Neurology | Trigeminal Nerve: Cranial Nerve V

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Ninja Nerds!
Join us in this lecture, where Professor Zach Murphy will discuss the trigeminal nerve, cranial nerve V, focusing on its complex anatomy, functions, and clinical importance. We begin by exploring its origin from the pons and its division into three major branches: the ophthalmic (V1), maxillary (V2), and mandibular (V3) nerves. Each branch carries sensory fibers, while the mandibular branch also carries motor fibers to the muscles of mastication.

We follow the sensory distribution of each branch, from the ophthalmic nerve innervating the cornea, forehead, and scalp; the maxillary nerve covering the cheek, upper lip, and maxillary teeth; to the mandibular nerve supplying the lower jaw, teeth, and anterior two-thirds of the tongue (general sensation only). Motor functions of the mandibular branch are highlighted, including its role in chewing through the temporalis, masseter, and pterygoid muscles. We also review the trigeminal ganglion, Meckel’s cave, and the distinct foramina through which each division passes—superior orbital fissure (V1), foramen rotundum (V2), and foramen ovale (V3).

We then discuss key clinical correlations such as the corneal reflex, trigeminal neuralgia, and lesions affecting different branches, emphasizing how to localize the lesion based on sensory or motor deficits. Special attention is given to the importance of distinguishing peripheral branch lesions from more proximal involvement at the level of the brainstem or ganglion.

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