The scalp has several layers with distinct characteristics and clinical implications:
1. The outer skin layer is prone to infections like sebaceous cysts due to sebaceous glands.
2. Below this is the connective tissue layer containing blood vessels and nerves. Its inelastic fibers prevent wound retraction.
3. The deepest layer, the aponeurosis, is made of muscle that can affect scalp tension and wound appearance. Exercise of this muscle improves scalp circulation.
The scalp has several layers with distinct characteristics and clinical implications:
1. The outer skin layer is prone to infections like sebaceous cysts due to sebaceous glands.
2. Below this is the connective tissue layer containing blood vessels and nerves. Its inelastic fibers prevent wound retraction.
3. The deepest layer, the aponeurosis, is made of muscle that can affect scalp tension and wound appearance. Exercise of this muscle improves scalp circulation.
The scalp has several layers with distinct characteristics and clinical implications:
1. The outer skin layer is prone to infections like sebaceous cysts due to sebaceous glands.
2. Below this is the connective tissue layer containing blood vessels and nerves. Its inelastic fibers prevent wound retraction.
3. The deepest layer, the aponeurosis, is made of muscle that can affect scalp tension and wound appearance. Exercise of this muscle improves scalp circulation.
The scalp has several layers with distinct characteristics and clinical implications:
1. The outer skin layer is prone to infections like sebaceous cysts due to sebaceous glands.
2. Below this is the connective tissue layer containing blood vessels and nerves. Its inelastic fibers prevent wound retraction.
3. The deepest layer, the aponeurosis, is made of muscle that can affect scalp tension and wound appearance. Exercise of this muscle improves scalp circulation.
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The main layers of the scalp are the skin, connective tissue, aponeurosis, loose areolar connective tissue and pericranium. Each layer has unique characteristics and clinical implications.
The main layers are the skin, connective tissue below the skin, the aponeurosis layer and the loose areolar connective tissue layer below it.
The skin layer can develop infections in the hair follicles and sebaceous cysts. The connective tissue layer contains blood vessels and fibers that prevent tissue damage. The aponeurosis layer influences scalp wound tension. The loose layer contains dangerous emissary veins.
SCALP
Layers of the Scalp and their
Clinical Implications SKIN 1-1.5 mm thick Thickest at the occipital area Hair follicles Sebaceous glands SKIN
The ducts of the sebaceous glands are prone to infection and damage which is why sebaceous cysts of the scalp are common. CONNECTIVE TISSUE Also known us Subcutaneous Tissue Soft fibrous septa: unites the skin to the underlying layer Aponeurosis Fibrofatty With numerous nerves and blood vessels embedded in inelastic fibers CONNECTIVE TISSUE
The layer is made up of blood vessels superficial veins and branches of external and internal carotid arteries.
The INELASTIC FIBERS prevent retracting and narrowing of the layer when parted during injuries.
APONEUROSIS Also known as Epicranium galea aponeurotica (helmet of fibrous tissue) Occipito-frontalis muscles Occipital belly Frontal belly
Aponeurosis APONEUROSIS *Epicranium tension can pull an injury into a gaping wound; makes a blunt hit on the head and an incised wound look similar
Scalp injuries should be closed with sutures.
Exercise of the occipito-frontal muscules improves scalp circulation since it involves movement of the top three layers: skin, connective tissue and the aponeurosis. So KEEP MAKING FACES!!! Loose Areolar Connective Tissue Separates the first three layers from the pericranium
The Dangerous Layer of the Scalp:
Emissary Veins are valveless veins that are direct links to the skull.
Osteomyelitis and Subdural Hematoma
PERICRANIUM Periosteal covering of the skull bones
Intersutural Fibrous Tissue
Subperiosteal bleeding may be limited to one bone because of the sutures.
Limited or absent osteogenic capabilities
SCALP LAYER REMARKABLE COMPONENTS CLINICAL IMPLICATIONS SKIN Hair Follicles Sebaceous Glands Sebaceous Cysts Common Scalp infections (ex: Folliculitis) CONNECTIVE TISSUE Blood vessels embedded on INELASTIC FIBERS Prevents narrowing and retracting of the tissue *Bleeding APONEUROSIS Occipito-frontalis muscles Scalp and face muscle exercise to improve circulation Epicranium Tension and scalp wounds LOOSE AREOLAR CONNECTIVE TISSUE Emissary Veins the dangerous layer of the scalp Osteomyelitis Subdural Hemorrhage PERICRANIUM *Intersutural fibrous tissue w/o osteogenic capabilities Limited subperiosteal bleeding Skull bones do not fuse together Neurovascular Supply and Venous Drainage Blood Vessels cross the connective tissue layer, which receives its arterial supply from the internal and external carotid arteries.
