Trigeminal (V) cranial nerve

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Presentation transcript:

Trigeminal (V) cranial nerve (nervus trigeminus)

Contents 1. General description of trigeminal nerve 2. Topography of trigeminal nerve 3. Branches of trigeminal nerve Ophthalmic nerve (nervus ophtalmicus) Maxillary nerve ( nervus maxillaris) Mandibular nerve (nervus mandibularis) 4.Клинические проявления поражения тройничного нерва

Trigeminal nerve (nervus trigeminus) contains motor and sensory fibres Type of fibres Beginning End 1. Motor fibres Neurons contained in the trigeminal nerve motor nucleus (situated in the upper part of the rhomboid fossa (dorsal pons)) Effectors in the innervated muscles 2. Sensory fibres Pseudounipolar neurons contained in the trigeminal ganglion Central processes end in the trigeminal nerve sensory nuclei: mesencephalic; -pontine; -spinal Peripheral processes end in the skin of the innervated regions or in the muscles by extero- and proprioceptors To return to the contents

Location of the trigeminal nerve nuclei Mesencephalic trigeminal nerve nucleus (nucleus mesencephalicus nervi trigemini) is a communication centre of the conduction tract of proprioceptive sensation from the mimic and masticatory muscles, palatine muscles, tensor tympani and suprahyoid muscles Trigeminal ganglion (ganglion trigeminale) Motor trigeminal nerve nucleus (nucleus motorius nervi trigemini) Spinal trigeminal nerve nucleus (nucleus et tractus spinalis nervi trigemini) Is a communication centre of the conduction tract of pain and temperature sensations from the face region Pontine trigeminal nerve nucleus (nucleus pontinus nervi trigemini) is a communication centre of the conduction tract of the tactile sensation from the face region

Location of the trigeminal nerve roots The motor root is formed by axons arising from the neurons situated in the trigeminal nerve motor nucleus The sensory root is formed by the central processes arising from the neurons contained in the trigeminal ganglion

Location of the trigeminal (Gasserian) ganglion (ganglion trigeminale) Trigeminal impression (impressio trigemini)

The place where the trigeminal nerve emerges from the brain Motor root (radix motoria) Sensory root (radix sensoria) Вернуться к содержанию

The divisions of the trigeminal nerve To return to the contents

The divisions of the trigeminal nerve 1. Ophthalmic nerve (nervus ophthalmicus) 2. Maxillary nerve (nervus maxillaris) 3. Mandibular nerve (nervus mandibularis)

The divisions of the trigeminal nerve Ophthalmic nerve Ganglion trigeminale Maxillary nerve Mandibular nerve

Ophthalmic nerve Вернуться к содержанию

(nervus ophthalmicus) Ophthalmic nerve (nervus ophthalmicus) contains only sensory fibres is formed by peripheral processes arising from the neurons contained in the trigeminal ganglion end in the pontine, spinal and mesencephalic nuclei of the trigeminal nerve

Course of the ophthalmic nerve in the cranial cavity Superior orbital fissaure (fissura orbitalis superior) Cavernous sinus (sinus cavernosus) Ophthalmic nerve (nervus ophthalmicus) Trigeminal nerve (ganglion trigeminale)

Branches of the ophthalmic nerve Nasociliary nerve (n. nasociliaris) Frontal nerve (n. frontalis) Lacrimal nerve (n. lacrimalis) 1. Posterior and anterior ethmoidal nerves (nn. ethmoidales posterior et anterior) Supraorbital nerve, n. supraorbitalis (ramus medialis et lateralis) Supratrochlear nerve (n. supratrochlearis) Long cicliary nerves (nn. ciliares longi) 3. Nasal branches (rami nasales) 4. Infratrochlear nerve (n. infratrochlearis) Connecting branch to the ciliary ganglion, (ramus communicans cum ganglion ciliare)

The structures through which the ophthalmic nerve branches pass Supraorbital foramen (foramen supraorbitalis) Anterior ethmoidal foramen (foramen ethmoidale posterius) Posterior ethmoidal foramen (foramen ethmoidale anterius) Superior orbital fissure (fissura orbitalis superior) Frontal notch (incisura frontalis) Pyramid of the temporal bone (pyramis ossis temporalis)

Supraorbital foramen (foramen supraorbitale) To return to initial slide

To return to initial slide Posterior ethmoidal foramen (foramen ethmoidale posterius) To return to initial slide

