For medical, nursing and physiotherapy undergraduates, and postgraduates

1. MANDIBULAR
NERVE

2. INTRODUCTION
 It is the largest of the three divisions of
Trigeminal nerve.
 It is the nerve of First Branchial arch.

3. COMPONENTS
 It is a Mixed nerve :
• Sensory component : derived from Trigeminal
nerve
• Motor component : directly from the Pons

4. COURSE
 From the Middle Cranial fossa, both the roots
emerge through Foramen Ovale and
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.

7. DIVISIONS
• Anterior division – small
• Posterior division – large

8. 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

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

14. 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.

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

17. 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

19. 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.

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

21. 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.

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

23. 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.

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

25. BRANCHES
• Distributing :
• It provides the 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.

26. CHORDA TYMPANI NERVE
• It is a branch of facial nerve and conveys
• It arises from Facial nerve about 6mm above
Stylomastoid foramen.
• After going a course through Tympanic
membrane between its mucous and fibrous
layers, it enters Infra-temporal fossa through
Medial end of Petro-tympanic suture.

27. CHORDA TYMPANI NERVE
• It pass down and forwards under cover of LP.
Crosses the medial side of spine of sphenoid
and joins posterior border of Lingual nerve at
acute angle.

29. CHORDA TYMPANI NERVE
• In Infra-temporal fossa its relation are :
• Laterally : MMA, Roots of Auriculo-temporal
nerve and Inferior alveolar nerve.
• Medially : Tensor palati & Auditory tube.
• In front : Trunk of Mandibular nerve and Otic
ganglion.

30. OTIC GANGLION
• It is a Small, oval, Para-sympathetic ganglion of
2-3mm in size.
• It is situated in Infra-temporal region.
• Functionally : it is related to IX nerve
• Topographically : it is related to Mandibular
nerve.

31. SITUATION
• It lies immediately below the Foramen Ovale.
• It lies medial to the trunk of Mandibular
nerve.
• It lies Lateral to Tensor Veli Palatini muscle.
• It lies in front of Middle Meningeal artery and
behind Medial Pterygoid muscle.

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

33. BRANCHES
• Post ganglionic para-sympathetic fibres :
• Post ganglionic sympathetic fibres :
• Fibres from nerve to Medial pterygoid pass
through the ganglion without interruption and
supply Tensor veli Palatini and Tensor Tympani
muscle.

34. APPLIED ANATOMY
 Referred pain
 Mandibular block : in conditions like
Trigeminal neuralgia