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Questions and Answers
What type of fibers does the maxillary nerve (V2) primarily consist of?
What type of fibers does the maxillary nerve (V2) primarily consist of?
Which structure does the infra-orbital nerve NOT supply?
Which structure does the infra-orbital nerve NOT supply?
Which terminal branch of the infra-orbital nerve supplies the skin of the lower eyelid?
Which terminal branch of the infra-orbital nerve supplies the skin of the lower eyelid?
What does the posterior superior alveolar nerve primarily supply?
What does the posterior superior alveolar nerve primarily supply?
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Which nerve specifically supplies the maxillary incisors and canine?
Which nerve specifically supplies the maxillary incisors and canine?
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Which nerve supplies the mucosa of the hard palate and palatal gingivae, except the round incisive papilla?
Which nerve supplies the mucosa of the hard palate and palatal gingivae, except the round incisive papilla?
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Which nerve enters the nasal cavity through the sphenopalatine foramen?
Which nerve enters the nasal cavity through the sphenopalatine foramen?
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The Zygomatic Nerve divides into which two branches?
The Zygomatic Nerve divides into which two branches?
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What does the Maxillary nerve supply?
What does the Maxillary nerve supply?
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Which cranial nerve is known as the 5th and largest cranial nerve?
Which cranial nerve is known as the 5th and largest cranial nerve?
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What primarily does the maxillary branch of the trigeminal nerve supply?
What primarily does the maxillary branch of the trigeminal nerve supply?
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Which structure does NOT exit the skull through the foramen rotundum?
Which structure does NOT exit the skull through the foramen rotundum?
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Which of the following is a motor root supplied by the trigeminal nerve?
Which of the following is a motor root supplied by the trigeminal nerve?
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What is the primary function of the maxillary branch of the trigeminal nerve?
What is the primary function of the maxillary branch of the trigeminal nerve?
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From which part of the brain does the trigeminal nerve arise?
From which part of the brain does the trigeminal nerve arise?
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Which anatomical region is supplied by the maxillary branch of the trigeminal nerve?
Which anatomical region is supplied by the maxillary branch of the trigeminal nerve?
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Which of the following muscles is innervated by a motor root of the trigeminal nerve?
Which of the following muscles is innervated by a motor root of the trigeminal nerve?
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Which of these functions is NOT associated with the trigeminal nerve?
Which of these functions is NOT associated with the trigeminal nerve?
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What structure do the three divisions of the trigeminal nerve come together at?
What structure do the three divisions of the trigeminal nerve come together at?
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Which cranial nerve division is responsible for conveying sensory information from the conjunctiva and cornea?
Which cranial nerve division is responsible for conveying sensory information from the conjunctiva and cornea?
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Which of the following is a branch of the ophthalmic nerve?
Which of the following is a branch of the ophthalmic nerve?
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Where does the maxillary nerve exit the skull?
Where does the maxillary nerve exit the skull?
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What role does the trigeminal nerve nucleus play in the nervous system?
What role does the trigeminal nerve nucleus play in the nervous system?
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Which cranial nerves traverse the superior orbital fissure along with the ophthalmic nerve?
Which cranial nerves traverse the superior orbital fissure along with the ophthalmic nerve?
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What anatomical feature does the pterygo-maxillary fissure lie between?
What anatomical feature does the pterygo-maxillary fissure lie between?
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What does the maxillary nerve divide into in the pterygopalatine fossa?
What does the maxillary nerve divide into in the pterygopalatine fossa?
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Study Notes
Trigeminal Nerve - Maxillary Branch (V2)
- The maxillary branch (V2) is a major division of the trigeminal nerve (CN V).
- It is essential for dental professionals to understand this branch.
- The nerve's function includes sensing facial touch, pain, and temperature as well as controlling muscles used for chewing.
- Key learning objectives include describing its function, outlining the anatomical regions it supplies, and explaining its relevance to dentistry.
GDC Learning Outcomes
- Relevant dental, oral, craniofacial, and general anatomy should be described and applied to patient management.
Intended Learning Outcomes
- Describe the function of the maxillary branch of the trigeminal nerve (CN V).
- Outline the anatomical regions the maxillary branch supplies.
- Explain the relevance of the maxillary branch of the trigeminal nerve to dentistry.
Nerve Roots
- Each trigeminal nerve is made up of two roots; one motor (thinner) root, and one sensory (thicker) root.
- The trigeminal nerve is responsible for sensing facial touch, pain, and temperature. It also controls muscles involved in chewing.
- Distinguish the trigeminal nerve from the facial nerve (CN VII), which controls other facial movements.
What is Supplied?
-
Sensory (afferent) roots:
- Maxillary dentition
- Mandibular dentition
- Skin of the face and head
- Oral mucosa
- Nasal mucosa
- Air sinuses
- Meninges
-
Motor (efferent) roots:
- Muscles of mastication (Masseter, Temporalis, Medial pterygoid, Lateral pterygoid, Anterior belly of digastric)
- Mylohyoid
- Tensor tympani
- Tensor veli palatini
Brain Origin
- The trigeminal nerve originates from the pons.
