Infraorbital nerve

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Infraorbital nerve
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Left orbicularis oculi, seen from behind. (Infraorbital nerve labeled at lower left.)
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Sensory areas of the head, showing the general distribution of the three divisions of the fifth nerve. (Infraorbital nerve labeled at center left, at the nose.)
Details
From Maxillary nerve
To Posterior superior alveolar nerve, middle superior alveolar nerve, anterior superior alveolar nerve, palpebral branches, nasal branches, superior labial branches
Identifiers
Latin nervus infraorbitalis
TA98 A14.2.01.059
TA2 6239
FMA 52978
Anatomical terms of neuroanatomy

The infraorbital nerve is a branch of the maxillary nerve (itself a branch of the trigeminal nerve (CN V)). [1] It arises in the pterygopalatine fossa. It passes through the inferior orbital fissure to enter the orbit. [2] It travels through the orbit, then enters and traverses the infraorbital canal, exiting the canal at the infraorbital foramen to reach the face. It provides sensory innervation to the skin and mucous membranes around the middle of the face. [1]

Contents

Structure

Origin

The infraorbital nerve is a branch of the maxillary nerve (CN V2), itself a branch of the trigeminal nerve (CN V); [2] it may be considered as the terminal branch of the maxillary nerve. [3] It arises from the maxillary nerve in the pterygopalatine fossa. [2]

Course

It travels through the inferior orbital fissure to enter the orbit. [2] It runs anteriorly along the floor of the orbit in the infraorbital groove to the infraorbital canal of the maxilla. Within the infraorbital canal it has three branches, the posterior superior alveolar nerve, middle superior alveolar nerve and anterior superior alveolar nerve. After traversing the canal it emerges onto the anterior surface of the maxilla through the infraorbital foramen. Here, it divides into its terminal branches; palpebral, nasal and superior labial.

Branches

Within infraorbital canal from proximal to distal:

After it exits the infraorbital foramen:

The palpebral branches ascend deep to the orbicularis oculi and pierce the muscle to supply the skin of the lower eyelid. The nasal branches supply the skin of the side of the nose and the moveable part of the nasal septum. The superior labial branches descend deep to the levator labii superioris to supply the skin of the anterior cheek and upper lip.

Relations

Along its course, the infraorbital nerve is accompanied by the infraorbital artery and vein. [2]

Distribution

The infraorbital nerve provides sensory innervation to the skin of the lower eyelid, [2] the side of the nose, [2] the moveable part of nasal septum,[ citation needed ] the anterior cheek,[ citation needed ] and part of the upper lip. [2] It does not provide motor supply to any muscles.[ citation needed ]

Clinical significance

Infraorbital nerve block

The infraorbital nerve is often blocked with local anesthetic to induce analgesia. This may be due to chronic pain, [2] or during dental or surgical procedures of the face such as for the management of postoperative pain associated with cleft lip correction. [4] The needle is inserted (aiming medially) near to the infraorbital foramen, which can be palpated. [2] The nerve may be blocked using either a transcutaneous or intraoral approach. [4]

Trigeminal neuralgia

The infraorbital nerve can be implicated in trigeminal neuralgia, where patients have severe orofacial pain. [5]

Orbital fracture

A fracture of the floor of the orbit can injure the infraorbital nerve resulting in anesthesia in its sensory distribution.

Related Research Articles

<span class="mw-page-title-main">Facial nerve</span> Cranial nerve VII, for the face and tasting

The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue. The nerve typically travels from the pons through the facial canal in the temporal bone and exits the skull at the stylomastoid foramen. It arises from the brainstem from an area posterior to the cranial nerve VI and anterior to cranial nerve VIII.

<span class="mw-page-title-main">Mandibular nerve</span> Branch of the trigeminal nerve responsible for the lower face and jaw

In neuroanatomy, the mandibular nerve (V3) is the largest of the three divisions of the trigeminal nerve, the fifth cranial nerve (CN V). Unlike the other divisions of the trigeminal nerve (ophthalmic nerve, maxillary nerve) which contain only afferent fibers, the mandibular nerve contains both afferent and efferent fibers. These nerve fibers innervate structures of the lower jaw and face, such as the tongue, lower lip, and chin. The mandibular nerve also innervates the muscles of mastication.

<span class="mw-page-title-main">Orbit (anatomy)</span> Cavity or socket of the skull in which the eye and its appendages are situated

In anatomy, the orbit is the cavity or socket/hole of the skull in which the eye and its appendages are situated. "Orbit" can refer to the bony socket, or it can also be used to imply the contents. In the adult human, the volume of the orbit is about 28 millilitres, of which the eye occupies 6.5 ml. The orbital contents comprise the eye, the orbital and retrobulbar fascia, extraocular muscles, cranial nerves II, III, IV, V, and VI, blood vessels, fat, the lacrimal gland with its sac and duct, the eyelids, medial and lateral palpebral ligaments, cheek ligaments, the suspensory ligament, septum, ciliary ganglion and short ciliary nerves.