Anterior ethmoidal foramen (foramen ethmoidale anterius) To return to initial slide

Pyramid of temporal bone (pyramis ossis temporalis) To return to initial slide

To return to initial slide Frontal notch (incisura frontalis) To return to initial slide

Superior orbital fissure (fissura orbitalis superior) To return to initial slide

The course of the ophthalmic nerve`s branches (ganglion trigeminale) n.frontalis Lacrimal gland n.lacrimalis Ophthalmic nerve (n. ophthalmicus) Trigeminal ganglion (ganglion trigeminale) n.nasociliaris

To return to initial slide Ophthalmic nerve (n. ophthalmicus) To return to initial slide

To return to initial slide Trigeminal ganglion (g. trigeminale) To return to initial slide

To return to initial slide Frontal nerve (n.frontalis) To return to initial slide

Lacrimal nerve (n.lacrimalis) To return to initial slide

To return to initial slide Nasociliary nerve (n.nasociliaris) To return to initial slide

The branches of the frontal nerve (n.frontalis) (ganglion trigeminale) r.lateralis n.supraorbitalis n. frontalis n. lacrimalis r.medialis n.supratrochlearis Trigeminal ganglion (ganglion trigeminale) n. nasociliaris

The branches of nasociliary nerve (n.nasociliaris) n.infratrochlearis n.ethmoidalis anterior n. frontalis n.ethmoidalis posterior n. lacrimalis ramus communicans cum ganglion ciliare Trigeminal ganglion (ganglion trigeminale) n.nasociliaris rr. nasales nn.ciliares longi Ciliary ganglion (gandlion ciliare) Transit the ciliary ganglion without interruption and then pass via the short ciliary nerves (nn. ciliares breves) to the iris; the give the sensory innervation to the pupillary muscles and ciliary muscle

Supratrochlear nerve (n. supratrochlearis) provides the sensory innervation to Foreheard Upper eyelid Nasal root To return to initial slide

Supraorbital nerve (n. supraorbitalis) provides the sensory innervation to Temporal and parietal regions Forehead To return to initial slide

Long ciliary nerves (nn. ciliares longi) provides sensation to Fibrous coat Vascular coat To return to initial slide

To return to initial slide Anterior ethmoidal nerve (n. ethmoidalis anterior) provides sensation to Mucosa of the ethmoidal labyrinth Mucosa of the frontal sinus Dorsum of the nose To return to initial slide

To return to initial slide Posterior ethmoidal nerve (n. ethmoidalis posterior) provides sensation to Mucosa of ethmoidal labyrinth Mucosa of the sphenoidal sinus To return to initial slide

Nasal branches of the anterior ethmoidal nerve provide sensation to Mucosa of the anterior part of the nasal cavity To return to initial slide

Lacrimal nerve (n. lacrimalis) To return to initial slide provides sensation to Lacrimal gland To return to initial slide

To return to initial slide Infratrochlear nerve (n. infratrochlearis) provides sensation to Dorsum of the nose and medial angle of eye Lacrimal sac To return to initial slide

Thus, the ophthalmic nerve provides sensory innervation to: Ophthalmic nerve (n. ophthalmicus) - Lacrimal gland - Eyeball - Lacrimal sac Mucosa of frontal and sphenoidal sinuses - Upper eyelid - Forehead, dorsum of nose - Mucosa of ethmoidal labyrinth and anterior part of nasal cavity

the second division of the trigeminal nerve Maxillary nerve (n.maxillaris) - the second division of the trigeminal nerve To return to the contents

Maxillary nerve (nervus maxillaris) contains only sensory fibres is formed by peripheral processes arising from the neurons contained in the trigeminal ganglion end in the pontine, spinal and mesencephalic nuclei of the trigeminal nerve

Branches of maxillary nerve (n. maxillaris) Infraorbital nerve (nervus infraorbitalis) Zygomatic nerve (nervus zygomaticus) Ganglionic branches (rami ganglionares) Inferior palpebral branches (rami palpebrales inferiores) Zygomaticotemporal branch (ramus zygomaticotemporalis) External and internal nasal branches (rami nasales externi et interni) 2. Zygomaticofacial branch (ramus zygomaticofacialis) 3. Communicating branch of lacrimal nerve Anterior, middle and posterior superior alveolar branches (rami alveolares anteriores, medius et posteriores) 4. Superior labial branches (rami labiales superiores)

