The Scalp and Face Flashcards
What is the Scalp?
Soft Tissue covering Cranial Vault
Boundaries of the Scalp
Anterior: Supraorbital Margin
Posterior: External Occipital Protuberance and Superior Nuchal Line
Lateral: Superior Temporal Line
Layers of the Scalp
SCALP
Skin
Connective Tissue Layer
Aponeurotic Layer (occipito-frontalis/galea aponeurotica)
Loose Areolar Tissue
Pericranium/Periosteum
Layers of Scalp: Skin
Components
Hairs
Sebaceous Glands
Sweat Glands
Layers of Scalp: Skin
Skin layers is a common site for formation of …
sebaceous cysts (due to blockage of glands causing buildup of secretions)
Layers of Scalp: Dense Connective Tissue Layer
What is found in this layer?
Anastomotic Blood Vessels
Layers of Scalp: Dense Connective Tissue Layer
What happens when a cut causes blood vessels to tear?
Bleed Profusely but heals well
Bleeding can be stopped by pressure
Layers of Scalp: Aponeurotic Layer
Description
Musculoaponeurotic Layer
Layers of Scalp: Aponeurotic Layer
Components
Occipitofrontalis Muscle
Epicranial Aponeurosis
Layers of Scalp: Aponeurotic Layer
Parts of the Occipitofrontalis
Frontal Bellies
Occipital Bellies
Layers of Scalp: Aponeurotic Layer
Origin of Frontal Bellies of Occipitofrontalis
Epicranial Aponeurosis
Layers of Scalp: Aponeurotic Layer
Insertion of Frontal Bellies of Occipitofrontalis
Skin of Eyebrows
Layers of Scalp: Aponeurotic Layer
Action of Frontal Bellies of Occipitofrontalis
Elevates Eyebrows producing Horizontal Wrinkles of Forehead
Layers of Scalp: Aponeurotic Layer
Origin of Occipital Bellies of Occipitofrontalis
Superior Nuchal Line
Layers of Scalp: Aponeurotic Layer
Insertion of Occipital Bellies of Occipitofrontalis
Epicranial Aponeurosis
Layers of Scalp: Aponeurotic Layer
Action of Occipital Bellies of Occipitofrontalis
Pull aponeurosis posteriorly towards Occipital Bone
Layers of Scalp: Aponeurotic Layer
What is the Epicranial Aponeurosis?
Flat Tendon
Layers of Scalp: Aponeurotic Layer
What does the Epicranial Aponeurosis adhere to?
The 2 layers superficial to it
This means the 3 layers move as one unit on the pericranium
Layers of Scalp: Aponeurotic Layer
When do wounds of the scalp gape?
When cut along Plane of Gaping (transverse/coronal division of aponeurosis)
Superficial scalp wounds do not gape
Layers of Scalp: Loose Areolar Tissue
Continuous with …
loose connective tissue of upper eye lid
Layers of Scalp: Loose Areolar Tissue
What does it contain?
Emissary Veins
Emissary Veins connect scalp veins to blood sinuses
Layers of Scalp: Loose Areolar Tissue
Tear in emissary veins causes …
… bleeding which gravitates into eyelids producing black eye
… infection with collection of pus which passes into cranial cavity through emissary veins
Layers of Scalp: Pericranium
Description
Loosely covers Bones
Firmly attached at Sutural Lines
Layers of Scalp: Pericranium
What is Cephalohematoma?
Birth Trauma ruptures Blood Vessels crossing Periosteum forming bump on the head
Layers of Scalp: Pericranium
Caput Succedaneum
Pressure exerted by Vaginal Wall on Infant’s Head during delivery causes swelling of scalp
Nerve Supply of Scalp Muscles
Frontal Bellies: Temporal Branch of Facial Nerve
Occipital Bellies: Posterior Auricular Branch of Facial Nerve
Divisions of Blood Supply of Scalp
Anterior
Posterior
Blood Supply of Anterior Part of Scalp
Supratrochlear Artery and Vein
Supraorbital Artery and Vein
Superficial Temporal Artery and Vein
Blood Supply of Posterior Part of Scalp
Posterior Auricular Artery and Vein
Occipital Artery and Vein
Lymphatic Drainage of Scalp
Anterior Part: Preauricular (Parotid) Lymph Nodes
Posterior Part: Post-auricular (Mastoid) Lymph Nodes
What are the Muscles of the Face?
