Trigeminal nerve Domina Petric, MD

Trigeminal nerve has two roots: Introduction radix sensoria (larger part) radix motoria Trigeminal nerve has two roots:

Radix sensoria (sensorineural root) General sensation (pain, temperature, touch): face scalp teeth oral and nasal cavity dura mater

Radix sensoria (sensorineural root) Proprioceptive sensation from the muscles innervated by motor root and from temporomandibular joint.

Trigeminal nerve nuclei nucleus motorius n. trigemini (special visceral efferent fibres) nucleus principalis n. trigemini (general somatic afferent fibres) nucleus spinalis n. trigemini (general somatic afferent fibres) nucleus mesencephalicus n. trigemini (general somatic afferent)

Ganglion trigeminale (ganglion semilunare) Cavum trigeminale Ganglion trigeminale (ganglion semilunare) V1 V2 V3

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V1: n. ophtalmicus The smallest part of the trigeminal nerve. It has only sensation fibres for: eye socket, lacrimal gland eye conjunctiva, part of nasal mucosa nose skin, eyelids, forehead and part of the scalp

V1 branches V1: n. ophtalmicus n. lacrimalis (communicates with zygomatical nerve) n. frontalis divides on n. supratrochlearis and n. supraorbitalis n. nasociliaris divides on r. communicans cum ganglio ciliari, n. ethmoidalis posterior et anteriror, n. infratrochlearis

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V2: n. maxillaris Sensory fibres only! It has branches in the cranial cavity and pterygopalatinal fossa: r. meningeus (innervates dura mater of the middle cranial fossa) rr. ganglionares ad ganglion pterygopalatinum (sensory root for pterygopalatinal ganglion, radix sensoria ganglii pterygopalatini )

Ganglion pterygopalatinum The largest peripheral parasympathetic ganglion. It is located in fossa pterygopalatina near the foramen sphenopalatinum. It has three roots: parasympathetic, sympathetic and sensory root.

V2: n. maxillaris Other branches are: in the pterygopalatinal fossa n. zygomaticus, rr. alveolares superiores posteriores in the infraorbital canal r. alveolaris superior medius, rr. alveolares superiores anteriores on the face n. infraorbitalis

V2: n. maxillaris Sensory innervation of: cheek, lower eyelid, lateral part of the nose upper lip, teeth and maxillary mucosa sphenoidal and maxillary sinus posterior ethmoidal cells

V2: n. maxillaris upper and middle nasal concha palate and palatine tonsil pharyngeal roof dura mater of the middle cranial fossa

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It has two trunks: anterior and posterior. V3: n. mandibularis The largest branch of the trigeminal nerve with sensory and motor fibres. It has two trunks: anterior and posterior.

V3: n. mandibularis Before it divides into two trunks, mandibular nerve gives some branches: r. meningeus (sensory innervation of middle cranial fossa dura mater and mastoidal cells)

V3: n. mandibularis n. pterygoideus medialis (motor innervation of medial pterygoideal muscle) rr. ganglionares ad ganglion oticum (sensory fibres that create radix sensoria ganglii otici )

Anterior trunk of the V3 n. buccalis (sensory innervation of the cheek mucosa and skin) n. massetericus (motor innervation of musculus masseter and temporomandibular joint) nn. temporales profundi (motor innervation of m. temporalis) n. pterygoideus lateralis (motor innervation of lateral pterygoideal muscle)

Posterior trunk of the V3 n. auriculotemporalis n. lingualis n. alveolaris inferior

N. auriculotemporalis innervates glandula parotis (parasympathetic fibres for parotid gland) n. meatus acustici externi r. membranae tympani nn. auriculares anteriores rr. temporales superficiales rr. parotidei rr. communicantes cum nervo faciale sensory fibres

N. lingualis rr. isthmi faucium n. sublingualis rr. linguales rr. ganglionares ad ganglion submandibulare (radix sensoria ganglii submandibularis) rr. ganglionares ad ganglion sublinguale (radix sensoria ganglii sublingualis) sensory fibres

N. alveolaris inferior Sensory fibres are: n. mentalis (rr. mentales, rr. labiales, rr. gingivales) rr. dentales et gingivales inferiores (plexus dentalis inferior) Motor branch is N. mylohyoideus: motor innervation for mylohyoideal muscle and anterior belly of digastric muscle.

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Literature: Anatomymcqs.com Krmpotić-Nemanić J. Marušić A. Anatomija čovjeka, Medicinska naklada, Zagreb, 2007.