Eckel CNV & VII
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| Origin of CN V nuclei | Nuclei are located in the pons and they emerge from the pons LATERALLY
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| Two emerging roots of CNV | 1.Sensory: (Big) Major sensory nerve of the face.
2.Motor: (Small) innervates the muscles of mastication, anterior digastric, mylohyoid, tensor veli palatini, tensor tympani
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| Three division of CN V | 1. Opthalmic (Exits thru Sup. Orbital Fissure).
2.Maxillary (Exits thru foramen rotundum).
3.Mandibular (Exits thru foramen ovale).
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| Where is the Trigeminal ganglion located | Both Motor and sensory roots form the ganglia in the Middle cranial fossa. This is also the exit sites for V1, V2, V3 from the ganglia.
**it is equivalent to the posterior root ganglia
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| Branches of the Opthalmic division: Frontal N | forms in the orbit, is the most superior branch of V1. Splits into Supra-orbital(L) and Supratemporal(M) nerves which exit the orbit superiorly and are the lateral and medial cutaneous nerves for the scalp
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| Branches of the Opthalmic division: Lacrimal N | Smallest of the branches. Runs superolaterally through the orbit. Recieves secretomotor fibers from zygomaticotemporal N which act on the lacrimal gland. It is sensory for the area of skin of lateral superior eyelid.
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| Branches of the Opthalmic division: Nasociliary N | Deep in the orbit. Gives rise to:
1.Infratrochlear: passes infeior to trochlea on medial wall to innervate skin lateral to root of nose/ medial eyelids.
2.External Nasal: Emerges from nasal cavity to innervate the dorsum,ala,vestibule, apex of nose
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| Branches of the Maxillary division: Zygomatic N | formed in the ptergyopalatine fossa. Forms:
1.Zygomaticofacial: goes thru zyg.fac. canal to inferiolat orbit to innv. the cheek.
2.Zyo.temporal: passes thru the zygo.temp. canal in temp bone to temporal fossa. Innv. hairless skin of ant. temp. fossa.
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| Zygomaticotemporal also give off a branch to: | the lacrimal N. it is a secretomotor communicating branch.
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| Branches of the Maxillary division: Superior Alveolar N | Gives off a Ant, middle, and post superior alveolar branch that for the root of the upper teeth as well as innervates the palate.
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| Branches of the Maxillary division: Infra-orbital N | Exits via infraorbital foramen. Forms:
1.Inferior palpebral: skin/conjunctiva of inferior eyelid.
2.Lateral Nasal: lateral nose/anteroinferior nasal septum.
3.Superior Labial: Skin and mucosa of upper lip
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| 4 major nerve branches of Maxillary N (V2) | 1.Infra-orbital N.
2.Zygomatic N.
3.Superior Alveolar N.
4.Palatine N (Greater and lesser)
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| Mandibular Division (V3) | Contains BOTH sensory and motor fibers.
Innervates:
1.Muscles of mastication.
2.Tensor tympani.
3.Tensor veli palatini.
4.Anterior Digastric.
5.Mylohyoid.
6. Skin over chin, lower lip, mandible, and ear.
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| Major Branches of Mandibular N (V3) | 1.Auriculotemporal N.
2.Inferior Alveolar N.
3.N. to Mylohyoid.
4.Lingual. (GSA of tongue)
5.Buccal.
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| Buccal N (Mandibular Branch) | Originates in the infratemporal fossa and pass b/w the lateral pterygoids, emerging anteriorly from the ramus of the mandible and masseter. It connects with the Buccal branch of the facial N.
**Cutaneous nerve for skin and oral mucosa of cheek
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| Auriculotemporal N (Mandibular Branch) | Originates in the infratemporal fossa and passes posteriorly deep to ramus of mandible, superior to parotid gland. Emerges posterior to TMJ. Cutaneous nerve for auricle/Ant ear and posterior 2/3 of temporal region.
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| Inferior Alveolar N (Mandibular Branch) | Enters the Mandible via the Mandibular foramen. serves as the roots of inferior teeth (dentists numb this nerve). Forms the Mental N when it exits the mental foramen (Cutaneous N for chin and lower lip).
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| Parasympathetics associated with CN V | All the ANS parasymp. ride along with the divisions of CN V. 4 ganglia: ciliary, otic, submandibular, and pterygopalatine
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| Lesions of CN V | loss of light touch, pain, and heat sensation. Paralysis of muscles of mastication (**chin will point to side of lesion). Loss of afferent limb of corneal reflex (both eyes blink).
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| Trigeminal Neuralgia | Disorder in sensory root of CN V. sudden attacks of excruciating facial pain lasting up to 15 min. V2 is the most commonly affected CN V branch.
**May be cause by compression from aberrant BL vessels
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| Locatoin of CN VII's nucleus | Located in the Pons and emerges between the pons and brainstem.
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| Geniculate ganglion | Ganglion of CN VII Facial N where the motor and sensory roots merge.
**Equivalent to the posterior root ganglion.
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| CN VII Motor fiber innervate? | Major part of CN VII. Innervate:
1.Muscles of Facial expression.
2.Posterior Digastric.
3.Stapedius (ear).
4.Stylohoid (pharynx).
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| Pathway of CN VII to exit the skull | Internal auditory meatus -> Facial canal (within the temporal bone) -> geniculate ganglion -> Stylomastoid foramen
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| CN VII gives rise to ? in within the facial canal | 1.Greater Petrosal N.
2.Chondra tympani N.
3.N. to Stapedius M.
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| Chondra Tympani N. | branches from CN VII within the facial canal. jumps on the lingual N to the tongue. Sensory taste (SA) for anterior 2/3 of tongue, submandibular gland, sublingual gland (**since the lingual N passes just superior to them)
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| Parasympathetics involved in Chondra Tympani N. | Carries Pre (GVE) and postgang.(GVA) parasymp fibers to submandibular glad. Also carries Postgang. (GVA) parasymp. fibers to sublingual gland.
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| Greater Petrosal N. | Carries preganglionic (GVE) parasymp. fibers to pterygopalatine ganglion.
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| Postganglionic parasympathetic targets of Pterygopalatine ganglion | After recieving pregang. fibers from the Greater petrosal N, it targets:
1.lacrimal gland.
2.mucous glands of palate.
3.mucous glands of maxillary.
4.mucous glands of sinus.
5.mucous glands of nasal cavity.
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| branch of the Facial N (CN VII) that comes after immediately after the stylomastoid foramen? | Posterior Auricular N. (Cutaneous to parietal region).
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| Branches of CN VII that exit from the Parotid gland | 1.Temporal.
2.Zygomatic.
3.Buccal.
4.Mandibular.
5.Cervical.
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| Does CN VII innervate the parotid gland? | NOOOO, glossopharyngeal (IX)
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| Bell's Palsy | most common cause of a lesion near the stylomastoid foramen causing paralysis of the facial expression muscles on THAT side. Can also see decreased glandular secretions.
**Loss of EFFERENT limb of the corneal reflex.
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| Testing the Corneal Reflex: If One eye doesn't blink? | There is a problem with the Motor reflex arm (Facial N). Confirm by then testing Orbicularis Oculi. If they cant blink one eye at a time, then there is a lesion on the Facial N.
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| Testing the Corneal Reflex: If neither eye blinks? | There is a lesion on the Trigeminal N. and the sensory arm of the reflex is damaged.
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