The structures through which the maxillary nerve branches pass Infraorbital canal (canalis infraorbitalis) Inferior orbital fissure (fissura orbitalis inferior) Foramen rotundum (foramen rotundum) Infraorbital foramen (foramen infraorbitale) Pyramid of temporal bone (pyramis ossis temporalis) Pterygopalatine fossa (fossa pterygopalatina) Zygomaticoorbital foramen (foramen zygomaticoorbitale) Zygomaticotemporal foramen (foramen zygomaticotemporale) Zygomaticofacial foramen (foramen zygomaticofaciale)

Pyramid of temporal bone (pyramis ossis temporalis) To return to initial slide

To return to initial slide Pterygopalatine fossa (fossa pterygopalatina) To return to initial slide

To return to initial slide Zygomaticoorbital foramen (foramen zygomaticoorbitale) To return to initial slide

Zygomaticofacial foramen (foramen zygomaticofaciale) To return to initial slide

Zygomaticotemporal foramen (foramen zygomaticotemporale) To return to initial slide

To return to initial slide Foramen rotundum (foramen rotundum) To return to initial slide

Inferior orbital fissure (fissura orbitalis inferior) To return to initial slide

(foramen infraorbitalе) To return to initial slide Infraorbital foramen (foramen infraorbitalе) To return to initial slide

The course of the maxillary nerve branches (n. maxillaris) n. infraorbitalis ganglion trigeminale rr. ganglionares Pterygopalatine ganglion (ganglion pterygopalatinum) n. zygomaticus

Maxillary nerve (n.maxillaris) To return to initial slide

n.infraorbitalis To return to initial slide

n.zygomaticus To return to initial slide

rr. alveolares superiores The branches of infraorbital nerve (n. infraorbitalis) n. maxillaris n. infraorbitalis rr. palpebrales inferiores ganglion trigeminale rr. nasales externi et interni rr. ganglionares pes anserinus minor ganglion pterygopalatinum n. zygomaticus rr. alveolares superiores anteriores, medius et posteriores plexus dentalis superior  rr. labiales superiores

Anterior superior alveolar branches (rr. alveolares superiores anteriores) innervate Upper incisors, canine teeth, upper gum, mucosa in the maxillary sinus Next slide

Middle superior alveolar branch (r. alveolaris superior medius) innervates Upper premolars, upper gum, mucosa in the maxillary sinus Next slide

Posterior superior alveolar branches (rr. alveolares superiores posteriores) innervate Upper molars, upper gum, mucosa in the maxillary sinus To return to initial slide

Superior labial branches (rr. labiales superiores) innervate Skin and mucosa of upper lip To return to initial slide

Inferior palpebral branches (rr. palpebrales inferiores) innrevate Lower eyelid To return to initial slide

External nasal branches (rr. nasales externi) Internal nasal branches (rr. nasales interni) innervate innervate wing of nose Mucosa in the anterior part of the nasal cavity To return to initial slide

Branches of zygomatic nerve (n. zygomaticus) n. maxillaris n. infraorbitalis Communicating branch of the lacrimal nerve (contains parasympathetic fibres running from pterygopalatine ganglion) n. lacrimalis ganglion trigeminale rr. ganglionares ganglion pterygopalatinum n. zygomaticus  r. zygomaticotemporalis  r. zygomaticofacialis

Zygomaticofacial branch (r. zygomaticofacialis) innervates zygomatic and buccal regions To return to initial slide

Zygomaticotemporal branch (r. zygomaticotemporalis) innervates temporal region and lateral angle of the eye To return to initial slide

Ganglionic branches (rr. ganglionares) n. maxillaris n. infraorbitalis ganglion trigeminale rr. ganglionares ganglion pterygopalatinum n. zygomaticus Pass through pterygopalatine ganglion (ganglion pterygopalatinum) without interruption and then they are included in the following branches arising from the pterygopalatine ganglion (see the next slide):

Branches of the pterygopalatine ganglion Medial superior posterior nasal branches (rami nasales posteriores superiores mediales) Lateral superior posterior nasal branches (rami nasales posteriores superiores laterales) Nasopalatine nerve (nervus nasopalatinus) Greater palatine nerve (nervus palatinus major) Inferior posterior nasal branches (rami nasales posteriores inferiores) Lesser palatine nerves (nervi palatini minores)

