For medical, nursing and physiotherapy undergraduates, and postgraduates

1. MANDIBULAR
NERVE
DR. SUNDIP CHARMODE
ASSISTANT PROFESSOR

2. INTRODUCTION
 It is the largest of the three divisions of
Trigeminal nerve.
 Nerve of first branchial arch.

3. COMPONENTS
 Mixed nerve
• Sensory component (large): derived from
Trigeminal nerve
• Motor component(small): directly from the
Pons

4. COURSE
 Both roots emerge through Foramen Ovale
 Immediately below the foramen unite to form
the trunk of Mandibular nerve in the Infra-
temporal fossa.
 The trunk intervenes between Tensor Veli
Palatini medially & Lateral Pterygoid laterally.

8. DIVISIONS
• Anterior division – small
• Posterior division –
large
BRANCHES
 From the Trunk
 From the Anterior Division
 From the Posterior Division

9. FROM THE TRUNK
1. Meningeal branch (Nervous spinosus)
2. Nerve to Medial Pterygoid
3. A few fibres will supply Tensor tympani and
Tensor veli Palatini

11. FROM ANTERIOR DIVISION
 Three motor branches
1. Masseteric nerve
2. Deep temporal nerve (2)
3. Nerve to Lateral Pterygoid
 One sensory branch
1. Buccal nerve

14. FROM POSTERIOR DIVISION
 Three Sensory branches
1. Auriculo-temporal nerve
2. Inferior alveolar nerve
3. Lingual nerve
 One Motor branch
1. Mylohyoid nerve

15. AURICULO-TEMPORAL NERVE
• Usually arises from two roots, encircling MMA
and unite to form the nerve trunk.
• It passes backwards, under cover of LP, winds
round the neck of mandible, close to the
upper part of Parotid gland.
• It ascends upwards, enters temple and divides
into Superficial temporal branches.

17. COMMUNICATING BRANCHES
• It receives a communicating branch from Otic
ganglion, which convey secreto-motor fibres
to Parotid gland

18. DISTRIBUTING BRANCHES
• Auricular branches :
1. Skin of tragus
2. Adjoining upper part of Auricle
3. Roof and anterior wall of external ear
4. Adjoining Cuticular layer of Tympanic membrane
• Superficial temporal branches : Skin of temple
• Articular branches : T-M Joint

20. INFERIOR ALVEOLAR NERVE
 Conveys both Motor and Sensory fibres,
emerge undercover of the lower border of
Lateral Pterygoid muscle.
 It passes down and forwards, between ramus
of mandible and Spheno-mandibular ligament.
 Finally enters into Mandibular foramen
accompanied by same vessels.

21. INFERIOR ALVEOLAR NERVE
 Within the canal it divides into Incisive and
Mental nerves.

23. BRANCHES
 Distributing :
1. From Mandibular canal supplies molar,
premolar and adjoining gums.
2. Incisive nerve – canine, incisors and adjoining
gums.
3. Mental nerve – Skin over chin and lower lip.
4. Mylohyoid nerve – supplies Mylohyoid and
Ant. Belly of Digastric ms.

24. BRANCHES
 Communicating :
 A communicating branch joins Inferior
alveolar and Lingual nerve.

25. LINGUAL NERVE
• It lies in front of the Inferior Alveolar nerve
between LP and TVP.
• It receives Chorda-tympani nerve from behind
at acute angle.
• It emerges from lower border of LP and passes
down and forwards between Ramus and MP.

26. LINGUAL NERVE
• It then comes in direct contact of mandible
medial to the 3rd molar tooth
• It intervenes between origins of Superior
constrictor and Mylohyoid ms.
• Here it is only covered by mucous membrane
of the gum & becomes palpable 1 cm just
behind and below 3rd molar tooth.

27. BRANCHES
• Distributing :
• Nerve of general sense to anterior 2/3rd of
tongue, floor of mouth and mandibular gums.
• Communicating :
• With Chorda-tympani nerve
• With Submandibular ganglion.
• With Hypoglossal nerve.

28. OTIC GANGLION
• It is a small, oval, para-sympathetic ganglion of
2-3mm in size.
• It is situated in Infra-temporal region.
• Functionally, related to IX nerve
• Topographically, related to Mandibular nerve.

29. SITUATION
• Immediately below the Foramen Ovale.
• Medial to the trunk of Mandibular nerve.
• Lateral to Tensor Veli Palatini muscle.
• Lies in front of Middle Meningeal artery and
behind Medial Pterygoid muscle.

30. CONNECTIONS
• Parasympathetic / Motor root :
• Sympathetic root :

32. BRANCHES
• Post ganglionic para-sympathetic fibers-
auriculotemporal nerve - secretomotor
• Post ganglionic sympathetic fibers-
auriculotemporal nerve - vasomotor
• Fibers from nerve to Medial pterygoid pass
through the ganglion without interruption-
Tensor veli Palatini and Tensor Tympani muscle.

33. CLINICAL CORRELATES
1. Referred pain
2. Mandibular block: In conditions like
Trigeminal neuralgia