Trigeminal nerve

Dr Mohd Imran ANATOMY JNMC AMU 1

 Trigeminal nerve (V)
• Mixed nerve – both motor and sensory fibres
• but predominantly it is sensory
1. Ophthalmic
2. Maxillary
3. Mandibular
• (L. trigeminus = triplet)
• Motor nerve to the muscles of mastication
and several small muscles
• Principal sensory nerve of head and face
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 Trigeminal nerve (V)

• Largest cranial nerve

• Its sensory ganglion

– largest in the body
– located within the cranial cavity

(cf. all the sensory ganglia are located

outside the cranial cavity)
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 Functional components

1. Special Visceral Efferent (SVE) fibres

2. General Somatic Afferent (GSA) fibres

a) Exteroceptive sensations

b) Proprioceptive sensations

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Special Visceral Efferent (SVE) fibres

• Motor nucleus
1st pharyngeal arch mesoderm derivative:

1. Muscles of Mastication

2. Tensor Tympani

3. Tensor Palati

4. Anterior belly of Digastric

5. Mylohyoid
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General Somatic Afferent (GSA) fibres

• EXTEROCEPTIVE sensations from skin of the

face and mucous membrane of the mouth and nose

• Cell bodies of neurons lie in trigeminal ganglion

• Central processes of these neurons bifurcate

• Ascending branches end in chief sensory nucleus
• Descending branches end in the spinal nucleus

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General Somatic Afferent (GSA) fibres

PROPRIOCEPTIVE sensations from:

• Muscles of mastication
• Temporomandibular joint
• Teeth
• Tongue

 Cell bodies lie in Mesencephalic nucleus

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 Trigeminal nerve
• arises by 2 roots-
1. smaller medial motor root
2. larger lateral sensory root

• from the ventrolateral aspect of pons

• at its junction with middle cerebellar
peduncle

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 Ophthalmic N.
Frontal Nasociliary

i. Supraorbital i. Anterior Ethmoidal

ii. Supratrochlear ii. Infratrochlear

iii. Posterior Ethmoidal

Lacrimal iv. Long Ciliary

v. N to Ciliary Ganglion

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 Maxillary N.
1. Meningeal Branch
2. Ganglionic Branches

3. Zygomatic Nerve

4. Posterior Superior Alveolar N

5. Middle Superior Alveolar N
6. Anterior Superior Alveolar N

7. Infraorbital Nerve
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 Mandibular N.
Trunk: 1. Meningeal Branch (Nervus Spinosus)
2. Nerve to Medial Pterygoid

Anterior Division: 1. Nerve to Lateral Pterygoid

2. Deep Temporal Nerves
3. Nerve to Masseter
4. Buccal Nerve

Posterior Division:1. Auriculotemporal Nerve

2. Inferior Alveolar Nerve
(Inferior Dental)
3. Lingual Nerve
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 Lesion of trigeminal n.
• Loss of general sensation from face and mucous
membrane of oral and nasal cavities

• Loss of corneal reflex

• Flaccid paralyses of muscles of mastication

• Jaw deviates to the side of lesion due to
unopposed action of lateral pterygoid muscle

• Hypoacusis (partial deafness to low pitched

sounds due to paralysis of tensor tympani) 24
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 Trigeminal neuralgia
• Paroxysmal severe pain
• of sudden onset and short duration

• in the area of cutaneous distribution of

one or more of the divisions of the
trigeminal n

• usually affecting the 2nd and 3rd divisions

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Inferior alveolar nerve block
• Most common nerve block performed in
dentistry to carry out dental procedures on
the mandibular teeth
• The anesthetic agent is injected slightly
superior to the entry of inferior alveolar
nerve into the mandibular foramen being
overhung by the lingula
• If needle is inserted too far posteriorly, it
may enter the parotid gland and damage the
facial nerve leading to transient facial palsy

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 Lingual nerve
• The lingual nerve is at great risk (10%)
during surgical removal of the impacted
3rd molar teeth
• The nerve is also at risk during surgical
removal of the submandibular salivary
gland, during which the submandibular
duct must be dissected out carefully
from the nerve

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