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trigeminal nerve 2 (CN3) Flashcards

1
Q

what is the motor part of the mandibular division of the trigeminal nerve for

A
  • muscles of mastication and 4 other muscles
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2
Q

what is the sensory part of the mandibular division of the trigeminal nerve

A
  • skin of the face
  • oral, nasal and sinus mucosa
  • and teeth
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3
Q

what are the 3 divisions of the trigeminal nerve

A
  • ophthalmic (CNV1)
  • maxillary (CNV2)
  • mandibular (CNV3)
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4
Q

what is the most important division of the trigeminal nerve for us

A
  • 3rd division = mandibular

- target it a lot during LA

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5
Q

what is the course of the mandibular division of trigmeinal nerve

A
  • passes through the foramen ovale and into the infratemporal fossa where it gives several branches
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6
Q

where does the trigeminal nerve go

A
  • goes from pons into Meckel’s cave which is underneath dura and then forms the ganglion then the 3 divisions formed take different routes
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7
Q

which division is most laterally located

A
  • the 3rd division = mandibular division

- it is not in close proximity to the cavernous sinus like the 1st and 2nd division

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8
Q

which foramen does CNV3 pass through

A
  • foramen ovale
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9
Q

which foramina can you see from the base of the human skull

A
  • can’t see the foramen rotunda or superior orbital fissure

- can see the foramen ovale

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10
Q

what is different for the foramen ovale compared to the foramen rotundum and superior orbital fissure

A
  • there is no bone protecting the foramen ovale

- means it can be vulnerable to damage but it can be accessed easier

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11
Q

what rests at the infratemporal fossa

A
  • the temporalis muscle
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12
Q

what are the boundaries of the infratemporal fossa

A
  • lateral = ramus of the mandible
  • medially = lateral pterygoid plate of sphenoid bone
  • anteriorly = posterior aspect of maxilla
  • posteriorly = tympanic plate, mastoid and styloid process
  • superiorly = infratemporal crest of sphenoid bone
  • inferiorly = angle of the mandible
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13
Q

what can affect the branches of the mandibular division

A
  • if patient gets and anterior dislocation of the mandible
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14
Q

what is the sensory part of the mandibular division for

A
  • lower face, hair temple, anterior 2/3 of the tongue
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15
Q

what are the brachiomotor part of the mandibular division for

A
  • muscles of mastication, tensors tympani and palati
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16
Q

what are the main branches of the mandibular division

A
  • auriculotemporal
  • buccal
  • mental
  • lingual
  • muscular
  • inferior alveolar nerve
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17
Q

what is the most important nerve branch of the mandibular division to us

A
  • inferior alveolar nerve
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18
Q

what is the skin over the angle of the mandible supplied by

A
  • not the trigeminal nerve

- supplied by the cervical plexus with the great auricular nerve (C2,3)

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19
Q

which areas are innervated by the sensory mandibular division

A
  • temple, jaw and part of the chin
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20
Q

how many branches does the mandibular division divide into

A
  • 3 main branches
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21
Q

where does the 3rd division of the trigeminal ganglion come through

A
  • the foramen ovale

- mandibular division

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22
Q

what does the main mandibular division divide into

A
  • anterior and posterior trunk
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23
Q

what occurs before the division into anterior and posterior trunks of the mandibular nerve

A
  • main trunk has few branches coming off of it
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24
Q

how many little branches does the mandibular divisions have coming off it before division

