Trigeminal Nerve Maxillary hard

Trigeminal Nerve - Maxillary Branch (V2)

• The trigeminal nerve is the 5th and largest cranial nerve.
• The nerve has three divisions: ophthalmic, maxillary, and mandibular.
• The maxillary branch (V2) is a sensory nerve.
• The maxillary nerve exits the skull via the foramen rotundum.
• It enters the pterygopalatine fossa.
• The nerve divides into four main branches: zygomatic, infraorbital, posterior superior alveolar, and pterygopalatine.
• The zygomatic nerve supplies the skin of the temple and cheeks.
• The infraorbital nerve runs through the infraorbital groove and foramen to supply the skin of the lower eyelid, nose, and upper lip.
• The posterior superior alveolar nerve supplies the posterior maxillary teeth and the maxillary sinus.
• The pterygopalatine nerves give rise to the greater palatine, lesser palatine, and nasopalatine nerves (which, in turn, have specific distributions in the mouth, nasal cavity, and palate).
• The maxillary nerve supplies the maxillary teeth and associated structures, hard and soft palate, maxillary sinus, and skin over the middle part of the face.
• The maxillary nerve is important for dental professionals due to its role in sensation and function of the teeth and associated structures.

GDC Learning Outcomes

• Describe relevant and appropriate dental, oral, craniofacial, and general anatomy and explain their application to patient management.

Intended Learning Outcomes

• Describe the function of the maxillary branch of the trigeminal nerve (CN V).
• Outline the anatomical regions it supplies.
• Explain the relevance of the maxillary branch of the trigeminal nerve to dentistry.

Resources

• Anatomy.tv
• Acland's Video Atlas of Human Anatomy
• Netter's Head and Neck Anatomy for Dentistry
• Teach Me Anatomy (app/website)
• Other resources (YouTube, etc.)

Nerve Roots

• Each trigeminal nerve consists of a motor and a sensory root.
• The motor root is involved in controlling muscles of mastication, the sensory root handles facial sensations.

What is Supplied?

• (Sensory)*
• Maxillary dentition
• Mandibular dentition
• Skin of face and head
• Oral mucosa
• Nasal mucosa
• Air sinuses
• Meninges
• (Motor)*
• Muscles of mastication (masseter, temporalis, medial pterygoid, lateral pterygoid, anterior belly of digastric)
• Mylohyoid
• Tensor tympani
• Tensor veli palatini

Brain Origin

• The trigeminal nerve arises from the pons.
• The trigeminal nerve has one motor and three sensory nuclei.

Pathway from Skull

• Ophthalmic nerve enters orbit through the superior orbital fissure.
• Maxillary nerve leaves via foramen rotundum then infra-orbital canal to the infraorbital foramen.
• Mandibular nerve leaves via foramen ovale.

The Three Divisions

• The three divisions come together in the Gasserian ganglion.
• Signals traveling through the trigeminal nerve reach specialized groups of neurons known as the trigeminal nerve nucleus within the brain stem.

Ophthalmic Nerve (V1)

• The ophthalmic nerve is the smallest division of the trigeminal nerve.
• It carries sensory information from the upper face.
• It enters the orbit through the superior orbital fissure.
• Its branches include lacrimal, frontal, nasociliary, and others, supplying different parts of the forehead, eye, and nasal regions.

Branches of Ophthalmic Nerve

• The ophthalmic nerve has several branches, each with a specific area of supply.
• The lacrimal nerve supplies the lacrimal gland and surrounding skin.
• The frontal nerve branches into the supraorbital and supratrochlear nerves, supplying skin and anterior forehead.
• The nasociliary nerve supplies nasal region, eyes, and foreheads.

Pterygo-maxillary fissure

• Lies between the posterior surface of the maxilla and the pterygoid process of the sphenoid bone.
• Forms a crucial gap for the transmission of nerves and vessels.
• The pterygomaxillary fissure leads to the pterygopalatine fossa.
• The maxillary nerve passes through this fissure/fossa.

Maxillary Nerve (V2)

• The maxillary branch exits the skull and enters the pterygopalatine fossa.
• Further branches: zygomatic, infraorbital, posterior superior alveolar, and pterygopalatine.

Infra-orbital Nerve

• The infraorbital nerve is a terminal branch of the maxillary nerve.
• Runs through the inferior orbital fissure and infraorbital groove.
• Exits the orbit via infraorbital foramen.
• Branches into middle superior alveolar, anterior superior alveolar, palpebral, nasal, and labial nerves.
• These branches supply areas of the face and nasal cavity.

Terminal Branches

• The terminal branches of the infraorbital nerve arise at the infraorbital foramen.
• Palpebral nerves supply the skin of the lower eyelid.
• Nasal nerves supply the skin of the side of the nose.
• Labial nerves supply skin and oral mucosa of the upper lip and anterior maxillary teeth.

Posterior Superior Alveolar Nerve (C)

• The posterior superior alveolar nerve (PSA) originates from the pterygopalatine fossa, and exits via the pterygomaxillary fissure.
• It supplies sensory information to the posterior maxillary teeth (molars).
• Also supplies the maxillary sinus.

Middle & Anterior Superior Alveolar Nerves (G)

• Middle superior alveolar nerve (MSA): Supplies the maxillary premolars and the mesiobuccal root of the first maxillary molar.
• Anterior superior alveolar nerve (ASA): Supplies the maxillary incisors and canines.

Pterygopalatine Nerves

• Part of the maxillary nerve: supplies greater palatine, lesser palatine, and nasopalatine nerves.
• These, in turn, supply various structures in the mouth, nose, and palate.

Greater Palatine Nerve

• Passes through the greater palatine canal.
• Enters the hard palate via the greater palatine foramen.
• Supplies much of the hard palate mucosa and palatal gingiva.

Lesser Palatine Nerve

• Passes through the greater palatine canal and then exits through the lesser palatine foramen.
• Supplies the soft palate mucosa.

Nasopalatine Nerve

• Enters the nasal cavity via the sphenopalatine foramen.
• Passes through the incisive canal in the hard palate.
• Supplies the oral mucosa around the incisive papilla.
• Also supplies the nasal septum.

Zygomatic Nerve

• Divides into zygomaticofacial and zygomaticotemporal nerves.
• Supplies skin over the prominence of the cheeks and part of the temple.

Trigeminal and Facial Nerve Examination

• A specific examination technique for the trigeminal and facial nerve functions is described.

Summary

• The trigeminal nerve is the largest cranial nerve, vital for sensation, and has three divisions, including the maxillary.
• The maxillary nerve (V2) innervates the upper teeth and surrounding structures, and is essential for sensory function in the mouth, upper face and nasal cavity.
• Various important foramina allow the trigeminal nerve to reach these crucial structures.

This quiz covers the details of the trigeminal nerve, specifically focusing on its maxillary branch (V2). Learn about the function, pathways, and branches of this sensory nerve, including the zygomatic, infraorbital, and posterior superior alveolar nerves. Uncover its crucial role in supplying various regions of the face and mouth.