Scalp Flashcards
Definition
Region covering skull vault.
Extent
Superciliary arches (eyebrows) anterior TO superior nuchal lines posterior AND superior temporal lines on each side.
Superficial to deep layers (5)
- Skin
- Connective tissue
- Epicranial aponeurosis
- Loose areolar tissue (sub-aponeurotic)
- Pericranium
Skin
Contains:
1. Hair follicles
2. Sebaceous glands
Firmly adherent to underlying layer.
Connective tissue
Senses fibrous tissue binding skin to 3rd layer.
It contains:
1. Vessels and nerves of the scalp
2. Rich in fat and fibrous septa
Epicranial aponeurosis
Wide tendon connecting frontal and occipital bellies of occipitofrontalis muscle.
Epicranial aponeurosis attachment anterior
Frontal bellies
Epicranial aponeurosis attachment posterior
- Occipital bellies
- External occipital protuberance
- Highest nuchal lines
Epicranial aponeurosis attachment on each side
Superior temporal lines
Loose areolar tissue
Facilitates movement of aponeurosis.
Pericranium
Periosteum covering skull vault and is adherent to suture lines.
Applied anatomy CT
- Infection in CT is limited due to fibrous septa presence.
- Cut wound leads to severe bleeding due to rich blood supply and inability of arteries to contract due to its attachment to fibrous septa.
Applied anatomy loose areolar tissue
- Loose areolar tissue is scalp dangerous area because infection can pass into cranial cavity via emissary veins present in it.
- Hemorrhage from emissary veins is large and separates scalp from skull bones.
Nerve supply
10 nerves on each side
5 in front of auricle
1. 4 sensory (trigeminal 5th cranial)
2. 1 motor (from facial nerve)
5 behind auricle
1. 4 sensory (C2 and C3 spinal nerves)
2. 1 motor (facial nerve)
4 sensory in front of auricle
- Supratrochlear nerve
- Supraorbital nerve
- Zygomaticotemporal nerve
- Auriculotemporal nerve
Motor in front of auricle
Temporal nerve
Sensory behind auricle
- Great auricular nerve: C2 and C3
- Lesser occipital: C2
- Greater occipital: C2
- Third occipital: C3
Motor behind auricle
Posterior auricular nerve
Supratrochlear and supraorbital nerve origin
Frontal branch ophthalmic nerve
Supratrochlear and supraorbital nerve supply
- Scalp anterior part
- Upper eyelid
- Forehead near median plane (Supratrochlear nerve)
- Scalp till lamboid suture (supraorbital nerve)
Supratrochlear nerve course
Passes through orbit superomedial angle
supraorbital nerve course
Passes through Supraorbital notch
Zygomatictemporal nerve origin and course
- From zygomatic branch maxillary nerve
- Reaches scalp through Zygomaticotemporal foramen
Zygomaticotemporal nerve supply
Anterior part temple
Auriculotemporal nerve origin and course
- From posterior division mandibular nerve
- Leaves parotid upper end
- Passes in front of auricle
Auriculotemporal nerve supply
- Upper 2/3 of auricle lateral surface
- Posterior part temple
Temporal nerve course
- Leaves parotid
- Crosses zygomatic arch
Temporal nerve supply
- Frontal belly of occipitofrontalis
- Orbicularis oculi upper part
4 sensory behind auricle nerve supply
- Back of auricle
- Back of scalp
- Upper part back of neck
Greater auricular nerve supply
C2 and C3
1. Small part of scalp near auricle lower part
Lesser occipital nerve supply
C2
1. Small part scalp back near auricle upper part
Greater occipital nerve supply
C2
1. Upper part scalp back
Third occipital
C3
1. Lower part scalp back
2. Upper part neck back
Posterior auricular nerve supply
Occipital belly occipitofrontalis
Atrial supply anterior part
2 arteries from ophthalmic artery of ICA
1. Supratrochlear artery
2. Supraorbital artery
Atrial supply lateral part
1 artery ECA one of its 2 terminals
1. Superficial temporal artery
Atrial supply posterior part
2 arteries ECA
1. Posterior auricular artery
2. Occipital artery
Venous drainage anterior part
2 veins
1. Supratrochlear vein
2. Supraorbital vein
Venous drainage lateral part
1 vein
1. Superficial temporal vein
Venous drainage posterior part
2 veins
1. Posterior auricular vein
2. Occipital vein
Supratrochlear artery and Supraorbital artery blood supply
- Scalp anterior part
- Anastomose with superficial temporal artery branches
Superficial temporal artery course
- Leaves parotid upper end
- Ascends in front of auricle
- Crosses zygomatic arch
- Ends 5 cm above zygomatic arch
- Divide into frontal and parietal tortuous branches
Superficial temporal artery blood supply
- Scalp side
- Anastomose with other arteries forming collateral circulation between ICA and ECA
Superficial temporal artery branches
Divide into frontal and parietal tortuous branches
1. Parotid
2. TMJ
3. Transverse facial artery
4. Zygomaticorbital artery
5. Middle temporal artery
6. Anterior auricular artery
Anterior auricular artery blood supply
- Auricle front
- External auditory meatus
Posterior auricular artery and occipital artery blood supply
- Scalp back
Posterior auricular artery and occipital artery course
- Pass upwards and backwards
- Deep to digastric posterior belly
Supratrochlear and Supraorbital vein course
- Unite at medial angle eye
- Form anterior facial vein
Superficial temporal vein course
- Enters parotid upper end
- Unite with maxillary vein
- Form posterior facial vein (retromandibular vein)
Posterior auricular vein drainage
- Back auricle
- Back scalp
Posterior auricular vein course
- Unite with posterior division posterior facial vein
- Form external jugular vein (EJV)
Occipital vein drainage
- Scalp back into sub occipital venous plexus in sub occipital triangle
Lymphatic drainage anterior part
Submandibular lymph node
Lymphatic drainage lateral part
Parotid lymph node
Lymphatic drainage posterior part
- Mastoid lymph node
- Occipital lymph node