Trigeminal nerve

hi everyone so today's topic for the India's finish line is on trigeminal nerve and it's applied aspects so the facial and the trigeminal nerve are equally important they can be asked as essays so the contents as I said they're very important so first you have to write these contents for this trigeminal nerve so again under individual content you can give a subheadings like for example under anatomy you can give the headings like ganglia on the branches and the new clay of the trigeminal nerve okay on it and again under examination you can give the subheadings like the history taking and the examination and the physical examination like that you can get and under the clinical aspects what all the diseases that you are going to cover for example the trigeminal neuralgia so you can give the subheadings like the clinical features management so like that you can even give this up headings but these are the main contents that you have to cover so coming to the trigeminal nerve if it comes an essay so you can write the other cranial nerves you can just name the other cranial nerves followed by which you can write the introduction for the trigeminal nerve so we can call it as a fifth cranial nerve which is one of the largest and the trigeminal means three so it has it has main three branches or three major branches which are the ophthalmic the maxillary and the mandibular okay so coming to the next heading that is a nuclei you have to write the nucleus which commander or which is the trigeminal nerve has so it has three units that is a motor nucleus the sensory mission cephalic nucleus and the third one is a sensor nuclear complex which is again divided as two distinct nuclear that is the main sensory nucleus and the nucleus of this spinal tract so you can put this diagram there but where it is showing the missing cephalic nucleus and the primary sensory nucleus okay as shown in the picture so you can put this diagram so diagrammatic representation is very important and even you can draw the spinal nucleus which is it this rostral and you can see so the blue thing is a spinal nucleus even you can draw like that and the death Syrian or the trigeminal ganglion which is a crescent shaped structure you can showing the three main branches so you can draw this small diagram it is like scoring for you okay so again coming to the individual nuclear you can just give a bit of description of the individual nuclei as in the motor nuclei where the two principal muscles have been involved that the masseter and the temporal and coming to the missing cephalic nuclei where it consists of a missing cephalic nucleus which is unipolar and most of these are proprio or proprioceptive in function with receptive terminals responding to the stretch of the muscles of mastication okay so you can give slight description of these new clay as given here so that to increase the bulk of the answer if it comes as a twenty marks question then you have to increase the answer by giving extra points like this the main thing is you have to give good headings okay so these diagrams and headings are equally important so coming to the next part is a trigeminal route this route again consists off like the sensory and the motor divisions which are seen as a separate routes as you can see in the picture there are two separate routes okay these are again supplied by the group of vessels which are called as a trigeminal arteries so you can give this small diagram if you want so next coming to its gangly on the ganglion for the trigeminal new nerve is AG acid in Daniel and whereas for the facial nerve is a geniculate ganglion that is simple you have to remember so this ganglion again you can give a description for that that it is christen shape it lies in the metal scape it lies on the anterior posterior or sorry anterior superior surface of the petrous bone it is an expansion of the proximal sensory artery or sensory route okay so like that and it is surrounded by eric annoyed and dura mater so all these important points related to Brazilian ganglion you can give because gasoline Rangel alkane can be asked as a simple very short answer so you have to put this diagram you can give little explanation again if you have if it comes as very short also this small thing is not enough then you have to add the other important aspects of trigeminal so putting this diagram will be very important and fetching for the very shot so have a note of this so especially you have to write this part that it is surrounded by Eric nerd and durometer as shown in the picture so you can highlight that okay and also it lies in the anti row superior surface of the petrous bone so all these points if you have to put in there so coming to the main branches it is trigeminal so it has three main branches that is ophthalmic the maxillary and the mandibular so after writing the gasolene ganglion if the guy sitting idle or individually comes as a question then again you can write these notes because you can write that this ophthalmic nerve arises from the anterior medial aspect of the gasoline ganglion so like that you can extend your answer so this point will be fetching there again okay the branches of the the branches of the ophthalmic nerve are these three that is neck lacrimal the frontal and the nasal ciliary so this diagram you can put in okay or tall diagrams you can draw from your cherish a textbook all those diagrams if we put in there it will be very much fetching for the score okay so anyways examiner will look how you have presented well so it depends on how nicely headings you have put and what all diagrams you have included especially like anatomy related questions so you can write draw these diagrams if you can next time into the lacrimal nerve so you have to write the cause of how it passes and and again before entering to the gland it has divided into two okay so like that you can put so it supplies the lacrimal gland again so next coming to the frontal nerve so the frontal nerve it gives off again to main small branches that is super trolly ER and supraorbital so like in the middle of the orbit it gives these two so as you can see in this diagram okay so that you can put in there next coming to the nasal ciliary it is a nerve further sensory supply to the eye so it is for the sensory supply okay apart from that these branches are the long end of the long and sensory road the long ciliary nerves the infrastructure nerve nasal branches so the frontal nerve is Supra trochlear but as infrared rock layer comes under nasal ciliary so these points you have to put in again so individual branches of those individual nerves of that particular division you have to write you can simply end up with ophthalmic division and you can you can simply give those three branches and go to the next division if you write again the individual in a nice flow chart and if you put a diagram there it will be fetching okay next coming to the maxillary it is a purely sensory division it's completely sensory and it arises from the frontal central portion of the gasoline ganglion okay so that point you have to highlight if you get a question on gasoline ganglion again so the most important branches is the middle meningeal nerve as you can see so it's a middle meningeal nerve is the most this and again passes through the foreign foramen rotundum so as we know this was the important question in a PG