p. 260, p. 283)
Termination of Nasociliary nerve, exits orbit inferior to trochlea
Supplies:
Trigeminal Nerve Worksheets, Distributions – Page 2
V2 (Maxillary nerve)
Modality:
All branches of V2 also carry parasympathetics from CN VII (Greater petrosal n.)
V2 passes through Foramen rotundum to enter Pterygopalatine fossa (PPF)
1. Zygomatic nerve
Enters orbit through Inferior Orbital Fissure
Runs along lateral wall of orbit, sends communicating branch up to Lacrimal n. of V1
Passes through Zygomatic bone (Zygomatic canal)
Canal diverges into two foramina: Zygomaticofacial foramen, Zygomaticotemporal foramen
1a. Zygomaticofacial nerve (p. 293, p. 318)
Supplies:
1b. Zygomaticotemporal nerve (p. 293, p. 318)
Supplies:
2. Infraorbital nerve
Enters orbit through Inferior Orbital Fissure
Runs along the floor of the orbit, runs in Infraorbital groove
Passes into Infraorbital canal of Maxilla and drops off two branches within the bone:
2a. Middle superior alveolar nerve (p. 293-4, p. 319)
Supplies:
Dental branches:
Maxillary sinus branches:
Gingival branches:
2b. Anterior superior alveolar nerve (p. 294, p. 319)
Supplies:
Dental branches:
Maxillary sinus branches:
Gingival branches:
Nasal branches:
Exits maxilla through Infraorbital foramen, splits into three terminal branches:
2c. Inferior palpebral nerve (p. 294, p. 319)
Supplies:
2d. Lateral nasal nerve (p. 294, p. 319)
Supplies:
2e. Superior labial nerve (p. 294, p. 319)
Supplies:
Trigeminal Nerve Worksheets, Distributions – Page 3
3. Posterior Superior Alveolar nerve (p. 293, p. 318)
Enters maxilla through Posterior superior alveolar foramen
Supplies:
Dental branches:
Maxillary sinus branches:
Gingival branches:
4. Nasopalatine nerve (p. 294, p. 322)
Exits PPF medially through Sphenopalatine foramen which takes it into the nasal cavity
Runs anterior-inferiorly along nasal septum
Passes through incisive foramen of maxilla to reach anterior hard palate
Supplies:
5. Posterolateral nasal nerves (p. 295, p. 322)
Exit PPF medially through Sphenopalatine foramen which takes them to nasal cavity
Supplies:
6. Pharyngeal branches (p. 295, p. 322)
Exits PPF medially through Sphenopalatine foramen which takes it into the nasal cavity
Supplies:
7. Greater palatine nerve (p. 294, p. 320)
Exits PPF inferiorly through palatine canal, passes through Greater palatine foramen to reach
hard palate
Supplies:
8. Lesser palatine nerve (p. 294, p. 320-322)
Exits PPF inferiorly through palatine canal, passes through Lesser palatine foramen to reach soft
palate
Supplies:
Trigeminal Nerve Worksheets, Distributions – Page 4
V3 (Mandibular nerve)
Modalities:
Passes through Foramen ovale to enter Infratemporal fossa
1. Buccal n. (p. 286, p. 309)
Passes anteriorly between heads of lateral pterygoid m. to cheek region
Supplies:
2. Lingual n. (p. 286, p. 311)
Passes between medial and lateral pterygoid mm.
Also receives fibers from Chorda tympani (CN VII)
Enters floor of the mouth
Supplies:
3. Inferior Alveolar n. (p. 287, p. 311)
Passes between medial and lateral pterygoid mm.
Drops off one branch before entering mandible:
3a. Nerve to mylohyoid (motor) (p. 287, p. 311)
Supplies:
Enters mandible through Mandibular foramen
Supplies:
Exits mandible through Mental foramen to become:
3b. Mental nerve (p. 287, p. 312)
Supplies:
4. Auriculotemporal n. (p. 286, p. 309)
Passes laterally, posterior to TMJ, then on side of face, just anterior to ear
Carries post-ganglionic parasympathetics from CN IX to Parotid gland
Supplies:
5. Nervus spinosus (p. 286, p. 309)
Passes through foramen spinosum to re-enter skull
Supplies:
Other motor branches: (pp. 285-286, p. 309)
Nerve to Masseter
Nerve to Temporalis
Nerve to Medial pterygoid
Nerve to Lateral pterygoid
Nerve to Tensor Tympani
Nerve to Tensor Veli Palatini
Trigeminal Nerve Worksheets, Distributions – Page 5