[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Trigeminal nerve (V) [Nervous system](https://durgical.com/en/anatomy/system/nervous-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Trigeminal nerve (V) The trigeminal nerve (cranial nerve V) gives feeling to the face, eyes, nose, mouth and teeth and powers the chewing muscles. Official name: Trigeminal nerve [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=trigeminal_nerve&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The large nerve from the pons that splits into three branches (V1, V2, V3). ## What it does Feeling of the face, eye, nose, mouth and teeth; powers the chewing muscles. ## Key points - Trigeminal neuralgia: brief, shooting, electric pains in the V2 or V3 area, set off by light touch, chewing, talking or a breeze; often a vessel pressing on the root at the pons - Only V3 carries motor fibres: a lesion weakens chewing, and on opening the jaw deviates toward the weak side, pushed by the healthy [lateral pterygoid](https://durgical.com/en/anatomy/superior-head-of-lateral-pterygoid-muscle/) - The [skin](https://durgical.com/en/anatomy/skin/) over the angle of the jaw is not trigeminal: it belongs to the great auricular nerve (C2–C3), so numbness there does not fit a trigeminal lesion - Referred pain travels within the nerve: a lower molar can ache in the ear (auriculotemporal branch) and irritated dura is felt as headache ## Key facts **Roots** Motor nucleus and sensory nuclei (pons, mesencephalic to spinal); trigeminal ganglion; V1 [superior orbital fissure](https://durgical.com/en/anatomy/superior-orbital-fissure/), V2 [foramen rotundum](https://durgical.com/en/anatomy/foramen-rotundum/), V3 foramen ovale **Moves** Muscles of mastication, [mylohyoid](https://durgical.com/en/anatomy/mylohyoid-muscle/), anterior [digastric](https://durgical.com/en/anatomy/anterior-belly-of-digastric-muscle/), tensor tympani, tensor veli palatini (V3) **Feeling from** Face, [cornea](https://durgical.com/en/anatomy/cornea/), nasal and oral mucosa, teeth, anterior two thirds of the [tongue](https://durgical.com/en/anatomy/tongue/) (general), dura ## Relations **Course** Leaves the side of the [pons](https://durgical.com/en/anatomy/pons/) as a large sensory root and a small motor root, crosses to the petrous apex and enters Meckel's cave, where the [trigeminal ganglion](https://durgical.com/en/anatomy/trigeminal-ganglion/) gives off the three divisions; the [V1 ophthalmic](https://durgical.com/en/anatomy/ophthalmic-nerve/) and [V2 maxillary](https://durgical.com/en/anatomy/maxillary-nerve/) nerves run in the lateral wall of the [cavernous sinus](https://durgical.com/en/anatomy/cavernous-sinus/), while the [V3 mandibular](https://durgical.com/en/anatomy/anterior-division-of-mandibular-nerve/) nerve drops straight through the [foramen ovale](https://durgical.com/en/anatomy/foramen-ovale/) **Above** Near the root entry zone, the [superior cerebellar artery](https://durgical.com/en/anatomy/superior-cerebellar-artery/), the vessel most often found pressing on the root in trigeminal neuralgia **Medial** The cavernous sinus and the [internal carotid artery](https://durgical.com/en/anatomy/internal-carotid-artery/), medial to the ganglion and its first two divisions ## How to find it Sensation is compared side to side on the forehead (V1), the cheek (V2) and the chin (V3). Motor power is felt in the [masseter](https://durgical.com/en/anatomy/superficial-part-of-masseter/) and [temporalis](https://durgical.com/en/anatomy/temporalis-muscle/) while the person clenches the teeth. ## Examination - Facial sensation: light touch and pinprick on forehead, cheek and chin; loss in one division points to a branch, loss in all three to the ganglion or the root - Corneal reflex: touching the cornea with a wisp of cotton makes both eyes blink; afferent V1 (nasociliary), efferent [facial nerve (VII)](https://durgical.com/en/anatomy/facial-nerve/) - Jaw jerk: a tap on the chin with the mouth slightly open; a brisk jerk suggests an upper motor neuron lesion above the pons - Motor: clenching (bulk of masseter and temporalis) and opening against resistance; the jaw deviates toward a weak side ## On imaging Thin-slice MRI through the cisternal segment looks for a vessel touching the root (neurovascular contact) and for tumours or multiple sclerosis plaques at the root entry zone. ## Common problems - Trigeminal neuralgia: brief electric-shock pains in the face triggered by touch, chewing or wind. - Shingles in the V1 area can damage the eye. ## How it is diagnosed Typical history; MRI to look for a vessel pressing on the nerve. ## Treatment - Anti-seizure medicines (such as carbamazepine). - Microvascular decompression or procedures through the foramen ovale when medicines fail. - Antivirals early for shingles. ## Clinical notes - Trigeminal neuralgia in a young adult, or on both sides, raises the question of multiple sclerosis - Procedures for neuralgia that does not respond to treatment act on the root or the ganglion: microvascular decompression, percutaneous ganglion procedures and radiosurgery - Lateral medullary syndrome damages the spinal trigeminal nucleus: loss of pain and temperature on the same side of the face and the opposite side of the body - Cavernous sinus disease can numb the V1 and V2 areas but spares V3, which does not pass through the sinus ## Memory aid Exits of the divisions, top to bottom: "Standing Room Only": Superior orbital fissure (V1), Rotundum (V2), Ovale (V3). ## Related conditions - [Migraine](https://durgical.com/en/conditions/migraine/) - [Trigeminal neuralgia](https://durgical.com/en/conditions/trigeminal-neuralgia/) - [Cluster headache](https://durgical.com/en/conditions/cluster-headache/) ## Test yourself Think of the answer, then tap the question to see it. ## What is trigeminal neuralgia and what usually causes it? Brief, electric shooting pains in the V2 or V3 area triggered by touch, chewing, talking or a breeze; often a vessel (superior cerebellar artery) pressing on the root. ## Through which foramina do the three divisions of the trigeminal nerve (V) leave the skull? V1 the superior orbital fissure, V2 the foramen rotundum, V3 the foramen ovale. ## Which way does the jaw deviate on opening in a trigeminal motor lesion, and why? Toward the weak side, pushed by the healthy lateral pterygoid; only V3 carries motor fibres. ## What are the afferent and efferent limbs of the corneal reflex? Afferent: V1 of the trigeminal nerve (nasociliary). Efferent: the facial nerve (VII), closing both eyes. ## Why does numbness over the angle of the jaw not fit a trigeminal nerve lesion? That skin is supplied by the great auricular nerve (C2–C3), not the trigeminal nerve. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/trigeminal-nerve/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** nervus trigeminus TA2 6192 **Official Spanish (DeCS)** Nervio Trigémino DeCS D014276 **English (TA2)** Trigeminal nerve **Also called** cranial nerve V · Gasserian ganglion Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=14675); [Neuroanatomy, Cranial Nerve 5 (Trigeminal)](https://www.ncbi.nlm.nih.gov/books/NBK482283/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/trigeminal-nerve/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/trigeminal-nerve/