Scalp
- 2. Consists of five layers • S : Skin • C : Connective tissue • A : Aponeurosis • L : Loose areolar connective tissue • P : Pericranium
- 6. SKIN Thick & hair- bearing and contains numerous sebaceous glands
- 7. CONNECTIVE TISSUE • The superficial fascia is a fibro fatty layer • Connects skin to the underlying aponeurosis of the occipitofrontalis muscle • Provides a passageway for nerves and blood vessels. CLINICAL IMPORTANCE: If the vessels are cut, this attachment prevents vasospasm, which could lead to profuse bleeding after injury.
- 8. APONEUROSIS • A thin, tendinous sheet that unites the occipital and frontal bellies of the OCCIPITOFRONTALIS muscle. • Lateral margins are attached to the temporal fascia. • the sub-aponeurotic space is the potential space beneath the epicranial aponeurosis
- 9. The clinically important layer is the aponeurosis. Scalp lacerations through this layer mean that the "anchoring" of the superficial layers is lost and gaping of the wound occurs and this requires suturing.
- 10. • Loosely connects the epicranial aponeurosis to the pericranium & allows the superficial 3 layers of the scalp to move over the pericranium. • Contains Emissary veins which connects the superficial scalp veins to the Diploic veins of skull and with intracranial venous sinuses.
- 11. • is the periosteum covering the outer surface of skull bones. • at the sutures between individual skull bones, the pericranium become continuous with periosteum (endosteum) on the inner surface of skull bones.
- 12. OCCIPITOFRONTALIS: • consists of four bellies two Occipital & two Frontal connected by an aponeurosis. • the Occipital belly is supplied by Posterior Auricular branch & Frontal belly is supplied by temporal branch of facial nerve. ACTION: • The loose areolar tissue (4th layer) allowing the aponeurosis to move on the pericranium. • frontal bellies can raise the eyebrows in expression of surprise or horror.
- 13. SENSORY NERVE SUPPLY Six sensory nerve branches of either the trigeminal nerve or the cervical nerve supply the scalp. Can be remembered by Z-GLASS” Zygomaticotemporal nerve Greater occipital nerve Lesser occipital nerve Auriculotemporal nerve Supratrochlear nerve Supraorbital nerve
- 14. The SUPRATROCHLEAR NERVE , branch of the ophthalmic division of the trigeminal nerve & supplies the medial plane at the frontal region up to the vertex. The SUPRAORBITAL NERVE , a branch of the ophthalmic division of the trigeminal nerve supplies the scalp at the front, lateral to the supratrochlear nerve distribution up to the vertex. The ZYGOMATICOTEMPORAL NERVE, branch of the maxillary division of the trigeminal nerve supplies the hairless temple . The AURICULOTEMPORAL NERVE, branch of the mandibular division of the trigeminal nerve supplies the skin over the temporal region of the scalp. The LESSER OCCIPITAL NERVE, branch of the cervical plexus (C2), supplies behind ear. The GREATER OCCIPITAL NERVE, branch of the posterior ramus of the second cervical nerve & supplies posteriorly upto the
- 15. SUPRATROCHLEAR & SUPRAORBITAL ARTERIES SUPERFICIAL TEMPORAL ARTERY POSTERIOR AURICULAR ARTERY OCCIPITAL ARTERY
- 17. The veins of the scalp accompany the arteries and have similar names. • The Supratrochlear & Supraorbital Veins • Superficial Temporal Vein • The Posterior Auricular Vein • Occipital Vein
- 19. LYMPHATIC DRAINAGE Anterior part of scalp & forehead drains into submandibular lymph nodes. Lateral part of scalp drains into superficial parotid lymph nodes. Lymph vessels above & behind the ear drain into mastoid lymph nodes Vessels in back drain into occipital lymph nodes.
Editor's Notes
- #3: The soft tissue envelope of the cranial vault is called the scalp. First three bound together and move as a unit.
- #14: The SUPRATROCHLEAR NERVE , branch of the ophthalmic division of the trigeminal nerve & supplies the medial plane at the frontal region up to the vertex.The SUPRAORBITAL NERVE , a branch of the ophthalmic division of the trigeminal nerve supplies the scalp at the front, lateral to the supratrochlear nerve distribution up to the vertex.The ZYGOMATICOTEMPORALNERVE, branch of the maxillary division of the trigeminal nerve supplies the hairless temple .The AURICULOTEMPORAL NERVE, branch of the mandibular division of the trigeminal nerve supplies the skin over the temporal region of the scalp.The LESSER OCCIPITAL NERVE, branch of the cervical plexus (C2), supplies behind ear.The GREATER OCCIPITAL NERVE, branch of the posterior ramus of the second cervical nerve & supplies posteriorly up to the vertex.
- #16: scalp has a rich vascular supply. The blood vessels traverse the connective tissue layer, which receives vascular contribution from the internal and external carotid arteries. The blood vessels anastomose freely in the scalp. The blood supply of the scalp is via five pairs of arteries, three from the external carotid and two from the internal carotid.
- #17: The supratrochlear and supraorbital arteries are 2 branches of the ophthalmic artery, which, in turn, is a branch of the internal carotid artery The superficial temporal artery is a smallerterminal branch of the external carotid artery,ascends in front of the auriclesupplies the scalp over the temporal region, travels with the auriculotemporal nerve and divides into anterior and posterior branches. The posterior auricular artery is a branch of the external carotid artery that ascends posterior to the auricle. The occipital artery is a branch of the external carotid artery. It is accompanied by the greater occipital nerve.
- #18: The veins of the scalp freely anastomose with one another and are connected to the diploic veins of the skull bones and the intracranial dural sinuses through several emissary veinsThe supratrochlear and supraorbital veins drain the anterior region of the scalp. These 2 veins unite to form facial vein. The superficial temporal vein unite with maxillary vein in parotid gland to form retromandibular vein. The posterior auricular vein unites with the posterior division of retromandibular vein just below the parotid gland to form the external juglar vein.The occipital vein terminates in the suboccipital venous plexus, which lies beneath the floor of the upper part of the posterior triangle.
- #19: The veins of the scalp freely anastomose with one another and are connected to the diploic veins of the skull bones and the intracranial dural sinuses through several emissary veinsThe supratrochlear and supraorbital veins drain the anterior region of the scalp. These 2 veins unite to form facial vein. The superficial temporal vein unite with maxillary vein in parotid gland to form retromandibular vein. The posterior auricular vein unites with the posterior division of retromandibular vein just below the parotid gland to form the external juglar vein.The occipital vein terminates in the suboccipital venous plexus, which lies beneath the floor of the upper part of the posterior triangle.