scalp scalp rishi naihs nepal

1. SCALP
MAJ RISHI POKHREL
DEPT OF ANATOMY
NAIHS

2. Scalp
• Soft tissue covering skull vault
• Extension
– Eyebrows to occipital protuberance
– Zygomatic arch to temporal lines

3. Layers
S : Skin
C : dense Connective tissue
A : Aponeurosis of occipito-frontalis
L : Loose connective tissue
P : Pericranium
First 3 layers forms a single
functional layer

4. Layers

5. Skin
– Thickest , 3-7 mm
– Abundance of hair,
sebaceous, sweat glands
Dense Connective tissue
– Corresponds to superficial
fascia
– Dense fibro fatty tissue
– Numerous blood vessels and
nerves
– Connects layer of skin with
aponeurosis

6. • Aponeurosis of occipeto-frontalis muscle
Attachments of muscle
• Frontal belly
– Ant: Skin of eyebrows, skin of root of nose &
orbicularis oculi
– Post: aponeurosis
• Occipital belly
– Behind : to lat ½ half of superior nuchal line
– Front : aponeurosis
• Functions
– Occipital belly : pulls scalp back, anchors aponeurosis
– Frontal belly : elevate eyebrow, transverse wrinkles
• Nerve supply: facial nerve
Occipitalis is attached to bone, frontalis is not
Aponeurosis (galea aponeurotica)

7. Loose connective tissue
• Loose areolar tissue
• Contain emissary veins
• Potential space over which
layer 1 to 3 move
Pericranium
• Periosteum of bone of skull
• Intimately adherent to
endocranium
• Firmly attached to suture
lines, loose elsewhere

8. Nerve supply of head & neck

9. Nerve supply of scalp

10. Nerve supply of scalp

11. Arterial supply & venous drainage of scalp

12. SCALP – NERVE & BLOOD SUPPLY

13. 1
2
3
4
5
6
8
7
9
10
1. Supratrochlear (V1)
2. Supraorbital (V1)
3. Z-T (V2)
4. Temp br CN VII
(supply frontalis)
5. Auriculotemp N
(V3)
6. Great auricular
( C1,C2)
7. Post auricular (CN
VII N- supply occipital
belly))
8. Lesser occipital
(C2, C3)
9. Greater occipital
(C2)
10. Third occipital (C3)
Supratrochlear – br of opth art
Supraorbital – br of opth art
superficial temporal art-
terminal br of ECA
post auricular art – br of ECA
occipital art – br of ECA
SCALP
Nerve supply
Blood supply

14. Venous Drainage
– Veins accompany the
artery
– Emissary vein from scalp to
intracranial venous sinus
– Diploic vein
• Drain frontal and occipital
diploe and enter main vein
of scalp
Lymphatic Drainage
– In front of ear : pre-
auricular group
– Behind ear : post auricular

15. EMISSARY VEINS
Emissary veins along with layers of skull

16. Clinical anatomy

17. Applied Anatomy
• Black eye
– Spread thro subaponeurotic space
• Scalp lacerations
• Sebaceous cysts
• Gaping wounds
– Due to incisional wound of galea in coronal plane
• Cephalhaematoma
• Bone flaps
• Dangerous area of scalp
– Loose areolar tissue – infection spread to intracranial venous sinus thro
emissary vein
• Caput succedaneum
• Safety valve mechanism
• Scalp avulsion

18. BLACK EYE
Blood tracks down below frontalis to eye lid

19. Hematoma in Scalp
• Caput succadeum : haematoma bt skin and aponeurosis
• Sub galeal haematoma :b/w aponeurosis and periosteum
• Cephalhaematoma :b/w skull bone and its periosteum
(limited by suture lines)

20. Scalp Avulsionpreoperative
postperative
Hair removed
After some time……

21. Sebaceous cyst
Gaping wound of scalp

22. ?