The structures through which the parasympathetic fibres arising from the pterygopalatine ganglion pass together with the sensory fibres arising from the maxillary nerve Pterygopalatine ganglion (ganglion pterygopalatinum) Sphenopalatine foramen (foramen sphenopalatinum) Incisive canal (canalis incisivus) Lesser palatine canals (canales palatini minores) Hard palate (palatum durum) Greater palatine canal (canalis palatinus major)

The course of the parasympathetic fibres from the pterygopalatine ganglion passing together with the sensory fibres from the maxillary nerve Medial superior posterior nasal branches (rami nasales posteriores superiores mediales) Pterygopalatine ganglion (ganglion pterygopalatinum) Lateral superior posterior nasal branches (rami nasales posteriores superiores laterales) Inferior posterior nasal branches (rami nasales posteriores inferiores) Lesser palatine nerves (nervi palatini minores) Nasopalatine nerve (nervus nasopalatinus) Greater palatine nerve (nervus palatinus major) To return to initial slide

The regions of innervation by parasympathetic fibres from the pterygopalatine ganglion and sensory fibres from the maxillary nerve Medial superior posterior nasal branches (rami nasales posteriores superiores mediales) Mucosa covering superior part of the nasal septum To return to initial slide

The regions of innervation by parasympathetic fibres from the pterygopalatine ganglion and sensory fibres from the maxillary nerve Lateral superior posterior nasal branches (rami nasales posteriores superiores laterales) Mucosa covering the superior and middle nasal conchae, superior nasal meatus and posterior part of the middle nasal meatus To return to initial slide

The regions of innervation by parasympathetic fibres from the pterygopalatine ganglion and sensory fibres from the maxillary nerve Nasopalatine nerve (nervus nasopalatinus) Mucosa covering the lower part of the nasal septum and anterior part of the hard palate To return to initial slide

The regions of innervation by parasympathetic fibres from the pterygopalatine ganglion and sensory fibres from the maxillary nerve Greater palatine nerve (nervus palatinus major) Mucosa covering the hard and soft palate, upper gum To return to initial slide

Next slide The regions of innervation by parasympathetic fibres from the pterygopalatine ganglion and sensory fibres from the maxillary nerve Inferior posterior nasal branches (rami nasales posteriores inferiores) arising from the greater palatine nerve Mucosa covering the inferior nasal concha, inferior nasal meatus and anterior part of the middle nasal meatus Mucosa covering the floor of the nasal cavity Next slide

The regions of innervation by parasympathetic fibres from the pterygopalatine ganglion and sensory fibres from the maxillary nerve Inferior posterior nasal branches (rami nasales posteriores inferiores) arising from the greater palatine nerve Mucosa in the maxillary sinus To return to initial slide

The regions of innervation by parasympathetic fibres from the pterygopalatine ganglion and sensory fibres from the maxillary nerve Lesser palatine nerves (nervi palatini minoris) Mucosa covering the soft palate and palatine tonsil To return to initial slide

Inferior orbital fissure (fissura orbitalis inferior) To return to initial slide

Sphenopalatine foramen (foramen sphenopalatinum) To return to initial slide

Greater palatine canal (canalis palatinus major) To return to initial slide

Lesser palatine canals (canales palatini minoris) To return to initial slide

Incisive canal (canalis incisivus) To return to initial slide

Hard palate (palatum durum) To return to initial slide

Thus, the maxillary nerve provides sensory innervation to: Maxillary nerve (n. maxillaris) - upper teeth and gum - skin and mucosa of the upper lip - mucosa covering the hard and soft palate zygomatic, buccal and temporal regions of the head - lower eyelid - external nose and mucosa in the nasal cavity - mucosa in the maxillary sinus

the third division of the trigeminal nerve Mandibular nerve n. mandibularis - the third division of the trigeminal nerve To return to the contents

(nervus mandibularis) contains motor and sensory fibres Mandibular nerve (nervus mandibularis) contains motor and sensory fibres Motor fibres Sensory fibres are formed by peripheral processes arising from the neurons contained in the trigeminal ganglion are formed by axons arising from the neurons contained in motor nucleus of the trigeminal nerve end in the pontine, spinal and mesencephalic nuclei of the trigeminal nerve end by effectors in the fibres of the innervated muscles

