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TRIGEMINAL NERVE DR. GALLATZ KATALIN

TRIGEMINAL NERVE DR. GALLATZ KATALIN. I. N. ophtalmicus II. N. opticus III. N. occulomotorius IV. N. trochlearis V. Trigeminal nerve VI. N. abducens VII. Facial nerve VIII. N. vestibulocochlearis IX. Glossopharyngeal nerve X. N. vagus XI. N. accessorius

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TRIGEMINAL NERVE DR. GALLATZ KATALIN

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  1. TRIGEMINAL NERVE DR. GALLATZ KATALIN

  2. I. N. ophtalmicus II. N. opticus III. N. occulomotorius IV. N. trochlearis V. Trigeminalnerve VI. N. abducens VII. Facialnerve VIII. N. vestibulocochlearis IX. Glossopharyngealnerve X. N. vagus XI. N. accessorius XII. N. hypoglossus CRANIAL NERVES

  3. DIVISIONS OF THE TRIGEMINAL NERVE

  4. Nuclei of thetrigeminalnerve nucleus of spinaltrigeminaltract protophatic principalsensorynucleus epicritic mesencephalicnucleus proprioceptív motor nucleus of V. nerve specialvisceromotoror branchialmotor

  5. Nuclei of thetrigeminalnerve SOMATOSENSORY nucleus of spinaltrigeminaltract prothopathic principalsensorynucleus epicritic mesencephalicnucleus proprioceptív SPECIAL VISCEROMOTOR OR BRANCHIALMOTOR motor nucleus of V. nerve

  6. Spinaltrigemininalnucleus 1. Caudal part 2. Interpolar part 3. Oral part

  7. Trigeminalnerveinnervates theskin of thescalp and frontalregion, V/1 themucousmembrane of theoralcavity, V/2 themucousmembrane of thenasalcavity, V/1, V/2 and paranasalsinuses, V/1, V/2 theeye, V/1 theteeth and gingiva, V/2, V/3 thedura mater, V/1, V/2, V/3 theanteriorwall of theext.acusticmeatus, V/3 theanterior part of thetympanicmembrane, V/3 thetemporomandibularjoint, V/3 thesalivaryglands and lacrimalgland, V/1, V/2, V/3 theanterior 2/3 of thetongue V/3 withsensoryfibers themuscles of mastication, thetensorvelipalatini, thetensortympani, theanteriorbelly of digastric, themylohyoid m. with motor fibers V/3

  8. Quality of thenervefibersinthetrigeminalnerve • General somatosensory (or GSA) • (pressure, vibration, discriminativesensation, pain, heatsensation) • 2. Branchiomotororspecialvisceromotor (SVM, SVE) • (innervation of themasticatorymuscles) • „Guestfibres”: • 3. General visceromotor • (GVM or GVE) / parasympathetic, • secretomotor • 4. Specialviscerosensory (or SVA) • Taste Superior (VII.) and inferiorsalivatory Nucleus (IX.) Nucleus of solitarytract (VII.)

  9. OPHTHALMIC NERVE V/1

  10. Branches of theophthalmicnerve tentorialbranch frontalnerve supratrochlear n. medialsupraorbital n. lateralsupraorbitaln.n. lacrimalnerve communicatingbranch withzygomaticnerve nasociliarynerve infratrochlear n. anteriorethmoidal n. posteriorethmoidal n. longciliary n.

  11. Branches of theophthalmicnerve tentorialbranch frontalnerve supratrochlear n. medialsupraorbital n. lateralsupraorbitaln. lacrimalnerve communicatingbranch withzygomaticnerve nasociliarynerve infratrochlear n. anteriorethmoidal n. posteriorethmoidal n. longciliary n.

  12. V/2 maxillarynerve

  13. Maxillarynerveinnervates the mucous membrane of the oral cavity, the post. part of mucous membrane of the nasal cavity, and paranasal sinuses (except the sphenoid) the upper teeth and gingiva, the dura mater, the nasal and palatine glands the inferior eyelid the externaal surface of the nose the superior lipV/3 withsomatosensoryfibers

  14. Branches of themaxillarynerve - Meningeal branch (1) - Zygomatic nerve (6) - Pterygopalatine nerves - Infraorbital nerve (17)

  15. Infraorbitalnerve - sup., post.alveolarnerves - sup., middlealveolarnerves -sup., ant.alveolarnerves Terminal branches - inf.palpebralisbranch - externalnasalbranch - Superiorlabialbranch

  16. Zygomaticnerve • Communicatingbranchwith • thelacrimalnerve -Zygomaticoorbital nerve -Zygomaticofacial nerve - Zygomaticotemporal nerve

  17. Pterygopalatinenerves - post., sup. nasal nerves medial rami lateral rami - post., inf. nasal nerves - greater palatine nerve -lesser palatine nerves

  18. - post., sup. nasal nerves NASOPALATINE (SCARPA’ nerve)

