Anatomy 403: The Human Body
CRANIAL NERVES V AND VII
Trigeminal nerve (CN V)
A. General
1. Mixed nerve – sensory and motor (from pons)
2. The major somatic sensory of the face, orbit, nasal cavity, and oral cavity
3. Provides the somatic motor supply for the muscles of mastication as well as the two “tensor” muscles of
the head (tensor tympani and tensor veli palatini)
4. Trigeminal ganglion (semilunar ganglion) - location of sensory cell bodies of trigeminal nerve
5. Has 3 divisions (branches) arising from trigeminal ganglion
        V1 - Ophthalmic nerve ! eye (pure sensory) superiororbitalfissure
        V2 - Maxillary nerve ! cheek (pure sensory) foramenrotund
                                                                    um
        V3 - Mandibular nerve ! mandible (motor + sensory) foramenovale
6. Serves as a conduit for the parasympathetic functions of CNs III, VII and IX
7. Disease
        a) Trigeminal Neuralgia (Tic Douloureux) - mainly the mandibular division, sometimes the
        maxillary division
                                             thatmic puresensory foreheadandeye
                                          popmaxillary puresensory midfacecheek
trigeminal n           trigeminal ganglion
                                             mandibularsensorymotor
                                                                      generalmandible
                                                                                    lambdoidal
                                                                           foreheadto
                                                                             suture ant no se
                                                                   V2          cheekmidface
                                                                               cornerof exe
                                                             V3                             plus
                                                                              fingerextension to
                                                                              cornerof mouth
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                                                                  ant halfoframusof
                                                                  mandible auricleof
                                                                                     ear
                                                                  halfoftemporallobe
                                                                                                      2
B. Ophthalmic division (V1)
1. Somatic sensory only dendritestrawl totrigeminalganglion sensory allbodies axons
                                                                                                       pons
2. Leaves the orbit via the superior orbital fissure and passes through the cavernous sinus
3. Main branches: frontal, lacrimal,
and nasociliary
3. Supplies sensation to the frontal and    frontal sphenoidayethoida
                                                                           niÉÉÉÉiÉii           citemapa
ethmoidal paranasal air sinuses                                              para
4. Supplies sensory innervation
(general) to nasal cavity
5. Supplies sensation to the upper
eyelid, side of the nose, forehead and
                                         i                 it
scalp (supraorbital nerve)
6. Provides a conduit for the
postganglionic parasympathetic fibres
from CN III after the ciliary ganglion
        a) short and long ciliary nerves
                                                parasympathetic                         tii
        b) pupillary constriction &           nasal            itself
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C. Maxillary division (V2)
1. Somatic sensory only
                                somaticsensory
2. Enters the floor of the orbit via the inferior orbital fissure
3. Passes through the pterygopalatine fossa
4. Enters the cranial cavity via the foramen rotundum and passes through the cavernous sinus
5. Main branches: zygomatic, superior alveolar, and infraorbital
6. Supplies sensation to the maxillary air sinus
7. Supplies sensation (general) to the nasal cavity
8. Supplies sensation to lower eyelid, skin of cheek, upper lip (infraorbital nerve)
9. Innervates maxillary (upper) teeth and gums
                                                     also    softpalateClesserpalantinen and  hardpalategreater
                                                                                            palantinen
10. Provides a conduit for the postganglionic parasympathetic fibres from CN VII after the pterygopalatine
ganglion
        a) zygomaticofacial nerve
        b) lacrimation      onits             to thelacrimal
                               wayup                    gland
civilpalate
                                                                                                           4
    C. Mandibular division (V3)
    1. Largest branch
    2. Mixed nerve - sensory and motor
    3. Leaves the cranial cavity via the foramen ovale
    4. Enters the infratemporal fossa (area medial to the mandible)
    5. Splits into several main branches: muscular, buccal, auriculotemporal, inferior alveolar, and lingual
    6. Sensory functions
            a) Sensory to meninges of middle and anterior fossa (nervus spinosus)
            a) Sensation to the lower lip, skin of mandible
            b) Innervates mandibular (lower) teeth and gums (inferior alveolar nerve)
            c) Supplies anterior 2/3 of tongue with general sensation (lingual nerve)
            d) Ends as mental nerve (chin) subcutaneous
                                                             span
            e) Carries proprioceptive information from muscles of mastication to brainstem - force of bite
    7. Motor functions
            a)Supplies muscles of mastication - Masseter, Temporalis, Medial pterygoid, Lateral pterygoid,
            accessory muscles of mastication
    8. Provides a conduit for the postganglionic parasympathetic fibres from CN VII after the submandibular
    ganglion and from CN IX after the otic ganglion
            a) CN VII - Submandibular and sublingual glands
            b) CN IX - Parotid gland
   Damage      triguminatminalgiclookup ticdouleureux
                                           it
          I       crixpat
parotid
      gland
stimulation
                                                                                                       a
                             beggarforamen
                           just
                              facialand  fat      arterial plexus
                                   all postgangsymcomingfromsup cervicalgang
         masseter temporalis medialpterygoid lateral pterygoid
  go  accessory        mylohyoid ant        belly ofdigastric
                                                                                                           5
D. Muscles of mastication and chewing