preparation so this passes through the foramen rotundum so again it has two other branches as i grammatic nerve intern that is zygomatic a facial and zygomatic or temporal so these points you have to put in there okay and the later you have to see that it travels through the inferior orbital fissure into the orbit which becomes a inferior orbital nerve infraorbital nerve which exits from the infraorbital foramen so all the course if you write it will be even more fetching if it comes with twenty months so we are done with ophthalmic and the maxillary nerve so you have to write the detail course so the points which have shown you can just make a small notes of it that's enough so coming to the large division is a mandibular it contains both sensory as well as a motor okay so it is formed by a large density root from the gasolene ganglion that has passed inferiorly through the motor root of the trigeminal nerve these through pass through the foramen ovale okay that one maxillary passes through foramen rotundum here it passes through foramen ovale okay again it has anterior and the posterior division so what all muscles and what all the things it or what are the structures it in our ways we have to write so these muscles which include that in the anterior division are the branch to the lateral pterygoid to the masseter to deep temporal and the Bucks inators so all these you have to write these are the structures that have been innovated by this nerve then the posterior division again you have to give this or Clos temporal the lingual and the inferior alveolar nerve so these points have to put in and again what are the importance of the individual branch if you write it was even more fetching okay so so we know the lingual nerve and the internal villain of it's a twin fellow a laverna almost supplies all the teeth and the of the lower jaw so again it gives off through branches at the like mental foramen mental nerve and again in the incisive foramen it gives incisive branches so all that in detail if you describe that's more fetching okay so oraculo temporal nerve you can see in structures being innovated that is upper part of lateral surface of the ear upper part of the meters a tympanic membrane the parotid gland and the skin off side of the face okay the lingual nerve is further sensation to the gums and the anterior portion of the tongue whereas in filler al-balad nerve it has three branches that is the mylohyoid nerve giving to the malahide muscle and the anterior belly of digastric posterior value of digastric is by facial nerve okay next the inferior dental plexus through the gums and the teeth of the mandible where as a mental nerve is for the skin of the chin and skin of the mucous membrane of the lower lip and the gum so all these innovations you have to write so that it increases your answer so coming to the examination so we have done with the gazillion ganglion we have done with a nuclei the trigeminal nerve and the individual branches also individual divisions along with the individual branches and the structure is being innovated by those branches so half this is just outline I am giving so these headings they have to fall in and then you can give your own detailed description along with the diagrams if you give it is fetching so next coming to the have you examined so based on the history if the patient is having any problem audience you can just see for the sense of touch you can just use small pin not the shock thing you can just use a small pin like structure to see for the sensations okay and also for the Cornell sensations you can see next with a motor function you can see the strength of the muscles especially the masseter the temporalis and the pterygoid you can ask the patient to open closed the mouth and give the lateral exertion moments and all that by that you can see the test for the motor function so coming to the clinical aspects so the most important disease or the condition which is associated with the trigeminal nerve which every department student has to write as a trigeminal neuralgia it is most important applied aspect you have to write irrespective of your department so especially for oral medicine surgery and or path it's equally important so write this for sure so what the exact condition you know you have to write the definition which is given by the International Association of the study of pain which is highlighted in this box so it's better you write that definition okay and you have to write which of the division is it was more commonly involved you can say the v3 that is mandibular division is more commonly in word followed by the other divisions ok the etiology could be anything so it is actually unknown but it could be the compression of the tri nerve root okay so it could be either by the compression caused by the superior cerebral artery on the v2 and v3 whereas anterior inferior cerebral artery on v1 okay this if you right it's useful for the etiology point of view next coming to the other it could be the tumors or veins or any at Raveena's malformations can cause so the pathogenesis if there is a compression then there will be breakdown of the myelin which cause abnormal depolarization and that results in ectopic impulse is causing the pain so this is a small pathogenesis which you can put there coming to the clinical features so you have to write these clinical features we know the sudden stabbing unilateral pain which just triggered by anything it can be triggered by even exposure to cold air or washing the face or doing makeup or whatever it is classically unilateral sudden and stabbing type of pain it has its own trigger Jones okay so this are the important findings that you have to write and then the management the pharmacological management the most important of commonly given rap is a common carbamazepine so that dosages if you right it's okay or as you can give it's major side effect so carbamazepine has a main side effect of causing a meteo suppression or a bone marrow suppression that's the reason next it's analog or it's more good version is oxcarbazepine so though these are anticonvulsant wrap they act on the sodium voltage-gated sodium channels because of which they have been given in this regime in a neuralgia this has less of bone marrow suppression so oxcarbazepine is now more given when compared to carbamazepine so now this is more more commonly given as a rub of choice so both are almost the same so these are the dosages if the oral medicine students can write it will be useful for you you can just keep the small box and write and coming to the surgical aspects so all these surgical aspects if you put in that's enough and if you can individually describe if you have time if you can describe that's enough or else you can leave it it's mean see basics paper they will mainly ask about the basic knowledge you have so you have to put in the anatomy and the if they ask an admiral point of you have to write an atomic point of view if they ask in the physiological point of you have tried the physiology point of view like that so if you mainly put in those points and applied aspects also do count marks they have some fortify marks for the applied aspects but the main clinical features of her and the have you examine and minimum thing of management if you write you can fetch those marks as well so that says students and at the at the end if you put it if you can