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Innervation of the head and neck , part I: Trigeminal nerve

Innervation of the head and neck , part I: Trigeminal nerve. Mark Kozsurek, M.D ., Ph.D. ED II., 25/03/2019. Trigeminal nerve has distinct nuclei for all the three modalities of sensory information : protopathic ( pain , heat ): spinal trigeminal nucleus

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Innervation of the head and neck , part I: Trigeminal nerve

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  1. Innervation of thehead and neck, part I: Trigeminalnerve Mark Kozsurek, M.D., Ph.D. ED II., 25/03/2019

  2. Trigeminalnerve has distinctnucleiforallthethreemodalities of sensoryinformation: • protopathic(pain, heat): spinaltrigeminalnucleus • epicritic(finetouch, vibration, two-pointdiscrimination): chief (orprincipalorpontine) sensorytrigeminalnucleus • proprioceptive(position and movement of joints and muscles): mesencephalictrigeminalnucleus • Must be notedthatthemesencephalictrigeminalnucleus is rather an internalizedsensoryganglionwithpseudounipolarcellsthen a realbrainstemnucleus!

  3. Trigeminal nerve is the sensory nerve of the facial skeleton (including the skin, the mucous membrane of the nasal and oral cavities, the teeth and the structures of the orbit). Trigeminal nerve innervates those muscles developing from the first pharyngeal arch (muscles of mastication; Mylohyoid, anterior belly of Digastric, Tensor tympani and Tensor veli palatini).

  4. „Guestfibres” Sensory branches of the trigeminal reach all the regions of the facial skeleton inside and outside. It is quite „economic” if pre- and/or postganglionic general visceromotor (GVM) as well as special viscerosensory(SVS, taste-sensing) fibres of the facial and glossopharyngeal nerves are joining the intrinsic fibres of the trigeminal nerve. As a result quite a lot trigeminal branches do not exclusively have general somatosensory and branchialmotor fibres as it could be predicted from the brainstem nuclei of the trigeminal nerve!!!

  5. trigeminalbranches FACIAL NERVE zygomatic / lacrimal nerves (lacrimal gland) pterygopalatine ggl. sup. salivatory nucl. (GVM) greater petrosal n. post. nasal branches, nasopalatine nerve, greater and lesser palatine nerves (salivary glands of the palate and the nasal cavity) lingual nerve (submandibular and sublingual glands) chorda tympani submandibular ggl. GLOSSOPHARYNGEAL NERVE otic ggl. inf. salivatory nucl. (GVM) auriculotemporal nerve (parotid gland) tympanic / lesser petrosal n.

  6. trigeminalbranches FACIAL NERVE zygomatic / lacrimal nerves (lacrimal gland) pterygopalatine ggl. sup. salivatory nucl. (GVM) greater petrosal n. post. nasal branches, nasopalatine nerve, greater and lesser palatine nerves (salivary glands of the palate and the nasal cavity taste buds of the soft palate) solitary nucl. (SVS) geniculate ggl. lingual nerve (submandibular and sublingual glands, taste buds of the anterior 2/3 of the tongue) chorda tympani submandibular ggl. GLOSSOPHARYNGEAL NERVE otic ggl. inf. salivatory nucl. (GVM) auriculotemporal nerve (parotid gland) tympanic / lesser petrosal n.

  7. supratrochlear n. lacrimal gland supraorbital n. med. et lat. branches ant. sup. nasal branches supraorbital foramen frontal notch infratrochlear n. zygomatic n. ant. ethm. n. ant. meningeal nerve ant. ethmoid for. long ciliary nerves post. ethmoidal n. post. ethmoid for. lacrimal n. frontal n. nasociliary n. inf. orbital fissure sup. orbital fissure pterygopalatine ggl. in the pterygopalatine fossa tentorial branches trigeminal ggl. greater petrosal n. from CN VII. for. rotundum Ophthalmicnerve (V/1.)

  8. Postganglionic symathetic fibres of the head arise from the superior cervical ganglion, the highermost one within the sympathetic trunk!

  9. Maxillarynerve (V/2.) lacrimal gland middlemeningealnerve zygomaticnerve ORBIT sphenopalatine foramen inf. orbital fissure foramen rotundum infraorbital foramen trigeminal ggl. sup. alveolarbranches infraorbitalnerve * nasalbr. NASAL CAVITY pterygoid canal nasopalatine n. greater petrosal nerve from CN VII. incisive canal greaterpalatine n. pharyngeal and esophagealbranches ORAL CAVITY greater and lesser palatine canals lesserpalatinenerves pharyngeal, palatine, nasal glands palatine taste buds * fibres to the pterygopalatine ganglion

  10. Posterior, middle and anterior superior alveolar nerves constitute the superior alveolar plexus. From this the dental branches enter through the root canals of the superior teeth and innervate the pulp, while gingival branches arrising also from this plexus supply the buccal gingiva. (Palatine gingiva is innervated by the incisive nerve – terminal branch of the nasopalatine –, and the greater palatine nerve.)

  11. mandibular meningeal nerve trigeminal ggl. lesser petrosal nerve from CN IX. foramen ovale foramen spinosum anterior motor group parotid gland chorda tympani from CN VII. otic ggl. buccal branches (!) auriculotemporal nevre branches of the motor group: masseteric nerve deep temporal nerve medial pterygoid nerve lateral pterygoid nerve tensor tympani nerve tensor veli palatini nerve buccal nerves (!) lingual nerve taste buds of tongue submandibular gland sublingual gland submandibular ggl. inf. alveolar nerve mylohyoid nerve (!) Mylohyoid Digastric, ant. belly Mandibularnerve (V/3.)

  12. Homework...

  13. Thankyouforyourattention!

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