The trigeminal nerve has distinct nuclei that process different sensory modalities. It is the sensory nerve of the facial skeleton and innervates muscles of the first pharyngeal arch. While its branches typically carry somatosensory and branchiomotor fibers, they can also contain "guest fibers" from other cranial nerves that supply visceral structures like salivary glands and taste buds. The trigeminal nerve has three major divisions - ophthalmic, maxillary, and mandibular nerves - which innervate different regions of the face and head.

1. Innervation of the head and neck, part I:
Trigeminal nerve
Mark Kozsurek, M.D., Ph.D.
ED II., 25/03/2019

3.  Trigeminal nerve has distinct nuclei for all the three
modalities of sensory information:
 protopathic (pain, heat): spinal trigeminal nucleus
 epicritic (fine touch, vibration, two-point discrimination):
chief (or principal or pontine) sensory trigeminal nucleus
 proprioceptive (position and movement of joints and
muscles): mesencephalic trigeminal nucleus
 Must be noted that the mesencephalic trigeminal
nucleus is rather an internalized sensory ganglion with
pseudounipolar cells then a real brainstem nucleus!

4.  Trigeminal nerve is the sensory nerve of the facial skeleton
(including the skin, the mucous membrane of the nasal and
oral cavities, the teeth and the structures of the orbit).
 Trigeminal nerve innervates those muscles developing
from the first pharyngeal arch (muscles of mastication;
Mylohyoid, anterior belly of Digastric, Tensor tympani and
Tensor veli palatini).

5. „Guest fibres”
 Sensory branches of the trigeminal reach all the regions of
the facial skeleton inside and outside.
 It is quite „economic” if pre- and/or postganglionic
general visceromotor (GVM) as well as special
viscerosensory (SVS, taste-sensing) fibres of the facial and
glossopharyngeal nerves are joining the intrinsic fibres of
the trigeminal nerve.
 As a result quite a lot trigeminal branches do not
exclusively have general somatosensory and
branchialmotor fibres as it could be predicted from the
brainstem nuclei of the trigeminal nerve!!!

6. FACIAL NERVE
greater petrosal n.
pterygopalatine ggl.
chorda tympani
submandibular ggl.
GLOSSOPHARYNGEAL NERVE
tympanic / lesser petrosal n.
otic ggl.
post. nasal branches,
nasopalatine nerve, greater
and lesser palatine nerves
(salivary glands of the palate and
the nasal cavity)
lingual nerve
(submandibular and
sublingual glands)
auriculotemporal nerve
(parotid gland)
trigeminal branches
zygomatic / lacrimal nerves
(lacrimal gland)
sup.
salivatory
nucl.
(GVM)
inf.
salivatory
nucl.
(GVM)

7. FACIAL NERVE
greater petrosal n.
pterygopalatine ggl.
chorda tympani
submandibular ggl.
GLOSSOPHARYNGEAL NERVE
tympanic / lesser petrosal n.
otic ggl.
post. nasal branches,
nasopalatine nerve, greater
and lesser palatine nerves
(salivary glands of the palate and
the nasal cavity
taste buds of the soft palate)
lingual nerve
(submandibular and
sublingual glands,
taste buds of the anterior 2/3
of the tongue)
auriculotemporal nerve
(parotid gland)
trigeminal branches
zygomatic / lacrimal nerves
(lacrimal gland)
sup.
salivatory
nucl.
(GVM)
solitary
nucl.
(SVS)
geniculate ggl.
inf.
salivatory
nucl.
(GVM)

9. sup. orbital fissure
ant. ethmoid for.
supraorbital
foramen
frontal
notch
frontal
n.
supraorbital n.
med. et lat. branches
supratrochlear n.
tentorial
branches
post. ethmoidal n.
ant. meningeal nerve
ant. ethm. n.
pterygopalatine ggl. in
the pterygopalatine fossa
inf. orbital fissure
trigeminal
ggl. for.
rotundum
zygomatic n.
lacrimal gland
greater petrosal n.
from CN VII.
post. ethmoid for.
Ophthalmic nerve (V/1.)

11. Postganglionic symathetic fibres of the head arise from the superior cervical
ganglion, the highermost one within the sympathetic trunk!

12. Maxillary nerve (V/2.)
inf. orbital fissure
foramen
rotundum
pterygoid
canal
greater and lesser
palatine canals
zygomatic nerve
infraorbital foramen
ORBIT
NASAL CAVITY
ORAL CAVITY
incisive canal
middle meningeal nerve
infraorbital nerve
sup. alveolar branches
nasal br.
lesser palatine nerves
pharyngeal and esophageal
branches
sphenopalatine foramen
trigeminal
ggl.
lacrimal gland
pharyngeal, palatine, nasal glands
palatine taste buds
greater petrosal
nerve from CN VII.
*
* fibres to the
pterygopalatine ganglion

13. Posterior, middle and anterior superior alveolar nerves constitute the superior
alveolar plexus. From this the dental branches enter through the root canals of the
superior teeth and innervate the pulp, while gingival branches arrising also from this
plexus supply the buccal gingiva. (Palatine gingiva is innervated by the incisive nerve
– terminal branch of the nasopalatine –, and the greater palatine nerve.)

15. Mandibular nerve (V/3.)
trigeminal
ggl.
mandibular
meningeal nerve
auriculotemporal nevre
submandibular ggl.
otic ggl.
sublingual gland
submandibular gland
chorda tympani
from CN VII.
parotid gland
lesser petrosal
nerve from CN IX.
taste buds of tongue
anterior motor
group
buccal branches (!)
branches of the motor group:
masseteric nerve
deep temporal nerve
medial pterygoid nerve
lateral pterygoid nerve
tensor tympani nerve
tensor veli palatini nerve
buccal nerves (!)
inf. alveolar nerve
Mylohyoid
Digastric, ant. belly

19. Homework...

23. Thank you for your
attention!