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Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Three main sensory nerves branch from the ophthalmic nerve (CN V1) and lie in the orbital region: the frontal nerve, the lacrimal nerve, and the nasociliary nerve (Plates 3.15 and 3.33; described in detail in Section 3.3.1.5). The frontal nerve gives rise to the supratrochlear nerve and the supraorbital nerve. The nasociliary nerve gives rise to the long ciliary nerves, anterior ethmoidal nerve (which leaves the orbit and enters the nasal region, giving rise to the external nasal nerve), and posterior ethmoidal nerve.
The viva: operative surgery and surgical anatomy
Published in Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad, Neurosurgery, 2014
Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad
The anterior ethmoidal foramen is a small opening formed when the anterior ethmoidal notch on the superior margin of the ethmoid bone corresponds to a similar small notch in the frontal bone creating a small foramen in the sutural junction of the two bones. The foramen transmits the anterior ethmoidal nerve, a branch of the nasociliary nerve, into the anterior and middle ethmoidal sinuses and nasal cavity. It also indicates the anterior extent of the cribriform plate. Identification of the anterior ethmoidal artery is an important landmark in endonasal endoscopic surgery as it passes from the orbit to anterior cranial fossa.
Clinical Neuroanatomy
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
The first division of the Vth nerve lies below the VIth nerve in the lateral wall of the cavernous sinus (see Figures 111.3 and 111.4) and is prone to damage by the same pathologies that cause extraocular nerve palsies (see above). Due to its extensive sensory distribution, severe pain in the eye, forehead, nose and scalp, extending back as far as the vertex, may result from such damage. The nerve divides into three branches as it enters the superior orbital fissure: The lacrimal nerve runs along the lateral rectus muscle to supply the lacrimal gland. It also supplies the skin over the lateral eyelid and brow. It picks up secretomotor fibres from the zygomaticotemporal nerve, which it conveys to the lacrimal gland. In the skin, it receives proprioceptive filaments from the facial nerve.The frontal nerve divides into two, the supratrochlear and supraorbital nerves, which supply the skin of the forehead and scalp to the vertex. They are prone to damage by minor injuries over the brow and a causalgic syndrome may follow local trauma.The nasociliary nerve has important autonomic and cutaneous functions: The main trunk traverses the orbit and enters the anterior ethmoidal foramen into the intracranial cavity, runs forwards across the cribriform plate and exits the skull through a slit in the crista galli to enter the nose. It supplies the mucosa of the nasal cavity and emerges at the lower end of the nasal bone to supply the skin over the tip of the nose, alar and vestibule.In the orbit, the nasociliary nerve gives off branches to the ciliary ganglion and two or three long ciliary nerves which carry the pupillodilator sympathetic fibres and convey sensation from the cornea. This is of cardinal importance for the protection of the very delicate cornea.The infratrochlear branch is given off just behind the anterior ethmoidal foramen and lies on the medial wall of the orbit and supplies the skin of the upper medial eyelid and upper side of the nose.
Neurotrophic keratopathy: current challenges and future prospects
Published in Annals of Medicine, 2022
Erin NaPier, Matthew Camacho, Timothy F. McDevitt, Adam R. Sweeney
The cornea is an avascular, prolate-shaped connective tissue that provides refractive power, structural integrity, and antimicrobial functions in the anterior portion of the eye [3]. It is mainly innervated by the nasociliary nerve of the ophthalmic branch (V1) of the trigeminal nerve and occasionally by sensory nerves of the maxillary branch (V2) innervate the inferior cornea [3,4]. Additionally, there is autonomic innervation from the superior cervical ganglion (sympathetic) and ciliary ganglion (parasympathetic), however, the role and density of these nerves remain unclear [4]. It is estimated that the subbasal plexus of the cornea has ∼19,000–44,000 axons [4]. Corneal innervation is critical in providing trophic factors (e.g. substance P, calcitonin gene-related peptide, acetylcholine, serotonin, neuropeptide Y) which help to maintain a healthy corneal epithelium. The mutual relationship between corneal nerves and epithelium is essential for corneal homeostasis as epithelial cells secrete neurotrophic factors (e.g. nerve growth factor and ciliary neurotrophic growth factor) with parallel effects on corneal nerves. Loss of innervation results in decreased metabolism and mitosis of epithelial cells, consequently leading to epithelial breakdown and hindered corneal healing [1,5,6]. This may result in persistent epithelial defects, ulceration, stromal melting, and perforation [7].
Transient anisocoria after a traumatic cervical spinal cord injury: A case report
Published in The Journal of Spinal Cord Medicine, 2020
Paul Overdorf, Gary J. Farkas, Natasha Romanoski
The sympathetic innervation to the eye is from the superior cervical ganglion (Fig. 1). The superior cervical ganglion lies anterior to the transverse processes of the second and third cervical vertebra. Anterior to the ganglion lies the carotid sheath with the internal carotid artery, internal jugular vein, and vagus nerve, while the longus capitis muscle is found posterior to the ganglion. Postganglionic sympathetic fibers from the superior cervical ganglion are distributed onto the internal carotid artery and help to form the internal carotid nerve plexus, which ascends on the internal carotid artery into the carotid canal to enter the cranial cavity (Fig. 1).11 Once in the cranial cavity, postganglionic fibers from the internal carotid nerve plexus travel on the nasociliary nerve of the ophthalmic division of the trigeminal nerve, while other fibers continue from the internal carotid nerve plexus as the sympathetic root of the ciliary ganglion.12 The sympathetic root of the ciliary ganglion traverses the ciliary ganglion without synapsing (Fig. 1). These nerves then travel on the short ciliary nerves of the ciliary ganglion to the eye where they innervate the dilator pupillae muscle. Some of these postganglionic sympathetic fibers also travel on the long ciliary nerve, a nerve branch of the nasociliary nerve, to reach the eye (Fig. 1). Sympathetic activation of the dilator pupillae muscle dilates the pupil.11,12
A review of dry eye disease therapies: exploring the qualities of varenicline solution nasal spray
Published in Expert Review of Ophthalmology, 2023
Siddharth Bhargava, Ranjani Panda, Asma M Azam, John D Sheppard
An integrated neural network is inherent in regulating tear secretion in a functional LFU. Consequently, exposure of the free corneal nerve endings, through intrinsic or extrinsic stressors, stimulates the nasociliary nerve of the ophthalmic branch of the trigeminal nerve [10,11]. This causes the release of the tear film as a response. A healthy tear film has vast implications for daily ocular functions and visual quality of life. The tear film is tasked to provide optical optimization through a smooth refractive air–eye interface. It also functions to maintain ocular health with abundant growth factors, oxygen, antimicrobial properties, and flushing debris. In addition, it ensures comfort through wetting of the cornea and prevents corneal and conjunctival desiccation [10–14].