Branches of mandibular nerve (n. mandibularis) Sensory branches Motor branches 1. Meningeal branch (ramus meningeus) Masseteric nerve (nervus massetericus) Deep temporal nerves (nervi temporales profundi) Buccal nerve (nervus buccalis) 3. Lateral and medial pterygoid nerves (nervi pterygoidei lateralis et medialis) 3. Inferior alveolar nerve (nervus alveolaris inferior) 4. Lingual nerve (nervus lingualis) Nerve to tensor tympani (nervus musculi tensoris tympani) Nerve to tensor veli palatini (nervus musculi tensoris veli palatini) 5. Auriculotemporal nerve (nervus auriculotemporalis)

The structures through which the mandibular nerve passes Foramen spinosum (foramen spinosum) Foramen ovale (foramen ovale) Pyramid of temporal bone (pyramis ossis temporalis) Mental foramen (foramen mentale) Tongue (lingva) Mandibular canal (canalis mandibulae)

To return to initial slide Mandibular canal (canalis mandibulae) To return to initial slide

To return to initial slide Foramen ovale (foramen ovale) To return to initial slide

To return to initial slide Foramen spinosum (foramen spinosum) To return to initial slide

Pyramid of temporal bone (pyramis ossis temporalis) To return to initial slide

To return to initial slide Mental foramen (foramen mentale) To return to initial slide

The course of the madibular nerve branches Ветви n. mandibularis r. meningeus n. mandibularis Trigeminal ganglion n. auriculotemporalis n. buccalis n. lingualis n. alveolaris inferior

Mandibular nerve (nervus mandibularis) To return to initial slide

Buccal nerve (nervus buccalis) Next slide

innervates the buccal region and angle of the mouth Buccal nerve (nervus buccalis) innervates the buccal region and angle of the mouth To return to initial slide

Lingual nerve (nervus lingualis) To return to initial slide

Auriculotemporal nerve (nervus auriculotemporalis) To return to initial slide

Нижний альвеолярный нерв (nervus alveolaris inferior) Вернуться к исходному слайду

Meningeal branch (ramus meningeus) Innervates the dura mater in the middle cranial fossa To return to initial slide

The branches of the inferior alveolar nerve (n. alveolaris inferior) Ветви n. mandibularis The branches of the inferior alveolar nerve (n. alveolaris inferior) r. meningeus n. mandibularis nucleus motorius nervi trigemini ganglion trigeminale n. auriculotemporalis n. buccalis rami labiales inferiores n. lingualis rami dentales et gingivales inferiores plexus dentalis inferior n. alveolaris inferior rami mentales ramus mylohyoideus n. mentalis

Inferior dental and gingival branches (rami dentales et gingivales inferiores) innervate lower teeth and gum To return to initial slide

Mylohyoid nerve (n. mylohyoideus) fully motor nerve innervating Anterior belly of digastric Mylohyoid muscle To return to initial slide

Mental branches (rami mentalis) innervate Mental region To return to initial slide

Нижние губные ветви (rr. labiales inferiores) иннервируют кожу нижней губы Вернуться к исходному слайду

The branches of the lingual nerve (n. lingualis) Ветви n. mandibularis The branches of the lingual nerve (n. lingualis) r. meningeus n. mandibularis ganglion trigeminale n. auriculotemporalis n. buccalis rami isthmi faucium rami linguales n. lingualis rami sublingualis n. alveolaris inferior

To return to initial slide Lingual branches (rami linguales) provide general sensation to the anterior 2/3 of the tongue To return to initial slide

Sublingual branches (rami sublinguales) Give sensory innervation to the sublingual and submandibular salivary glands To return to initial slide

To return to initial slide Branches to isthmus of fauces (rami isthmi faucium) innervate mucosa covering the palatoglossal arch palatine tonsils To return to initial slide

Branches of auriculotemporal nerve (n. auriculotemporalis) Ветви n. mandibularis rami temporales superficiales r. meningeus n. mandibularis ramus communicans cum gamglion oticum ganglion trigeminale Otic ganglion (ganglion oticum) rami meatus acustici externi n. auriculotemporalis rami parotidei rami membranae tympani n. buccalis rami auriculares anteriores Parotid gland n. lingualis n. alveolaris inferior

Branches to tensor tympani (rr. membranae tympani) innervate tympanic membrane To return to initial slide

Nerve to external acoustic meatus (n. meatus acustici externi) innervates skin and cartilage of the auricle To return to initial slide