  19. MANDIBULAR NERVE (V/3)

  20. BRANCHES OF THE MANDIBULAR NERVE 1 1. meningeal branch 2. MOTOR ROOT massetericnerve deeptemporalnerves lateralpterygoidnerve medialpterygoidnerve nervefortensortympani nervefortensorvelipalatini buccalnerve (onlysensorybranch of the motor root)

  21. BRANCHES OF THE MANDIBULAR NERVE

  22. 3. SENSORY ROOT Auriculotemporal nerve - anterior auricular branch - external acustic branch - branch for the tympanic membr. - articular branches (to TMJ) - parotid branches

  23. Lingual nerve - lingual branches - sublingual branches - ganglionar branches - branches for the isthmus of the fauces

  24. Lingual nerve

  25. Inferior alveolar nerve - mylohyoid nerve - dental and gingival branches - mental nerve

  26. MANDIBULAR NERVE Inferior alveolar nerve

  27. MANDIBULAR NERVE MOTOR ROOT SENSORY ROOT

  28. Mandibularnerve (V/3.) f menigeal fromDr.Kozsurek ggl. trigeminale foramen ovale foramen spinosum elülső motoros ágcsoport rr. buccales (!) n. auriculotemporalis Motor root masseteric br. deep temporal br. med. pterygoid br. lat. pterygoideus br. br. for tensor tympani m. Br. for tensor veli palatini Buccal branch (!) n. lingualis n. alveolaris inferior Mylohyoid n. (!) mylohyoid m. ant. belly of digastric

  29. r. meningeus n. mandibularis ggl. trigeminale n. petrosus minor ex n. IX. foramen ovale foramen spinosum elülső motoros ágcsoport gl. parotidea chorda tympani ex n. VII. ggl. oticum rr. buccales (!) n. auriculotemporalis motoros ágcsoport r. massetericus r. temporalis profundus r. pterygoideus med. r. pterygoideus lat. r. musculi tensoris tympani r. musculi tensoris veli palatini rr. buccales (!) nyelv ízlelőbimbói n. lingualis gl. sublingualis gl. submandibularis ggl. submandibulare n. alveolaris inferior n. mylohyoideus (!) m. mylohyoideus m. digastricus venter ant. n. mandibularis (V/3.)

  30. CUTANEOUS INNERVATION OF THE HEAD

  31. IMPORTANT! TRIGEMINAL NERVE PROVIDES THE SENSORY INNERVATION of thebigsalivaryglands (submandibular, sublingual, parotid) , thepalatine, the nasalglands and theglands of thetongue, but IT HAS NO PARASYMPATHETIC NUCLEUS, thereforeitgetsparasympathetic fibersfromthe VII. and IX. nerves. THE POSTGANGLIONIC FIBERS OF THESE NERVES JOIN TO THE SENSORY BRANCHES OF THE TRIGEMINAL NERVE

  32. Branches of trigeminalnerve Facialnerve Superiorsalivatorynucl. Zygomaticnerve Communicatingbranch Lacrimalnerve (lacrimalgland) Pterygopalatineggl. Greaterpetrosal n. Post. nasalnerves. Nasopalatine n., Greater and lesserpalatinenerves (mucousglands of thenasalcavity and hardandsoftpalate) Preganglionic fiber Postganglionic fibers

  33. Branches of trigeminalnerve n. facialis nucl. saliv. sup Zygomatic n./lacrimaln. Lacrimalgland Pterygopalatineggl. Post.nasalnerves,nasopalatine n.,greater and lesserpalatinenerves Palatine and nasalglands Greaterpetrosal n. Submandibularggl. Lingual n. submandibular, sublingual and anteriorlingualgl. chordatympani Glossopharyngeal n. inf. salivatory n. Oticggl auriculotemporal n. Parotidgland tympanicn. /lesserpetrosal n.

  34. PAIN • The pain is an unpleasant sensation, but it is life-important in our connection with the outside-world - The brain can recognize and localize the pain, and activates a lot of mechanizms. - The organism gives different and complex answers for the pain. In the formation of the pain participate: - sensory receptors, - sensory fibers, - ascending pathway- neurons. Receptors - nociceptors

  35. Nociceptors respondto a variety of noxiousstimuli: - extreme hotorcoldtemperatures, - intensemechanicalmanipulations (pinching, pinpricks, cutting), - increasedtissueacidity, and othercauses of injury, - a varietychemicalagentsreleasedfromcellsthat aredamagedorrespondingto a foreign body suchas an infectiousagent (forexample, a bacterium)

  36. The answers for the pain-producing stimuli - protective reflex– spinalcord, brainstem - vegetative reflex– spinalcord, brainstem -recognition and localization of thepain - primer és secundersensorycortex -emotionalreactions-- limbiccortex - hormonalchanges- hypothalamus

  37. SPINOTHALAMIC TRACT Trigeminothalamictract (Trigeminallemniscus) SPINORETICULOTHALAMIC TRACT Trigeminoreticulartract phylogenetically new pain localization anddiscrimination monosynaptic contralateral VPL/VPM phylogenetically old motivational behavior polysynaptic bilateral midline thalamic nuclei

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