- It has one motor nucleus and three sensory nuclei.
Pathway from Skull
- The three branches of the trigeminal nerve emerge from the middle cranial fossa.
- The Ophthalmic nerve (V1) exits via the superior orbital fissure (SOF).
- The Maxillary nerve (V2) exits via the foramen rotundum and travels through the pterygopalatine fossa, before exiting via the infraorbital foramen.
- The Mandibular nerve (V3) exits via the foramen ovale.
Gasserian Ganglion
- The three divisions of the trigeminal nerve come together at the Gasserian ganglion within the brainstem.
- Signals traveling through the trigeminal nerve reach specialized clusters of neurons called the trigeminal nerve nucleus.
Ophthalmic Nerve (V1)
- The smallest division, it's a sensory nerve.
- Carries information to the brain via the superior orbital fissure of the sphenoid bone.
- The superior orbital fissure is also traversed by cranial nerves II, IV, and VI.
- It supplies the conjunctiva, cornea, eyeball, orbit, forehead, ethmoidal and frontal sinuses, and portions of the dura mater.
Branches of Ophthalmic Nerve
- Lacrimal: Supplies the conjunctiva and skin covering the lateral part of the upper eyelid; tear production.
- Frontal: Supplies mucous membrane lining frontal sinus, skin, and conjunctiva covering upper eyelid, as well as skin on the forehead and scalp.
- Nasociliary: Sensory branches to the ciliary ganglion, including long ciliary nerves, posterior ethmoidal nerves, and infratrochlear nerve.
Pterygo-maxillary fissure
- Located between the posterior surface of the maxilla and the pterygoid process of the sphenoid bone.
- It fills a triangular gap between the lower ends of the medial and lateral pterygoid plates.
- The pterygomaxillary fissure leads into the area entered by the foramen rotundum and maxillary nerve.
Maxillary Nerve (V2)
- Exits the cranium via the foramen rotundum.
- Travels into the pterygopalatine fossa and divides into branches.
- Divides into: Zygomatic, Infraorbital, Posterior Superior Alveolar, and Pterygopalatine nerves.
- Supplies maxillary teeth, supporting structures, hard and soft palate, maxillary sinus, and skin over the middle part of the face.
Infra-orbital Nerve
- The terminal branch of the maxillary nerve
- Enters the orbit at the inferior orbital fissure and runs through the infraorbital groove.
- Exits the orbit at the infraorbital foramen.
- Branches into middle superior alveolar, anterior superior alveolar, and terminal branches (palpebral, nasal, and labial).
Terminal Branches
- Arise at the infraorbital foramen and provide sensation to various facial areas:
- Palpebral nerve: lower eyelid skin.
- Nasal nerve: sides of nose.
- Labial nerve: upper lip, labial gingivae, anterior maxillary teeth, and cheek skin over the maxilla.
Posterior Superior Alveolar Nerve (C)
- Leaves the pterygopalatine fossa through the pterygomaxillary fissure.
- Supplies the buccal gingivae of the maxillary molars.
- Pierces bone to provide maxillary sinus innervation and supply maxillary molars.
Middle & Anterior Superior Alveolar Nerves (G)
- Arise from the infraorbital nerve in the orbit.
- Middle: supplies maxillary premolars and the mesiobuccal root of the first maxillary molar.
- Anterior: supplies maxillary incisors and canines.
Pterygopalatine Nerves
- Greater Palatine: Passes through greater palatine canal to greater palatine foramen; supplies hard palate mucosa, except for around the incisive papilla.
- Lesser Palatine: Passes through greater palatine canal to lesser palatine foramen; supplies the soft palate.
- Nasopalatine: Enters nasal cavity through sphenopalatine foramen; supplies part of the nasal septum and oral mucosa around the incisive papilla.
Zygomatic Nerve
- Travels anteriorly to enter the orbit via the inferior orbital fissure.
- Divides into:
- Zygomaticotemporal nerve: sensory innervation to temple.
- Zygomaticofacial nerve: innervates skin on cheeks.
- Perforates the orbicularis oculi muscle.
Trigeminal and Facial Nerve Examination
- A clinical procedure for evaluating trigeminal and facial nerve function. Methods may include sensory testing and motor function assessments.
Summary
- The trigeminal nerve is the fifth cranial nerve.
- It has three main branches: ophthalmic (V1), maxillary (V2), and mandibular (V3).
- The ophthalmic nerve enters the orbit through the superior orbital fissure.
- The maxillary nerve leaves the cranium via the foramen rotundum.
- The maxillary nerve supplies the maxillary teeth, hard palate, maxillary sinus, and skin overlying the middle part of the face.
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