Secretomotor fibres carried on trigeminal branches

Postganglionic · M3 V2 → V1 lacrimal V3 lingual V3 auriculotemporal

Postganglionic parasympathetic fibres from the three secretomotor head ganglia reach their glands by hitch-hiking on branches of the trigeminal nerve: zygomatic (V2) then lacrimal (V1) to the lacrimal gland, lingual (V3) to the submandibular and sublingual glands, and auriculotemporal (V3) to the parotid.

Traced from the start

  1. Parasympathetic (craniosacral) outflow
  2. Superior and inferior salivatory nuclei (CN VII and IX)
  3. Pterygopalatine (sphenopalatine) ganglionSubmandibular ganglionOtic ganglion
  4. Secretomotor fibres carried on trigeminal branches

Detail

Pterygopalatine → lacrimal gland
Zygomatic nerve (V2) → zygomaticotemporal branch → communicating branch → lacrimal nerve (V1) → gland; nasal and palatine glands via nasopalatine and palatine nerves
Submandibular → glands
Direct short branches to the submandibular gland; via the lingual nerve to the sublingual gland
Otic → parotid
Auriculotemporal nerve (V3), which also carries sensation from the temple and auricle

When it goes wrong

Trigeminal (V3) nerve block or lingual nerve injury during third molar extraction

Reduced salivation on that side alongside tongue numbness, because the postganglionic fibres share the lingual nerve

Parotid surgery with regeneration of auriculotemporal parasympathetic fibres into the skin

Frey syndrome: gustatory sweating over the cheek — treated with topical glycopyrrolate or botulinum toxin, both acting on the cholinergic sweat gland

Practise this structure

1 question in the bank tagged Trigeminal Nerve.