Maxillary division of the trigeminal nerve (V2)
Division or branch · CN V2 Sensory
The purely sensory middle division runs in the lower lateral wall of the cavernous sinus, passes through the foramen rotundum into the pterygopalatine fossa, where the pterygopalatine ganglion hangs from it, then continues as the infraorbital nerve along the orbital floor to emerge on the cheek. It supplies the mid-face: lower eyelid, side of the nose, cheek, upper lip, upper teeth and gum, palate and nasal cavity.
Traced from the start
- Pons
- Trigeminal nerve (CN V)
- Foramen rotundum
- Maxillary division of the trigeminal nerve (V2)
Detail
- Sensory
- Cheek, lower eyelid, side of the nose and upper lip (infraorbital); upper teeth and gums (superior alveolar nerves); hard and soft palate (greater and lesser palatine); nasal cavity and nasopharynx; middle cranial fossa dura (meningeal branch)
- Branches
- Meningeal, zygomatic, infraorbital, posterior superior alveolar, ganglionic branches to the pterygopalatine ganglion (palatine, nasal, pharyngeal)
- Ganglion
- Pterygopalatine: parasympathetic relay for the greater petrosal nerve (VII), whose postganglionic fibres ride V2 branches to the lacrimal, nasal and palatine glands
- Anaesthesia
- Infraorbital block numbs the cheek and upper lip; greater palatine and posterior superior alveolar blocks for maxillary teeth
When it goes wrong
Orbital floor blow-out fracture crushing the infraorbital nerve in its canal
Numbness of the cheek, upper lip and upper teeth, together with diplopia on upgaze from inferior rectus entrapment and enophthalmos
Trigeminal neuralgia, which most often involves V2 and/or V3
Brief electric-shock pain in the cheek and upper jaw triggered by light touch, chewing, brushing teeth or cold wind, often first attributed to dental disease; isolated V1 neuralgia is rare and should prompt a search for another cause
Carcinoma of the maxillary antrum eroding the orbital floor and infraorbital canal
Cheek numbness with epistaxis, a loosening upper molar or facial swelling in an older patient
Practise this structure
1 question in the bank tagged Trigeminal Nerve.