<span class="mw-page-title-main">Lacrimal gland</span> Exocrine gland, one for each eye, that secrete tears

The lacrimal glands are paired exocrine glands, one for each eye, found in most terrestrial vertebrates and some marine mammals, that secrete the aqueous layer of the tear film. In humans, they are situated in the upper lateral region of each orbit, in the lacrimal fossa of the orbit formed by the frontal bone. Inflammation of the lacrimal glands is called dacryoadenitis. The lacrimal gland produces tears which are secreted by the lacrimal ducts, and flow over the ocular surface, and then into canals that connect to the lacrimal sac. From that sac, the tears drain through the lacrimal duct into the nose.

<span class="mw-page-title-main">Inferior alveolar nerve</span> Branch of the mandibular nerve

The inferior alveolar nerve (IAN) (also the inferior dental nerve) is a sensory branch of the mandibular nerve (CN V3) (which is itself the third branch of the trigeminal nerve (CN V)). The nerve provides sensory innervation to the lower/mandibular teeth and their corresponding gingiva as well as a small area of the face (via its mental nerve).

<span class="mw-page-title-main">Pterygopalatine ganglion</span> Parasympathetic ganglion in the pterygopalatine fossa

The pterygopalatine ganglion is a parasympathetic ganglion in the pterygopalatine fossa. It is one of four parasympathetic ganglia of the head and neck,.

<span class="mw-page-title-main">Greater petrosal nerve</span> Nerve in the skull

The greater petrosal nerve is a nerve of the head mainly containing pre-ganglionic parasympathetic fibres which ultimately synapse in the pterygopalatine ganglion. It branches from the facial nerve and is derived from the parasympathetic part of the nervus intermedius component of CN VII, with its cell bodies located in the superior salivary nucleus. In the connective tissue substance of the foramen lacerum, the greater petrosal nerve unites with the (sympathetic) deep petrosal nerve to form the nerve of the pterygoid canal which proceeds to the pterygopalatine ganglion.

<span class="mw-page-title-main">Maxillary nerve</span> Branch of the trigeminal nerve responsible for the mid-face

In neuroanatomy, the maxillary nerve (V2) is one of the three branches or divisions of the trigeminal nerve, the fifth (CN V) cranial nerve. It comprises the principal functions of sensation from the maxilla, nasal cavity, sinuses, the palate and subsequently that of the mid-face, and is intermediate, both in position and size, between the ophthalmic nerve and the mandibular nerve.

<span class="mw-page-title-main">Pterygopalatine fossa</span> Fossa in the skull

In human anatomy, the pterygopalatine fossa is a fossa in the skull. A human skull contains two pterygopalatine fossae—one on the left side, and another on the right side. Each fossa is a cone-shaped paired depression deep to the infratemporal fossa and posterior to the maxilla on each side of the skull, located between the pterygoid process and the maxillary tuberosity close to the apex of the orbit. It is the indented area medial to the pterygomaxillary fissure leading into the sphenopalatine foramen. It communicates with the nasal and oral cavities, infratemporal fossa, orbit, pharynx, and middle cranial fossa through eight foramina.

<span class="mw-page-title-main">Lacrimal nerve</span> Branch of the ophthalmic nerve

The lacrimal nerve is the smallest of the three main branches of the ophthalmic nerve (CN V1) (itself a branch of the trigeminal nerve (CN V)).

<span class="mw-page-title-main">Zygomatic nerve</span> Nerve of the face

The zygomatic nerve is a branch of the maxillary nerve. It arises in the pterygopalatine fossa and enters the orbit through the inferior orbital fissure before dividing into its two terminal branches: the zygomaticotemporal nerve and zygomaticofacial nerve.

<span class="mw-page-title-main">Inferior alveolar artery</span> Artery found in the head

The inferior alveolar artery is an artery of the head. It is a branch of the maxillary artery. It descends through the infratemporal fossa as part of a neurovascular bundle with the inferior alveolar nerve and vein to the mandibular foramen where it enters and passes anteriorly inside the mandible, supplying the body of mandible and the dental pulp of the lower molar and premolar teeth. Its terminal incisor branch supplies the rest of the lower teeth. Its mental branch exits the mandibula anteriorly through the mental foramen to supply adjacent lip and skin.