The blood vessels anastomose freely in the scalp. The Supratrochlear and Supraorbital arteries are 2 branches of the opthalmic artery, which is a branch of the internal carotid artery. The superficial artery supplies the scalp over the temporal region and travels with the auriculotemporal nerve The posterior auricular ascends posterior to the auricle and is a branch of the external carotid artery The occipital artery is also a branch of the external carotid artery and accompanies the greater occipital nerve. The supratrochlear and supraorbital veins drain the anterior region of the scalp
These 2 veins unite to form the angular vein and continues further down as the facial vein. The superficial temporal vein descends in front of the auricle and enters the parotid gland It joins the maxillary vein to form the retromandibular vein The anterior division of the retromandibular vein unites with the facial vein to form the common facial vein, which then drains into the internal jugular vein. The posterior auricular vein joins the posterior portion of the retromandibular vein to form the external jugular vein. Temporalis muscle Temporalis Muscle Origin: temporal fossa Insertion: coronoid process of the mandible Action: Elevate the mandible (closes the jaw) Helps in the retraction of the mandible Temporalis Muscle Innervation: deep temporal branches of the mandibular nerve Blood supply: The muscle receives its blood supply from the deep temporal arteries which anastomose with the middle temporal artery. THE NEUROCRANIUM AND VISCEROCRANIUM Neurocranium (encloses the eyes, the middle ear, the olfactory bulbs for the nose, and the brain) 1 Frontal bone 2 Parietal bones 1 Occipital Bone 2 Temporal Bones 1 Sphenoid bone 1 Ethmoid bone
SGD1 #5 Define the bony landmarks that demarcate the three cranial fossae and its contents. The Three Cranial Fossae Anterior cranial fossa LESSER WING OF THE SPHENOID Middle cranial fossa PETROUS PART OF TEMPORAL BONE Posterior cranial fossa Base of the Skull (internal surface) Foramen cecum Crista galli Lesser wing of the sphenoid Foramen rotundum Foramen ovale Foramen spinosum Foramen lacerum Foramen magnum Internal occipital protuberance Petrous part of the Temporal bone QUESTION :6 Identify the neurovascular structures transmitted by the different foraminae Neurovascular System of the Scalp Arteries are generally accompanied by corresponding similarly named veins and nerves except one Overview of Neurovascular System of the Scalp ANTERIOR (FOREHEAD) Supraorbital and supratrochlear vessels and sensory nerves Terminal branches of : Opthalmic Arteries and Nerves Emerge from orbital cavities
Opthalmic supraorbital Artery supratrochlear
supraorbital Opthalmic - communicating vein will join Vein sup. Opthalmic vein into cavernous sinus
supratrochlear
*supraorbital + supratrochlear = Angular Vein [facial vein] LATERAL (TEMPORAL) Superficial temporal vessels - ST Artery: principal artery that supplies blood to greater part of the scalp + Auriculo-temporal nerve - sensory branch of the mandibular nerve LATERAL (TEMPORAL) ECA superficial temporal artery
commencement: in front of ext. auditory meatus pulsations!!!
STA branches spread out over the lateral part of the scalp
Occipital suboccipital plexus of veins Vein region w/ vertebral veins POSTERIOR (OCCIPITAL) Superficial Temporal Vein + Maxillary Vein = Retromandicular Vein [descends in the parotid]
*Level- Zygomatic Arch Overview of Arterial and Venous System SCALP: NERVE SUPPLY G : Greater occipital/auricular L : Lesser occipital/auricular A : Auriculotemporal S : Supratrochlear S : Suppraorbital Base of the skull Anterior Cranial Fossa Middle Cranial Fossa Posterior Cranial Fossa Anterior Skull Base of the skull References R Snell, R.S. Clinical Anatomy by Regions, 8 th