Nerve course and its initial branches
By function, the maxillary nerve is entirely sensory. Its topography begins within the cranial cavity, from where the nerve heads toward its exit via the foramen rotundum. Having passed through this opening, the nerve trunk enters the pterygopalatine fossa, where its main division occurs.
Even before exiting the cranial cavity, a meningeal branch (r. meningeus) departs from the trunk. Its main task is providing sensory innervation to the dura mater.
Main branches in the pterygopalatine fossa
Upon reaching the space of the pterygopalatine fossa, the nervus maxillaris gives off a series of crucial branches that provide sensation to various structures of the facial skeleton:
- Posterior superior alveolar branches (nn. alveolares superiores). Participate in the innervation of the maxillary teeth.
- Ganglionic branches. Proceed toward the pterygopalatine ganglion (ganglion pterygopalatinum).
- Zygomatic nerve (n. zygomaticus). This branch further divides into two terminal branches: the zygomaticofacial branch (r. zygomaticofacialis) and the zygomaticotemporal branch (r. zygomaticotemporalis).
Together with the terminal segment of the nerve, these branches innervate extensive areas: the skin of the lower eyelid, cheek, upper lip, as well as the mucosa of the nasal cavity and palate.
Infraorbital nerve
Infraorbital nerve (n. infraorbitalis) is the direct and largest continuation of the maxillary nerve. Along its course, it gives off multiple branches to the structures of the face and the dentomaxillary system.
Among the branches of the infraorbital nerve are:
- Middle superior alveolar branch (r. alveolaris superior medius).
- Anterior superior alveolar branches (rr. alveolares superiores anteriores).
- Inferior palpebral branches (rr. palpebrales inferiores) — provide sensation to the skin of the lower eyelid.
- External and internal nasal branches (rr. nasales externi et interni) — innervate the corresponding parts of the nose.
- Superior labial branches (rr. labiales superiores) — responsible for the sensation of the upper lip.
Briefly: answers to topical questions
What are the functions of the pterygopalatine ganglion and which branches head toward it?
Pterygopalatine ganglion (ganglion pterygopalatinum) is a vegetative ganglion of the face associated with the second branch of the trigeminal nerve.
From the maxillary nerve (n. maxillaris, V2), branches to the ganglion pterygopalatinum proceed toward the pterygopalatine ganglion.
What are the exact exit points of the infraorbital nerve branches on the face?
The infraorbital nerve emerges onto the face through the infraorbital foramen into the loose adipose tissue of the canine fossa, where it forms the lesser goose's foot (pes anserinus minor).
Here it gives off its terminal branches:
- Inferior palpebral branches (rr. palpebrales inferiores) — head toward the skin of the lower eyelid.
- External and internal nasal branches (rr. nasales externi et interni) — proceed to the lateral surface of the nose.
- Superior labial branches (rr. labiales superiores) — innervate the skin and mucosa of the upper lip.
Which trigeminal nerve nuclei are connected with the sensory fibers of the maxillary nerve?
The sensory fibers of the maxillary nerve transmit afferent information to the three sensory nuclei of the trigeminal nerve in the brainstem.
- Chief sensory nucleus (nucleus principalis n. trigemini) — receives fibers of tactile sensation (touch, pressure).
- Spinal trigeminal nucleus (nucleus spinalis n. trigemini) — receives fibers of pain and temperature sensation.
- Mesencephalic nucleus (nucleus mesencephalicus n. trigemini) — receives fibers of proprioceptive sensation.
Class and exam questions
Does the maxillary nerve contain motor fibers?
No, the maxillary nerve is purely sensory. Motor and parasympathetic fibers are absent within the trunk itself.
Through which opening does the nerve leave the cranial cavity?
The trunk of the maxillary nerve passes through the foramen rotundum, after which it enters directly into the pterygopalatine fossa.
What does the meningeal branch innervate?
The meningeal branch (r. meningeus) provides sensory innervation to the dura mater.
Into which branches does the zygomatic nerve divide?
The zygomatic nerve (n. zygomaticus) divides into two main branches: zygomaticofacial (r. zygomaticofacialis) and zygomaticotemporal (r. zygomaticotemporalis).
What else to study on this topic
- Topography and boundaries of the pterygopalatine fossa
- Connections of the maxillary nerve with the pterygopalatine ganglion (ganglion pterygopalatinum)
- Formation of the superior dental plexus from alveolar branches
- Areas of innervation of the terminal branches of the infraorbital nerve on the face
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