A
  • 4
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25
what are the small branches that come off the mandibular division before it divides
- meningeal branch - branch to tensor tympani - branch to tensor veli - nerve to medial pterygoid
26
what is the meningeal branch for
- supplies sensory information to the dura mater | - very small branch but very important
27
what is the branch to tensor tympani for
- control the muscles in the ear that control the vibrations of the bones in the ear for sound - help with hearing in the middle ear - one muscle in the ear is the tensor tympani which controls how fast vibrations in the ear occur
28
if a patient has a problem with branch to tensor tympani nerve then what could happen
- likely to be sensitive to loud noises - have sensory problems to the jaw and chin - can't clench their teeth
29
what does the branch to tensor veli palatini do
- innervates the muscle of the soft palate that elevates it
30
what does the nerve to medial pterygoid do
- supplies the medial pterygoid muscle of mastication
31
which of the small branches of the mandibular division are motor
- all are motor apart from the meningeal nerve to the dura mater = it is sensory
32
which of the branches form the anterior trunk of the mandibular division are motor
- all are motor apart from the buccal nerve which is sensory
33
what are the branches of the anterior trunk of the mandibular nerve
- deep temporal nerves - nerve to lateral pterygoid - buccal nerve - masseteric nerve
34
what is the buccal nerve of the mandibular division not to be confused for
- buccal branch of the facial nerve (CNVII) - trigeminal buccal branch is a deep sensory nerve whereas the buccal branch of the facial nerve is superficial and deals with facial expression
35
what does the anterior branch of the mandibular division do
- innervates all the other muscles of mastication = other than the medial pterygoid
36
what does the deep temporal nerve do
- innervates the temporalis | - motor
37
what does the nerve to lateral pterygoid do
- innervates the lateral pterygoid | - motor
38
what does the masseteric nerve do
- innervates the masseter | - motor
39
where does the sensory buccal nerve sit of the anterior mandibular division sit
- deep in infratemporal fossa behind the mandible | - if someone has got a severe fracture to their mandible then they could affect this nerve
40
what are the nerves of the posterior trunk of the mandibular division of the trigeminal nerve
- auriculotemporal - inferior alveolair - lingual
41
what types of nerves are the branches of the posterior trunk of the mandibular division
- all are sensory apart form the inferior alveolar which is mixed
42
which nerve disappears into the mandible of the posterior branch
- inferior alveolar nerve
43
which nerve of the posterior trunk goes to the tongue
- lingual
44
where does the inferior alveolar nerve split into just sensory
- the superior portion of the nerve is mixed nerve - it then divides and one branch then becomes the nerve to the mylohyoid which innervates the mylohyoid and this is motor - the rest of the nerve after divisions carries on as inferior alveolar nerve as sensory and goes through the mental foramen where it then divides into more nerves, one of which being the mental nerve
45
what does the nerve to mylohyoid do
- innervates the mylohyoid muscles which is a muscle that is on the floor of the mouth and supports the mandible
46
where does CNV3 also supply general sensation to
- floor of the mouth - lower teeth and gums - anterior 2/3 of the tongue vie lingual nerve
47
what does the lingual nerve carry
- the chordates tympani nerve which is a branch of the CNVII
48
is the mandibular division an easy target for LA
- yes | - but it is not protected by bone like the ophthalmic and maxillary divisions
49
what does the auroculotemporal nerve innervate
- temple and anterior ear
50
what does the buccal nerve of the mandibular division innervate
- cheek
51
what does the mental nerve from the inferior alveolar form the posterior trunk of the mandibular division innervate
- chin
52
what is trigeminal neuralgia
- terrible pain in the CNV3 and occasionally the CNV2 - nothing to do with shingles - extreme pain - need to wait for it to settle before you give patient any treatment
53
what does the inferior alveolar nerve and its branch the incisive nerve innervate
- the lower teeth
54
what does the inferior alveolar nerve innervate
- skin of chin and lower lip as the mental nerve | - mucous membranes
55
how does the inferior alveolar nerve progress
- after the inferior alveolar nerve enters the mandibular foramen, it goes to the teeth as the incisive nerve and the branch that then goes through the mental foramen is the mental nerve for sensorial innervation to the chin and mucous membranes
56
where does the division of the inferior alveolar nerve take place
- before the mandibular division | - only the sensory part of the inferior alveolar nerve enters the mandibular foramen
57
what supplies the posterior teeth
- main trunk of the inferior alveolar nerve
58
what supplies the anterior teeth
- the incisive branch of the inferior alveolar nerve = but when doing LA will just target the main trunk
59
what supplies the gums
- lingual and buccal nerves
60
what supplies the mucus and skin on anterior
- mental nerve
61
what nerves innervate the teeth
- anterior superior alveolar nerve (upper anteriors) =CNV2 - middle superior alveolar (upper middle) = CNV2 - posterior superior alveolar nerve (upper posterior) = CNV2 - inferior alveolar nerve (lower posterior) = CNV3 - incisive nerve (lower anterior) = CNV3
62
what is the sensory supply for the tongue
- anterior 2/3 = general sensation mandibular nerve via lingual nerve - posterior 1/3 = general and special sensation via glossopharyngeal nerve
63
what is the motor supply for the tongue
- hypoglossal nerve
64
what happens if the lingual nerve is hit when trying to block the inferior alveolar
- it is very close to inferior alveolar | - patient will feel numbness
65
what is taste of the tongue provided by
- branch of the facial nerve = chorda tympani
66
what muscles other than muscles of mastication does the mandibular division supply
- tensor tympani (in middle ear), tensor palati (latter branch to medial pterygoid), mylohyoid and anterior belly of digastric
67
how does medial pterygoid sit
- vertically | - elevator of the jaw
68
how does the lateral pterygoid sit
- horizontally | - only muscle of mastication open the mouth - depress jaw
69
how does the jaw-jerk reflex work
- tap chin and stimulate propricopetion which is picked up the 3rd trigeminal division and goes to the mesencephalic muceli and then goes to the trigeminal motor nerves for response - afferent = sensory - efferent = motor - both afferent and efferent are trigeminal nerve
70
what does CNV1 supply over face
- supraorbital | - supratrochlear
71
what does CNV2 supply over face
- zygomaticotemporal
72
what does CNV3 supply over face
- auriculotemporal
73
what is varicella zoster virus
- reactivation of varicella zoster virus int eh trigeminal ganglion = shingles - cutaneous involvement in the distribution of CNV1 - erthyematous, vesicular, crusting rash and burning sensation - if on nose = Hutchinson's - Hutchinson's = more chance of eye problems, lose eyesight if shingles untreated - conjunctivitis, keratitis and uveitis
74
if giving LA and hit a vein which is it most likely to be
- pterygoid plexus
75
what happens if you hit a deep muscle while giving LA
- can cause trismus | - inability to open mouth
76
what can happen if you hit the facial nerve
- can cause half face paralysis = including forehead | - facial nerve palsy
77
what does the facial nerve supply
- all the muscles of facial expression
78
which is more common, trismus or facial nerve palsy
- trismus

BDS2 - Anatomy (4 decks)

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