APOSTLEJOHN’

SANAT
NOTE
THESCALP(DR.AGUWA) TUESDAY
25/
10/2022

Def
ini
ti
on

I
t’
sthesub-
ti
ssuecov
eri
ngv
aul
tsoft
heskul
l
.

Ext
ent

Ant
eri
orl
y–i
ntoey
ebr
ows(
incl
udesf
orehead)

Post
eri
orl
y–Super
iornuchal
li
ne

Lat
eral
l
y–ar
oundSuper
iort
empor
all
i
ne.

Lay
ersofscal
p

Ski
n:

• Thi
nexcepti
nocci
pit
alr
egi
on.

• Cont
ainssweatgl
ands,
sebaceousgl
andsandhai
rfol
l
icl
es.

• Hasabundantar
ter
ial
bloodsuppl
y,goodv
enousandl
ymphat
icdr
ainages.

• Cl
osel
yadher
entt
ounder
lyi
ngt
issues.

Connect
ivet
issue.

• For
mspeakdensev
ascul
ari
zedsubcut
aneousl
ayer
.

• Ri
chl
yinner
vat
edbycut
aneousner
ves.

• Fi
rml
yUni
tedt
oski
nabov
eandunder
lyi
ngepi
crani
alaponeur
osi
s.

Aponeur
osi
s(epi
crani
al)
:

• I
t’
sst
rongt
endi
noussheett
hatcov
erscal
var
ia.

• Provi
desatt
achmentforfr
ont
alandocci
pit
albel
l
iesofocci
pit
ofr
ont
ali
smuscl
eand
super
ioraur
icul
armuscle.

N/
B:Theabov
e3st
ruct
uresf
orm scal
ppr
oper(
muscul
oaponeur
oti
cepi
crani
um)
.

Epi
crani
alaponeur
osi
scor
respondst
odeepf
asci
a.

Looseconnect
ivet
issue:

• I
t’
sthespongel
i
kel
ayer
.
• Al
l
owsmov
ementofscal
ppr
operov
erunder
lyi
ngcal
var
ia.

• Haspot
ent
ial
spacest
hatmaydi
stendwi
thf
lui
dasar
esul
tofi
njur
yori
nfect
ion.

• I
t’
sext
entcor
respondst
oext
endofscal
pit
sel
f.

• I
t’
str
ansv
ersedbyemi
ssar
yvei
nspassi
ngf
rom scal
ptoi
ntr
acr
ani
alv
enoussi
nuses.

Per
icr
ani
um:

• I
t’
sdensel
ayerofCT.

• For
msext
ernal
per
iost
eum ofneur
ocr
ani
um.

• Fi
rml
yatt
achedbutcanbest
ri
ppedfairl
yeasi
l
yfr
om calvar
iaofl
ivi
ngpeopl
eexcept
wher
eiti
sconti
nuouswit
hfi
broust
issuesint
hecrani
alsut
ures.

Bl
oodsuppl
y

Ar
ter
ies
Ant
eri
orpar
t–supr
aor
bit
al,
supr
atr
ochl
earbr
anchesofopht
hal
micar
ter
y.

Lat
eral
par
t–ant
eri
orandpost
eri
orbr
anchesofsuper
fi
cial
tempor
alar
ter
y.

Post
eri
orpar
t–occi
pit
alar
ter
y.

Vei
nsdr
ainage

Cor
respondst
oar
ter
iesandaccompanyt
hem.

Ner
vesuppl
y

Mot
orf
ibr
es:t
empor
alandaur
icul
arbr
anchesoff
aci
alner
ve

Sensor
yfi
bres:
Ant
eri
orpart–supr
atr
ochlearandsupr
aor
bit
albr
anchesofFr
ont
alner
ve(
brofopht
hal
mic
ner
ve–1stdiv
isi
onoftr
igeminalner
veCNV).

Lat
eral
par
t–zy
gomat
ic-
tempor
alner
ve,
aur
icul
otempor
alner
veandgr
eat
eraur
icul
arner
ve.

Post
eri
orpar
t–gr
eat
erocci
pit
al,
lesserocci
pit
alandt
hir
docci
pit
alner
ves.

Ly
mphdr
ainage

Occi
pit
al,
ret
roaur
icul
arandsuper
fi
cial
par
oti
dnodes.

Cl
i
nical

Scal
pwound

Asaresul
tofdensebl
oodsupplytoscal
p,woundsbl
eedprofusely
.Thismaybedi f
fi
cul
tto
st
opaswallsofthebl
oodvessel
sareadherentt
odensesubcutaneousfi
broust
issues.

Di
rectpr
essur
eov
ert
hewoundi
sneededt
ost
opt
hebl
eedi
ng.

Thi
sint
ensebl
oodsuppl
yhast
headv
ant
ageoff
aci
l
itat
ingheal
i
ngofscal
pwounds.

Thel
ooseCTl
ayeri
sthedangerar
eai
fscal
paspusorbl
oodspr
eadseasi
l
yini
t.I
nfect
ions
i
nthisl
ayercanal
sopassint
othecrani
alcavi
tythr
ought heemi
ssar
yvei
nspassingt
hrough
par
iet
alf
oraminai
ncalvar
iaandr
ichint
racr
anial
struct
uressuchast
hemeninges.

Scal
pinf
ect
ion

Thelooseareol
arCTlayeroft
hescal
pisdividedint
osmal
lpocket
sofdensefi
brousti
ssues.
Aninfecti
oninsubcut
aneoust
issuei
srestr
ictedtoasmal
lar
ea.Fort
hisr
easonpressur
eon
ner
vesi nthear
eaishighandl
eadstoseverepain.

Ast hi
slayeri
stransv
er sedbyemi ssaryvei
nsi
nfect
ioncanpassthr
oughtheseveinst
o
i
ntracrani
alvenoussi
nuses.Ost eomy el
it
isoft
heskullbonecanbecausedbyspreadof
i
nfecti
ont hr
oughemi ssaryvei
ns.