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
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
18.
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.
Notes de l'éditeur
The soft tissue envelope of the cranial vault is called the scalp. First three bound together and move as a unit.
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.
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.
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.
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.
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.