ScalpDr. Deepak K Gupta

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Introduction

• It is the soft tissue that covers the vault of skull

• Extends from sup.orbitalmargin to superior nuchal line

• On each side to superior temporal line

• It is hair bearing area of the skull

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Layers of Scalp

• S-Skin

• C-connective tissue (superficial fascia)

• A-aponeurosis (galeaaponeurotica)

• L-loose areolar tissue

• P-pericranium

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Layers of Scalp

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Skin

• Thick and hairy

• Firmly attached to the epicranial aponeurosisthrough dense fascia

• Abundance sebaceous glands

• Sebaceous cyst are common

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Connective tissue

• Fibrous and dense containing blood vessels and nerves

• Binds skin to subjacent aponeurosis• Wounds bleed profusely as blood vessels are

prevented from retraction by fibrous tissue. Bleeding is stopped by applying pressure against the bone

• Subcutaneous hemorrhage are not extensive since fascia is dense

• Inflammation cause little swelling but are much painful

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Aponeurosis

• Anteriorly frontal belly and posteriorlyoccipital belly of occipitofrontalis muscle

• Frontal belly originate from skin of forehead

• Occipital belly originate from lateral 2/3 of superior nucheal line

• It gaps if cut transversely and should be stitched

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Loose areolar tissue

• Extends anteriorly into the eyelids because frontalis has no bony attachment

• Posteriorly to superior nuchal line• On each side to superior temporal line• Bleeding cause generalized swelling of scalp• Called dangerous layer of scalp-emissary veins

open here and carry any infections inside the brain (venous sinus)

• Bleeding lead to black eye• Caput succedaneum in new born

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Pericranium

• Is the periosteum of skull

• Loosely attached to surface of bone but is firmly adherent to the sutures

• Injury deep to it take the shape of bone (cephalhaematoma)

• Scalping injury- should be replaced and stitched because healing is better

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Blood supply

• Arteries– Supratrochlear

– Supraorbital

– Superficial temporal

– Posterior auricular artery

– Occipital artery

• Veins-follows the artery

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They are 5 arteries on each side

3 in front of auricle 2 behind auricle

1- supratrochlear 1- post. Auricular

2- supraorbital 2- occipital

3- superficial temporal

Arterial supply of scalp

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Nerve supply

• In front of auricle– Supratrochlear n.– Supraorbital n.– Zygomaticotemporal n.– Auriculotemporal n.– Temporal branch of facial n.

• Behind auricle– Greater auricular n– Lesser occipital n.– Greater occipital n.– Third occipital n.– Post. Auricular branch of facial n.

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Nerve supply of scalp

5 in front of auricle 5 behind auricle

4 sensory

(From trigeminal N)

1 motor 1 motor 4 sensory

(From cervical Ns)

1-supra-trochlear N

2-supra-orbital N

3-zygomatico- temporal N

4-auriculo-temporal N

1- great auricular N

2- lesser occipital N

3- greater occipital N

4- 3rd occipital nerve

Temporal br.

Of facial Post. Auricular br. Of facial

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Lymphatics

• Anterior part

– Preauricular (parotid) gr. of lymph node

• Posterior part

– Posterior (mastoid) gr. of lymph node &occipital gr. of lymph node

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References

• Grays Anatomy for Students 2nd Edition

• Head and Neck Anatomy for Dental Medicine

• Head, Neck and Dental Anatomy, 4th Edition

• Netter’s Head and Neck Anatomy for Dentistry, 2nd Edition Neil S norton

• Oral Development and Histology, 3rd Edition

• Woelfel's Dental Anatomy

• Ten Cate’s Oral Histology - Development, Structure, and Function, 7th Edition