Peripheral Anatomy

The first division, or ophthalmic branch, leaves the cranial vault through the superior orbital fissure and surfaces onto the face through the superior orbital foramen. Read again the sections on lesions of the third, fourth, and sixth cranial nerves (Chapter 4) in the cavernous sinus and at the superior orbital fissure; you will find most of the lesions of this division of the trigeminal nerve. This division supplies the area labeled "1" in Figure 8-1—the cornea, the mucous membrane of the upper nose, and some meninges.

The second division, or maxillary branch, leaves the cranial vault through the foramen rotundum and surfaces through the infra-orbital foramen. This division supplies the area labeled "2" in Figure 8-1—the mucous membrane of the lower nose, the upper jaw, upper teeth, and anterior palate.

The third division, or mandibular branch, leaves the cranial vault through the foramen ovale and surfaces through the mental foramen. This division is also motor to the pterygoids, masseter, temporalis, mylohyoid, and anterior belly of the digastric muscles. This division supplies (sensory) area 3 in Figure 8-1—the tongue, the lower teeth, and the mucous membrane of the floor of the mouth, cheek, and lower lip.

Figure 8-1. The three cutaneous sensory divisions of the trigeminal nerve. The area marked with an asterisk is not part of the trigeminal nerve and is part of the territory of the greater auricular nerve (C2 and C3).

There is no overlap between the areas supplied by the three peripheral divisions of the trigeminal nerve, unlike the situation with the spinal nerves. All three divisions supply sensation to the dura.

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