Post on 24-May-2015
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Neuro-clinics 26Trigeminal nerve
Dr Pratyush Chaudhuri
Supported by Mankind Pharmaceuticals and Nirmal clinics
• Mixed Nerve• Largest cranial nerve
Motor functions• Supplies the Massater, temporalis and the internal
and external pterygoids.
• Also supplies the mylohyoid and the ant belly of the digastric ms.
• Tensor veli palatini and tensor vili tympani
• Sensory distribution1. Pontine nucleus2. Mesencephalic nucleus ( proprioceptive sensation from the
muscles supplied by the Vth nerve)
3. Nucleus of descending root (extends upto the c3 – c4 root-
tract of lissauers’
• Sensory supply is also to the 1. Cornea , iris2. Conjuctiva3. Mucosa of the frontal sinus4. Upper part of the nasal cavity.
• Several ganglions are related to the Vth nerve
1. Gasserian ganglion2. Spheno-palatine ganglion3. Otic 4. Submaxillary ganglion
Key Principles of examinations
• Jaw is deflected to the side of the involved nerve and the patient is unable to deviate it towards the unaffected side.
1. Open Jaw – pterygoides2. Close jaw -masseters
• Remember angle of the face is not supplied by the trigeminal – it is supplied by the C2- C3 root
Reflexes1. Corneal reflexes ( direct and consensual)2. Jaw jerk ( masseter reflex)3. Head retraction reflex4. Sneeze reflex5. Reflex of Bechterew
• Pain of trigeminal origin1. Trigeminal neuralgia 2. Herpes ophthalmicus3. Sluders’ syndrome [ neuralgia of spheno-palatine
ganglion]