Neuro clinics 26 - trigeminal nerve

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trigeminal nerve, fifth nerve

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Neuro clinics 26 - trigeminal nerve

  1. 2. Neuro-clinics 26 Trigeminal nerve Dr Pratyush Chaudhuri Supported by Mankind Pharmaceuticals and Nirmal clinics
  2. 3. <ul><li>Mixed Nerve </li></ul><ul><li>Largest cranial nerve </li></ul>
  3. 4. <ul><li>Motor functions </li></ul><ul><li>Supplies the Massater, temporalis and the internal and external pterygoids. </li></ul><ul><li>Also supplies the mylohyoid and the ant belly of the digastric ms. </li></ul><ul><li>Tensor veli palatini and tensor vili tympani </li></ul>
  4. 8. <ul><li>Sensory distribution </li></ul><ul><li>Pontine nucleus </li></ul><ul><li>Mesencephalic nucleus ( proprioceptive sensation from the muscles supplied by the Vth nerve) </li></ul><ul><li>Nucleus of descending root (extends upto the c3 – c4 root- tract of lissauers ’ </li></ul>
  5. 10. <ul><li>Sensory supply is also to the </li></ul><ul><li>Cornea , iris </li></ul><ul><li>Conjuctiva </li></ul><ul><li>Mucosa of the frontal sinus </li></ul><ul><li>Upper part of the nasal cavity. </li></ul>
  6. 13. <ul><li>Several ganglions are related to the Vth nerve </li></ul><ul><li>Gasserian ganglion </li></ul><ul><li>Spheno-palatine ganglion </li></ul><ul><li>Otic </li></ul><ul><li>Submaxillary ganglion </li></ul>
  7. 15. Key Principles of examinations <ul><li>Jaw is deflected to the side of the involved nerve and the patient is unable to deviate it towards the unaffected side. </li></ul><ul><li>Open Jaw – pterygoides </li></ul><ul><li>Close jaw -masseters </li></ul>
  8. 16. <ul><li>Remember angle of the face is not supplied by the trigeminal – it is supplied by the C2- C3 root </li></ul>
  9. 17. <ul><li>Reflexes </li></ul><ul><li>Corneal reflexes ( direct and consensual) </li></ul><ul><li>Jaw jerk ( masseter reflex) </li></ul><ul><li>Head retraction reflex </li></ul><ul><li>Sneeze reflex </li></ul><ul><li>Reflex of Bechterew </li></ul>
  10. 19. <ul><li>Pain of trigeminal origin </li></ul><ul><li>Trigeminal neuralgia </li></ul><ul><li>Herpes ophthalmicus </li></ul><ul><li>Sluders’ syndrome [ neuralgia of spheno-palatine ganglion] </li></ul>

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