Lec [8]: Mandibular nerve:

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Lec [8]: Mandibular nerve: The mandibular branch from the trigeminal ganglion lies in the middle cranial fossa lateral to the cavernous sinus. With the motor root of the trigeminal nerve [motor roots lies deep to trigeminal ganglion] it enters the foramen ovale, where the two join and emerge as the mandibular nerve. The nerve lies deep to the upper head of the lateral pterygoid, between it and the tensor palati muscle, with the otic ganglion on its deep surface [medial surface] of the nerve. After a short course the nerve divides into a small anterior (mainly motor) and a large posterior (mainly sensory) branch. Branches from the main trunk One sensory and one motor. The meningeal branch, or nervus spinosus, re-enters the middle cranial fossa via the foramen spinosum, or the foramen ovale, supplying the

meninges of the middle cranial fossa. The nerve to the medial pterygoid muscle runs forwards to the muscle, and gives a branch which passes through the otic ganglion [from which the otic ganglion is suspended] without synapse and through which motor fibers are transmitted to tensor palatini and tensor tympani. I0 Branches from the anterior division The anterior trunk gives off: 1 a sensory branch, the buccal nerve, which supplies part of the skin of the cheek and It then pierces the buccinator and supplies the mucous membrane of the cheek and the gum of the lower jaw opposite the lower molars and second premolar (i.e. up to the mental foramen). 2 motor branches to the masseter, temporalis and lateral pterygoid muscles.

This division is motor, except for one branch (the buccal nerve). Branches from the posterior division This division is sensory except for the motor fibers which are distributed via the mylohyoid nerve. Its branches are: 1 The auriculotemporal nerve, is derived by two roots from the posterior division; they embrace the middle meningeal artery. The nerve passes backwards between the neck of the mandible and the sphenomandibular ligament, lying above the maxillary vessels. It gives a branch to the parotid gland and temporomandibular joint, and ascends over the lateral aspect of the zygomatic arch. The auricular part innervates : *The skin of the upper part of the lateral surface of the auricle. *The external acoustic meatus. *The outer surface of the tympanic membrane. The temporal part is distributed to the skin of the temple.

2 The lingual nerve: The lingual nerve appears below the lateral pterygoid and passes forwards and downwards on the medial pterygoid. It then comes into contact with the mandible, where it form a shallow groove below and medial to the third molar, just above the posterior end of the mylohyoid line. This groove separates the attachments of the pterygomandibular raphe above and mylohyoid muscle below. The nerve is characteristically flattened here, rather than round, and it enters the mouth on the superior surface [deep] of the mylohyoid. It gives off a gingival branch which supplies all the lingual gum and mucous membrane of the floor of the mouth. The lingual nerve then crosses the submandibular duct and runs forwards and medially to the tongue. The chorda tympani (from the facial nerve) emerges through the petrotympanic fissure, and joins the lingual nerve at an acute angle, 2 cm below the base of the skull, and is distributed with it to the anterior two thirds of the tongue. It carries

parasympathetic secretomotor fibers to the submandibular ganglion and taste fibers from the anterior two-thirds of the tongue. 3 The inferior alveolar (dental) nerve, which passes down into the mandibular canal and supplies branches to the teeth of the lower jaw. It then emerges from the mental foramen to supply the skin of the chin and lower lip and mucous membrane of lower lip. This branch [inferior alveolar] also conveys the only motor component of the posterior trunk: the nerve to the mylohyoid, runs forward on the superficial (cervical) surface of the mylohyoid supplying the mylohyoid muscle and the anterior belly of the digastric. Otic ganglion

This small body lies between the tensor palati and the mandibular nerve, just below the foramen ovale. It is about 2 3 mm in diameter, closely applied to the medial surface of the nerve. It is a relay station for parasympathetic secretomotor fibers to the parotid gland; the lesser petrosal branch of the glossopharyngeal nerve brings these fibers. Postganglionic sympathetic fibers from the plexus around the middle meningeal artery, sensory fibers from the auriculotemporal nerve and a branch from the nerve to the medial pterygoid (to tensor tympani and palati) pass through the ganglion without relay.