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Phys Nerve Trigem
Trigeminal nerve pain
| Question | Answer |
|---|---|
| What cranial nerve is the trigeminal nerve? | Cranial nerve 5 |
| What are the three divisions of the trigeminal nerve? | V1 = Opthalmic division V2 = Maxillary division V3 = Mandibular division |
| What areas of the face does the Opthalmic division receive sensory information from? | Bridge of nose Cornea of eye Forehead other?? |
| What areas of the face does the Maxillary division receive sensory information from? | Upper lip Nasal cavity Oral cavity Upper teeth Upper gums |
| What areas of the face does the Mandibular division receive sensory information from? | Temple Lower teeth Lower gums |
| What openings do V1,2 and 3 pass through on their way to the trigeminal ganglia? (3 openings) | V1 = Superior orbital fissure V2 = Foramen rotundum V3 = Foramen ovale |
| Where are all of the cell bodies of the 3 divisions of the trigeminal nerves located? | The trigeminal ganglia |
| Where in the cranium is the trigeminal ganglia located? | Meckels cave which is infero-lateral to the pituitary gland and lateral to the sphenoid sinus |
| What is the difference between neurones and nerves? | A group of neurones form a nerve. Neurones are bundled into fascicles and there are a number of fascicles in each nerve. |
| Approximately how many neurones are in each division of the trigeminal nerve? Since this is a relatively large amount of sensory neurones relative to other parts of the body, would we expect this to take up a small or large amount of surface in the primary somatosensory cortex in the post central gyrus of the parietal lobe? | V1 = 26,000 V2 = 50,000 V3 = 78,000 Large quantity of neurones = large surface area of primary somatosensory cortex. |
| Each of the three divisions of the trigeminal nerve synapse with second order neurones starting within nuclei found within the pons. Name the nuclei within the pons that receive sensory input for touch, proprioception and nociception + temperature (3 nuclei) | Touch = principal sensory nuclei Proprioception = mesocephalic nuclei Nociception + temperature = spinal nuclei |
| What other 3 cranial nerves pass sensory input to the spinal nerve associated with nociception and temperature? | Cranial nerve 7 = Facial nerve Cranial nerve 9 = Glossopharangeal nerve Cranial nerve 10 = Vagal nerve |
| What ascending sensory pathway is taken following first order neurones of the trigeminal nerves synapsing with second order neurones in nuclei of the pons? | Second order neurones travel superiorly ipsilaterally and then decussate at the midbrain where they travel superiorly and contralaterally to synapse at the thalamus (relay station). Third order neurones travel from the thalamus to the primary somatosensory cortex in the post central gyrus in the parietal lobe. |
| What is the definition of pain? | An unpleasant sensory or emotional experience associated with actual or potential tissue damage. |
| How does nociceptive stimuli differ to pain? | Nociceptors detect possible noxious stimuli and nociception is the sensory nervous systems process of encoding potential noxious stimuli NOCICEPTION is the neural process of encoding noxious stimuli, whereas PAIN is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage |
| What parts of the brain interpret noxious/ stressful stimuli? | Reticular formation = sleep wake cycle + arousal Limbic system (specifically the amygdala) = emotional aspect of pain Hypothalamus = Release a cascade of hormones including - adrenaline and cortisol which contribute the acute stress response / sympathetic response. eg. Increased heart rate + breathing + sweating |
| Where are cell bodies located in the PNS? What are cell bodies in the CNS called? | In ganglia. Cell bodies in the CNS are called nuclei. |
| What is the theory behind an individual sometimes grinding their teeth / clench their jaw when stressed? | Part of the reticular formation known as the locus coeruleus generates noradrenaline. When an individual is stressed this part of the brain is stimulated to secrete noradrenaline which may be sent to V3 motor neurone (the only motor neurone of the trigeminal nerve). Binding of the noradrenaline neurotransmitter to specific receptors stimulates contraction (V3 = mandibular division) |
| How is pain via the trigeminal nerve endogenously counteracted? | 1. Locus coeruleus also sends NA to alpha 2 receptor on the proprioceptive pathway heading to the thalamus to inhibit sensory signal 2. In response to stress, the peri aquaductal grey matter (PAG) stimulates the raphe nuclei to release serotonin. This serotonin stimulates the release of opiods such as endorphins and dynorphins from an interneurone that connects to a nociceptive pathway? of the trigeminal nerve leading to the thalamus. This inhibits any nociceptive stimuli from reaching the brain. |
| How does the proprioceptive pathway of the trigeminal nerve prevent an individual from clenching so hard they break a tooth? | There is a reflex arc between the the proprioceptive pathway and V3 motor division which inhibits the motor pathway when required. |
Created by:
Bok1993