The nasociliary nerve is a branch of the

ophthalmic nerve The ophthalmic nerve (V1) is a sensory nerve of the face. It is one of three divisions of the trigeminal nerve (CN V). It has three branches that provide sensory innervation to the eye, the skin of the upper face, and the skin of the anterior sca ...

, itself a branch of the

trigeminal nerve In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewin ...

(CN V). It is intermediate in size between the other two branches of the ophthalmic nerve, the

frontal nerve The frontal nerve is the largest branch of the ophthalmic nerve (V1), itself a branch of the trigeminal nerve (CN V). It supplies sensation to the skin of the forehead, the mucosa of the frontal sinus, and the skin of the upper eyelid. It may be ...

and

lacrimal nerve The lacrimal nerve is the smallest branch of the ophthalmic nerve (V1), itself a branch of the trigeminal nerve (CN V). The other branches of the ophthalmic nerve are the frontal nerve and nasociliary nerve. Structure The lacrimal nerve branche ...

Structure

The nasociliary nerve enters the orbit via the superior orbital fissure, between the two heads of the

lateral rectus muscle Lateral is a geometric term of location which may refer to: Healthcare *Lateral (anatomy), an anatomical direction *Lateral cricoarytenoid muscle *Lateral release (surgery), a surgical procedure on the side of a kneecap Phonetics *Lateral cons ...

and between the superior and inferior rami of the

oculomotor nerve The oculomotor nerve, also known as the third cranial nerve, cranial nerve III, or simply CN III, is a cranial nerve that enters the orbit through the superior orbital fissure and innervates extraocular muscles that enable most movements of ...

. It passes across the

optic nerve In neuroanatomy, the optic nerve, also known as the second cranial nerve, cranial nerve II, or simply CN II, is a paired cranial nerve that transmits visual system, visual information from the retina to the brain. In humans, the optic nerve i ...

(CN II) and runs obliquely beneath the

superior rectus muscle The superior rectus muscle is a muscle in the orbit. It is one of the extraocular muscles. It is innervated by the superior division of the oculomotor nerve (III). In the primary position (looking straight ahead), its primary function is elevatio ...

and

superior oblique muscle The superior oblique muscle, or obliquus oculi superior, is a fusiform muscle originating in the upper, medial side of the orbit (i.e. from beside the nose) which abducts, depresses and internally rotates the eye. It is the only extraocular musc ...

to the medial wall of the

orbital cavity In anatomy, the orbit is the cavity or socket 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 , o ...

. It passes through the anterior ethmoidal opening as the anterior ethmoidal nerve and enters the cranial cavity just below the cribriform plate of the ethmoid bone. It supplies branches to the mucous membrane of the nasal cavity and finally emerges between the inferior border of the nasal bone and the side nasal cartilages as the external nasal branch.

Branches

posterior ethmoidal nerve The posterior ethmoidal nerve is a nerve of the orbit around the eye. It is a branch of the nasociliary nerve from the ophthalmic nerve (CN V1). It supplies sensation to the sphenoid sinus, the ethmoid sinus, and part of the dura mater in the ...

anterior ethmoidal nerve The anterior ethmoidal nerve is a nerve of the nose. It is a branch of the nasociliary nerve, itself a branch of the ophthalmic nerve (V1). It provides sensory innervation to some structures around the nasal cavity. Structure The anterior ethm ...

long ciliary nerves The long ciliary nerves are 2-3 nerves that arise from the nasociliary nerve (itself a branch of the ophthalmic branch (CN V1) of the trigeminal nerve (CN V)). They enter the eyeball to provide sensory innervation to parts of the eye, and sympat ...

infratrochlear nerve The infratrochlear nerve is a branch of the nasociliary nerve, itself a branch of the ophthalmic nerve. Structure The nasociliary nerve terminates by bifurcating into the infratrochlear and the anterior ethmoidal nerves. The infratrochlear ne ...

* communicating branch to ciliary ganglion

Function

The branches of the nasociliary nerve provide sensory innervation to structures surrounding the eye such as the cornea, eyelids, conjunctiva, ethmoid air cells and mucosa of the nasal cavity.

Clinical significance

Testing

Since both the short and long ciliary nerves carry the afferent limb of the

corneal reflex The corneal reflex, also known as the blink reflex or eyelid reflex, is an involuntary blinking of the eyelids elicited by stimulation of the cornea (such as by touching or by a foreign body), though it could result from any peripheral stimulus. S ...

, one can test the integrity of the nasociliary nerve (and, ultimately, the

) by examining this reflex in the patient. Normally both eyes should blink when either cornea (not the conjunctiva, which is supplied by the adjacent cutaneous nerves) is irritated. If neither eye blinks, then either the ipsilateral nasociliary nerve is damaged, or the

facial nerve 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 tas ...

(CN VII, which carries the efferent limb of this reflex) is bilaterally damaged. If only the contralateral eye blinks, then the ipsilateral facial nerve is damaged. If only the ipsilateral eye blinks, then the contralateral facial nerve is damaged.

Additional images

File:Gray776.png, Nerves of the orbit. Seen from above. File:Gray778.png, Distribution of the maxillary and mandibular nerves, and the submaxillary ganglion. File:Gray787.png, Dissection showing origins of right ocular muscles, and nerves entering by the superior orbital fissure. File:Ciliary ganglion pathways.png, Pathways in the ciliary ganglion. File:Slide4abab.JPG, Extrinsic eye muscle. Nerves of orbita. Deep dissection.

References

External links

* - "A deeper dissection of the right orbit from a superior approach." * () * () * {{Authority control Ophthalmic nerve Medical mnemonics