Superficial temporal branches (rr. temporales superficiales) innervate Temporal region To return to initial slide

Anterior auricular branches (rami auriculares anteriores) innervate skin and cartilage of the auricle To return to initial slide

To return to initial slide Parotid branches (rami parotidei) provide sensory innervation to the parotid gland To return to initial slide

The course of motor branches of the mandibular nerve Motor nucleus of trigeminal nerve (nucleus motorius nervi trigemini) Pons Deep temporal branches (nervi temporales profundi) to the temporal muscle Foramen ovale Nerve to tensor tympani (nervus musculi tensoris tympani) Lateral and medial pterygoid nerves (nervi pterygoidei lateralis et medialis) to the pterygoid muscles Mandibular nerve Nerve to tensor tympani (nervus musculi tensoris veli palatini) Masseteric nerve (nervus massetericus) to the masseter

Nerve to tensor tympani (n. musculi tensoris tympani) innervates tensor tympani muscle To return to initial slide

Thus, the mandibular nerve provides sensory innervation to: - lower teeth and gums Mandibular nerve (n. mandibularis) - lower lip - tongue and cheek mental region - submandibular and sublingual glands - masticatory muscles - tensor tympani and tensor veli palatini - mylohyoid and anterior belly of the digastric - temporomandibular joint

Cutaneous innervation of head Branches of ophthalmic nerve (n. ophthalmicus) Branches of maxillary nerve (n. maxillaris) Branches of mandibular nerve (n. mandibularis) Next slide

Cutaneous innervation of head and neck Zones innervated by trigeminal nerve Zones innervated by spinal nerves

trigeminal nerve injury Clinical symptoms of trigeminal nerve injury To return to contents

Levels of trigeminal nerve injury Motor part Sensory part Nucleus Nucleus Peripheral part Peripheral part Root Root

Поражение двигательных волокон тройничного нерва периферический парез или паралич жевательных мышц асимметрия контуров мышц асимметрия овала лица асимметрия напряжения мышц на больной и здоровой сторонах при двустороннем поражении жевательных мышц может наступить отвисание нижней челюсти снижение нижнечелюстного рефлекса Вернуться к исходному слайду

The damage to the sensory branches of the trigeminal nerve the decrease of sensation in the innervated zones paroxysmal pain in the projection of the trigeminal nerve branches the decrease or loss of corneal reflex (in damage to the ophthalmic nerve branches) To return to initial slide

The damage to the motor branches of the trigeminal nerve peripheral paresis or paralysis of the masticatory muscles deviation of the lower jaw to the injured side due to the prevalence of the functioning of the pterygoid muscles on the other side To return to initial slide

The damage to the sensory root of the trigeminal nerve Paresthesia and disorder of sensation in the zones innervated by all the trigeminal nerve divisions The decrease or loss of the corneal reflex To return to initial slide

The symptoms of the damage to the sensory trigeminal nerve nuclei The spinal nucleus injury dissociated disorder of pain and temperature sensation in the face in circular zones of Solder. At the same time the tactile and deep sensation are not disordered the damage to the upper part of the spinal nucleus leads to the disorder of pain and temperature sensation in the inner circular zone around the mouth the damage to the caudal part of the spinal nucleus leads to the disorder of pain and temperature sensation in the outer circular zone, lateral region of the face nucleus spinalis nervi trigemini Next slide

The symptoms of the damage to the sensory trigeminal nerve nuclei The pontine nucleus injury the loss of the tactile sensation in the side of the injury nucleus pontinus nervi trigemini Next slide

The symptoms of the damage to the sensory trigeminal nerve nuclei The mesencephalic nucleus injury the loss of deep sensation in the side of injury nucleus mesencephalicus nervi trigemini To return to initial slide

The symptoms of the damage to the motor trigeminal nerve nucleus peripheral paresis of masticatory muscles in the side of injury - atrophy of masticatory muscles - the inability to compress the jaws on the side of injury - during opening the mouth, the lower jaw deviates to the side of injury - the decrease or loss of the mandibular reflex nucleus mesencephalicus nervi trigemini To return to initial slide

Zones of Solder are circular cutaneous zones in the face, whose pain and temperature sensation depends on certain parts of the spinal trigeminal nerve nucleus The I zone is innervated from the upper part of the spinal nucleus The II zone is innervated from the middle part of the spinal nucleus The III zone is innervated from the lower part of the spinal nucleus