SCALP

SCALP The soft tissue which covers the calvaria of the skull

EXTEND OF SCALP

• Anteriorly: Supra orbital margin • Posteriorly: External occipital protuberance &

superior nuchal line• On each side: Zygomatic arch

SCALP CONSIST OF FIVE SCALP CONSIST OF FIVE LAYERSLAYERS

SS-Skin-Skin CC-Connective -Connective

tissuetissue AA-Aponeurosis -Aponeurosis

((galea galea aponeurotica)aponeurotica)

LL-Loose areolar -Loose areolar tissuetissue

PP-Pericranium-Pericranium

Skin (First layer)Skin (First layer)

Thick and hairyThick and hairy Firmly attached to the epicranial Firmly attached to the epicranial

aponeurosis through dense aponeurosis through dense connective tissue.connective tissue.

Abundance sweat & sebaceous Abundance sweat & sebaceous glands presentglands present

Sebaceous cyst are common.Sebaceous cyst are common.

Dense Connective tissue(2Dense Connective tissue(2ndnd layer)layer)

Fibrous and dense, containing blood vessels and Fibrous and dense, containing blood vessels and nerves.nerves.

Binds skin to subjacent aponeurosisBinds skin to subjacent aponeurosis

Wounds Wounds bleed profusely bleed profusely as blood vessels are as blood vessels are prevented from retraction by fibrous tissue. prevented from retraction by fibrous tissue. Bleeding is stopped by applying pressure against Bleeding is stopped by applying pressure against the bone.the bone.

Subcutaneous Subcutaneous hemorrhage are not extensive hemorrhage are not extensive since since tissue is dense.tissue is dense.

Inflammation cause little swelling but are much Inflammation cause little swelling but are much painful. painful.

Occipitofrontalis & its Occipitofrontalis & its aponeurosis(3aponeurosis(3rdrd layer) layer)

Anteriorly a pair of frontal bellies (Anteriorly a pair of frontal bellies (frontalisfrontalis) ) and posteriorly a pair of occipital bellies and posteriorly a pair of occipital bellies ((occipitalisoccipitalis) of occipitofrontalis muscle.) of occipitofrontalis muscle.

Occipitofrontalis & its Occipitofrontalis & its aponeurosis(3rd layer)aponeurosis(3rd layer)

Frontal belly has no bony origin.Frontal belly has no bony origin. Occipital belly originate from Occipital belly originate from

lateral 2/3 of superior nuchal line.lateral 2/3 of superior nuchal line. Nerve supply ?Nerve supply ? Action?Action?

Aponeurosis (Aponeurosis (galea aponeuroticagalea aponeurotica) it ) it connects occipitalis and frontalis.connects occipitalis and frontalis.

It gaps if cut transversely and should be It gaps if cut transversely and should be stitched.stitched.

Loose areolar tissue (4Loose areolar tissue (4thth layer) layer) Extends anteriorly into the eyelids because Extends anteriorly into the eyelids because

frontalis has no bony attachmentfrontalis has no bony attachment Posteriorly to superior nuchal linePosteriorly to superior nuchal line Called Called dangerous layer of scalpdangerous layer of scalp-emissary -emissary

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

Loose areolar tissue (4Loose areolar tissue (4thth layer) layer) Bleeding cause Bleeding cause generalized swelling generalized swelling of of

scalp.scalp.• Bleeding lead to Bleeding lead to black eye.black eye.• Fourth layer also forms safety valve Fourth layer also forms safety valve

haematoma during fracture of cranial haematoma during fracture of cranial vault.vault.

Caput succedaneum Caput succedaneum is temporary is temporary swallen of scalp swallen of scalp in new born.in new born.

Pericranium (5Pericranium (5thth layer) layer) Is the periosteum of skullIs the periosteum of skull Loosely attached to surface of bone but Loosely attached to surface of bone but

is firmly adherent to the suturesis firmly adherent to the sutures Injury deep to it produce localised Injury deep to it produce localised

swelling which take the shape of bone swelling which take the shape of bone ((cephalohaematomacephalohaematoma) )

BLOOD SUPPLY AND NERVE SUPPLY OF SCALP

VENOUS DRAINAGE OF SCALP

Facial Vein

Retromandibular vein

External jugular vein

LYMPHATIC DRAINAGE

The End.

Presented by Kishwor Bhandari.