Mandibular nerve

Mandibular nerve

1. MANDIBULAR NERVE BY: Dr. Mohammad Amaan

2. Introduction Largest mixed branch of the trigeminal nerve Nerve of the 1 st branchial arch Supplies all the structure derived from the 1 st arch Otic and submandibular ganglia are associated with this nerve

3. Course and relation It begins in the (MCF) middle cranial fossa Large sensory + small motor root = main trunk Sensory root arises from trigeminal ganglion and runs forwards and laterally towards foramen ovale Motor root arises from the trigeminal motor nucleus in the pons & runs deep to the trigeminal ganglion to join the sensory root in the foramen ovale

4. Cont.. Sensory root + motor root = main trunk The main trunk - lies in the infratemporal fossa - on the tensor veli palatini, deep to lat. Pterygoid The main trunk divides to - small anterior trunk - large posterior trunk

5. Branches of mandibular nerve A) Br a nch e s of t h e m a in n erve tr u nk. B) from the (small) a n ter i or divisio n C) from the (large) p o steri o r divisio n

6. 1. Branch from the M ain trunk 2 branches (one motor and one sensory) A) M- M eningeal branch B) M - Nerve to M edial Pterygoid

7. A. M eningeal branch / nervous spinosus (sensory) – it enters the skull through foramen spinosum with the middle M eningeal artery Supplies the Dura mater of M CF, middle cranial fossa

8. B. Nerve to m edial Pterygoid . ( M otor)- - arises close to the otic ganglion - s uppl i es m edial Pterygoid - it also gives a branch which traverse the otic ganglion without relay to supply the:- -- tensor veli palatini & -- ten s or ty mpani mus c le s

9. Branches of the anterior divis i on 4 branches (1 sensory and 3 motor) B – B uccal nerve (sensory) P – Lateral P terygoid M – M asseteric nerve T – deep T emporal nerves

10. 1. Buccal nerve Sensory branch Passes between two heads of lateral Pterygoid, runs downwards and forwards Supplies the:- - skin of the cheek - mucous membrane related to the buccinator - labial aspect of gums of molar and premolar teeth

11. 2. Masseteric nerve Emerges at the upper border of lateral Pterygoid Enters the deep surface of masseter Supplies:- -- masseter muscle -- TMJ

12. 3. Deep temporal nerves Two in number- anterior and posterior Passes between the skull and the lateral Pterygoid Enters the deep surface of temporalis

13. 4. Nerve to lateral Pterygoid Enters the deep surface of lateral pterygoid

14. 3) branches from the (large) p o steri o r divisio n A - Auriculotemporal nerve L - Lingual nerve I - Inferior Alveolar nerve

15. A - Auriculotemporal nerve Arises by 2 roots, runs backwards, encircle the middle Meningeal artery, unite to form a single trunk Auricular part :- supplies – Skin of the tragus Upper part of pinna External acoustic meatus Tymapnic membrane Temporal part :- supplies – skin of the temple Auriculotemporal nerve also supplies- Parotid gland ( secretomotor and sensory) TMJ

16. Lingual nerve Its sensory to the anterior 2/3 rd of the tongue and to the floor of the mouth Fibres of chorda tympani (branch of facial nerve) are also distributed through the lingual nerve. COURSE :- It begins one cm below the skull, little below it joins with the chorda tympani nerve .

17. 3.Inferior Alveolar nerve Larger terminal branch of posterior division It enters the mandibular foramen and runs in the mandibular canal. It is accompanied by the inferior alveolar artery

18. . BRANCHES :- 1. Mylohyoid branch - it arises before the inferior alveolar nerve enters the mandibular foramen. Supplies:- mylohyoid muscle, anterior belly of digatric 2. In the canal it gives branches that supply the lower teeth and gums 3. Mental nerves ;- emerges at the mental foramen,supplies skin of the chin, skin and mucous mebrane of the lower lip. Its incisive branch supply incisor and canine teeth

19. Otic ganglion It is peripheral parasympathetic ganglion, which relays secretomotor fibres to the parotid gland Topographically – related to mandibular nerve Functionally – related to gloss pharyngeal nerve

20. Size and situation It is 2-3 mm in size Situated in the infratemporal fossa, just below the foramen ovale Lies medial to the mandibular nerve, lateral to the tensor veli palatini.

21. Connection and branches The secretomotor or parasympathetic root is formed by the lesser petrosal nerve Sympathetic root is derieved from the plexus on the middle meningeal artery The sensory root comes from the auriculotemporal nerve and is sensory to the parotid gland.