<span class="mw-page-title-main">Nasopalatine nerve</span> Nerve of the head

The nasopalatine nerve (also long sphenopalatine nerve) is a nerve of the head. It is a sensory branch of the maxillary nerve (CN V2) that passes through the pterygopalatine ganglion (without synapsing) and then through the sphenopalatine foramen to enter the nasal cavity, and finally out of the nasal cavity through the incisive canal and then the incisive fossa to enter the hard palate. It provides sensory innervation to the posteroinferior part of the nasal septum, and gingiva just posterior to the upper incisor teeth.

<span class="mw-page-title-main">Zygomaticotemporal nerve</span> Small nerve of the face

The zygomaticotemporal nerve (zygomaticotemporal branch, temporal branch) is a cutaneous (sensory) nerve of the head. It is a branch of the zygomatic nerve (itself a branch of the maxillary nerve (CN V2)). It arises in the orbit and exits the orbit through the zygomaticotemporal foramen in the zygomatic bone to enter the temporal fossa. It is distributed to the skin of the side of the forehead. It also contains a parasympathetic secretomotor component for the lacrimal gland which it confers to the lacrimal nerve (which then delivers it to the gland).

<span class="mw-page-title-main">Anterior ethmoidal nerve</span> Nerve of the nose

The anterior ethmoidal nerve is a nerve of the head. It is a branch of the nasociliary nerve (itself a branch of the ophthalmic nerve (V1)). It arises in the orbit, and enters first the cranial cavity and then the nasal cavity. It provides sensory innervation to part of the meninges, parts of the nasal cavity, and part of the skin of the nose.

<span class="mw-page-title-main">Infraorbital artery</span>

The infraorbital artery is a small artery in the head that arises from the maxillary artery and passes through the inferior orbital fissure to enter the orbit, then passes forward along the floor of the orbit, finally exiting the orbit through the infraorbital foramen to reach the face.

<span class="mw-page-title-main">Infratemporal fossa</span> Cavity that is part of the skull

The infratemporal fossa is an irregularly shaped cavity that is a part of the skull. It is situated below and medial to the zygomatic arch. It is not fully enclosed by bone in all directions. It contains superficial muscles, including the lower part of the temporalis muscle, the lateral pterygoid muscle, and the medial pterygoid muscle. It also contains important blood vessels such as the middle meningeal artery, the pterygoid plexus, and the retromandibular vein, and nerves such as the mandibular nerve (CN V3) and its branches.

<span class="mw-page-title-main">Anterior superior alveolar nerve</span>

The anterior superior alveolar nerve (or anterior superior dental nerve) is a branch of the infraorbital nerve (itself a branch of the maxillary nerve (CN V2)). It passes through the canalis sinuosus to reach and innervate upper front teeth. Through its nasal branch, it also innervates parts of the nasal cavity.

<span class="mw-page-title-main">Posterior superior alveolar nerve</span>

The posterior superior alveolar nerves (also posterior superior dental nerves or posterior superior alveolar branches) are sensory branches of the maxillary nerve (CN V2). They arise within the pterygopalatine fossa as a single trunk. They run on or in the maxilla. They provide sensory innervation to the upper molar teeth and adjacent gum, and the maxillary sinus.

<span class="mw-page-title-main">Nerve of pterygoid canal</span>

The nerve of the pterygoid canal is formed by the union of the (parasympathetic) greater petrosal nerve and (sympathetic) deep petrosal nerve within the cartilaginous substance filling the foramen lacerum. From the foramen lacerum, the nerve of the pterygoid canal passes through the pterygoid canal to reach the pterygopalatine fossa, ending at the pterygopalatine ganglion.

References

  1. 1 2 Gray's anatomy : the anatomical basis of clinical practice. Standring, Susan (41 ed.). [Philadelphia]. 2016. ISBN   978-0-7020-5230-9. OCLC   920806541.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: others (link)
  2. 1 2 3 4 5 6 7 8 9 10 Candido, Kenneth D.; Batra, Mani (2008). "46 - Nerve Blocks of the Head and Neck". Raj's Practical Management of Pain (4th ed.). Mosby. pp. 851–870. doi:10.1016/B978-032304184-3.50049-2. ISBN   978-0-323-04184-3.
  3. Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42th ed.). New York. p. 683. ISBN   978-0-7020-7707-4. OCLC   1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  4. 1 2 Zdilla, M. J., Russell, M. L., & Koons, A. W. (2018). Infraorbital foramen location in the pediatric population: A guide for infraorbital nerve block. Pediatric Anesthesia, 28(8), 697–702. https://doi.org/10.1111/pan.13422
  5. Li, Yuanyuan; Jiao, Hena; Ren, Wenan; Ren, Fei (2019). "TRESK alleviates trigeminal neuralgia induced by infraorbital nerve chronic constriction injury in rats". Molecular Pain. 15: 1744806919882511. doi:10.1177/1744806919882511. ISSN   1744-8069. PMC   6822185 . PMID   31558093.