Corrugator Supercilli
Procerus
Orbicularis Oculi
Nasalis
Zygomaticus Major
Resorius
Levator Labii Superiois
Zygomaticus Minor
Depressor Labii Inferioris
Orbicularis Oris
Buccinator
Depressor Anguli Oris
Mentalis
Action of Corrugator Supercilli
Frowning - Vertical Wrinkles between Eyebrows
Action of Procerus
Transverse Wrinkles between Eyebrows
Orbicularis Oculi parts
Orbital Part
Palpebral part
Action of Orbital Part of Orbicularis Oculi
Tight Closure of Eyelids
Action of Palpebral Part of Orbicularis Oculi
Light Closure of Eyelids
Nasalis Parts
Transverse Part
Alar Part
Action of Transverse Part of Nasalis
Compresses Nostrils
Action of Alar Part of Nasalis
Dilates Nostrils
Action of Zygomaticus Major and Risorius
Bilateral Smile
Action of Levator Labii Superioris and Zygomaticus Minor
Elevate and Evert Upper Lip
Increase Nasolabial Furrow
Action of Depressor Labii Inferioris
Draw Lower Lip Downward
Buccinator
Origin
Alveolar Process of Maxilla and Mandible opposite 3rd molar
Buccinator
Fibers and insertions
Upper Fibers: Straight into Upper Lip
Lower Fibers: Straight into Lower Lip
Intermediate Fibers: Decussate at Modiolus where Upper goes to Lower Lip and Lower goes to Upper Lip
Buccinator
Action
Prevents accumulation of food in vestibule of mouth
Blowing
Whistling
Orbicularis Oris
Parts
Extrinsic Part
Intrinsic Part
Orbicularis Oris
Extrinsic Part
Derived from Intermediate Parts of Buccinator
Also formed from other facial muscles which decussate at modious
Orbicularis Oris
Intrinsic Part Origin
Incisive Fossae of Maxilla and Mandible
Part comes from Perioral Skin
Orbicularis Oris
Intrinsic Part Insertion
Mucous Membrane of Lips
Orbicularis Oris
Action
All Muscles: Close mouth + Articulation and Speech
Superficial Fibers: Protrudes Lips
Deep Fibers: Compress Lips
Action of Depressor Anguli Oris
Draws corner of mouth down and lateral
Action of Mentalis
Protrudes Lower Lip
Winkles Skin of Chin
Arteries of the Face are branches of …
External Carotid Artery (forms Facial Artery)
Internal Carotid Arteries (Gives rise to Ophthalmic Artery which forms Supraorbital and Trochlear Arteries)
Facial Artery
Where can its pulse be palpated?
Inferior Border of Mandible
Facial Artery
Enters the face at …
anterior border of Masseter Muscle
Facial Artery
Pathway
Passes along the side of nose
Terminates as Angular Artery at Medial Angle of Eye
At Medial Angle, it Anastomoses with terminal branch of Opthalmic Artery
Facial Artery
Branches
Lateral Nasal Artery
Superior Labial Artery
Inferior Labial Artery
Venous Drainage of Face
Facial vein
Tributeries of Facial Vein
Supraorbital Vein
Supratrochlear Vein
Pathway of Facial Vein
Descends behind Facial Artery
Crosses Base of Mandible to enter neck
Joined by Anterior Division of Retromandibular Vein to form Common Facial Vein
Terminates in Internal Jugular Vein
What is the Dangerous Area of the Face?
Area drained by Facial Vein where infection can spread and reach Meninges causing Meningitis and Intracranial Thrombosis
Which parts of the face form the Dangerous Area?
Upper Lip
Nasal Septum
Ala of Nose
Why can infections spread easily through the Facial Vein?
No Valves
Absence of Deep Fascia in Face means No Barrier to spread
Pathway of Facial Vein to Cavernous Sinus
Facial Vein → Superior Ophthalmic Vein → Cavernous Sinus
Facial Vein → Deep Facial Vein → Pterygoid Venous Plexus → Cavernous Sinus