1. Innervated by V3
2. Rotational movements occur at the temporomandibular joint (TMJ)
3. Rotation of condyle on the undersurface of the intra-articular disc
4. Jaw opening or depression (ie. abduction) ! results mainly from anterior pull of the lateral pterygoid
muscle; the anterior belly of digastric is involved for extreme depression (eg. during yawning)
5. Jaw closing or elevation (ie. adduction) ! results from pull of medial pterygoid, temporalis, and masseter
muscles
6. Superior pterygoid muscle (superior head of lateral pterygoid muscle) positions the condyle against the
surface of the articular eminence during jaw closing
tenso tympani
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Facial Nerve (CN VII)
A. General
1. Mixed nerve - Motor, sensory & parasympathetic
2. Attached to pons posterolateral surface
3. Cell bodies in geniculate ganglion • somatic sensation and special sense
4. Leaves skull via internal auditory meatus, stylomastoid foramen
5. Damage or disease
        a) Patient may loose taste (partly), salivation (partly) or lacrimation in one eye
        b) Bell’s Palsy (hemi-facial paralysis)
B. Motor Function
1. Muscles of facial expression (temporal, zygomatic, buccal, mandibular, and cervical branches)
2. Muscles of the scalp
        a) Frontalis (temporal branch)
        b) Occipitalis (posterior auricular n.)
3. Muscles of the external ear (posterior auricular n.)
4. Platysma m. • m. of facial exp.
5. Stylohyoid m.
6. Posterior digastric m.
7. Stapedius m. • smallest bone
                  of the body
C. Sensory Function
1. General sensation
       a) skin around the ear
       b) soft palate
2. Special sensation
       a) taste from anterior 2/3 of tongue (via chorda tympani - joins lingual n)
       b) taste from hard palate (via palatine nn. of V2)
D. Parasympathetic Function
1. Preganglionic fibres to the pterygopalatine ganglion via the greater petrosal n. Postganglionic fibres via
V2 and V1 to the lacrimal gland for tearing (lacrimation)
        Pathway: Facial n. (CN VII) ! greater petrosal nerve ! nerve of the pterygoid canal !
        pterygopalatine ganglion (synapse) ! maxillary n. (V2) ! zygomatic n. (branch of V2) !
        communicating branch to ! lacrimal n. (branch of V1) ! lacrimal gland
2. Preganglionic fibres to the submandibular ganglion. Postganglionic fibres via V3 to the submandibular
& sublingual salivary glands (salivation)
        Pathway: Facial n. (CN VII) ! chorda tympani n. ! joins the lingual n. (branch of V3) !
        submandibular ganglion (synapse) ! lingual fibres ! submandibular and sublingual glands
3. Postganglionic fibres to the mucous glands of the nasal region and the hard palate
                                                                                                                                                            7
                                       • sup. salivatory
                                         nucleus                                                                                              • somatic
                                                                                                                                                sensation from
                        • axons loop around                                                                                                     trigeminal
                          forming the facial                                                             • postgang para.
                          coloquiius
                                                                           • pregang. para
                      • abducens
                         nucleus
                      • facial nucleus
                   • somatic motor
  • spinal nucleus nerves
    of the
    trigeminal   Sensory ganglion w/                                                                                                             • supply nasal and
 • nucleus solitarius sensory nerve bodies                                                                                                         oral mucosa
   (gustatory nucleus),
 • also gets input from
   iX and X
• PA to occipital
  belly of                                                        ÉÉ
  frontalis                                                                                          EÉ
     • posterior
       auricular n.,                                                                         • sympathetic                                    • special sense taste
                                                                                                                                                (CNVII)
     • 5 facial nerves
                                                                     taste sensation
                                                                     that links up with
                                                                     lingual n. of V3,
                                                                     as well as para.
                                                                     to sublingual and
                                                                     submandibular
                                                                                                                              • upper third
                                                                                                                                still
                                                                                                                                functional       • ipsilateral
                                                                                                         • stroke a ects                           communication
                                                                                                           contralateral                           only to upper
                                                                                                           communication                           portion of facial
                                                                                                                                                   nucleus
                                                                                                             • UMN a ects
                                                                                                               contralateral side
                                                                                                    EEII.in
                                                           • Facial N.
                                                             LMN
                                                           • Damage will
                                                             result in
                                                             hemifacial
                                                             paralysis