Scalp

Savinaya
 Learning objectives

Describe the layers of scalp.

Describe the blood supply & nerve supply of
scalp.
Describe the clinical importance of different
layers of scalp.
 Scalp
Soft tissue covering
the cranial vault.
Extent:
- Anterior - supra
orbital margin.
- Posterior- external
occipital protuberance
& superior nuchal
lines.
- Sides - superior
temporal lines.
 Scalp-Layers
Scalp is made up of 5
layers.
1. Skin- S
2. Connective tissue
(superficial fascia)- C
3. Deep fascia A -
Epicranial aponeurosis or
galea aponeurotica with
occipito frontalis muscle.
4. Loose areolar connective
tissue- L
5. Pericranium- P
Layers of scalp
 Layers of scalp 1.skin
Thin skin and hairy-rich blood supply.
Adherent to the epicranial aponeurosis.
Hairy part and non-hairy part
Layers of scalp 2.superficial fascia

Fibrous and dense in the centre than periphery,

contains blood vessels and nerves of scalp.
Binds the skin to the aponeurosis(first layer to the
third layer).
Provides medium for the blood vessels and nerves to
pass through.
 Layers of scalp 3.Epicranial aponeurosis

Freely mobile over

the pericranium
along with the the
1st and 2nd layers.
Anteriorly receives
insertion of frontalis.
Posteriorly receives
insertion of
occipitalis.
Sides attached to
the superior
temporal lines.
 Layers of scalp : 4.Loose areolar
connective tissue

Anteriorly extends to the eyelid.

Posteriorly extends to the superior nuchal lines.
Laterally extends to the superior temporal lines.
 Layers of scalp : 5.Pericranium

Loosely attached to the bones.

But firm in the sutures.
 Muscle of scalp
Occipitofrontalis muscle:
Pairs of frontal and occipital belly connected by broad
aponeurosis- the galea aponeurotica
Attachments :
Occipital belly and galea aponeurotica - to occipital bone
(posterior) and zygomatic arches (lateral).
Frontal belly - into the skin
Function: moves the scalp, forehead skin (Tranverse wrinkles
Fright) and raise eyebrows ( surprise).
 Scalp- Arterial supply

In front of the auricle:

1.Supratrochlear Ophthalmic
2.Supraorbital artery -
Internal carotid
artery
3.Superficial temporal
External carotid artery.
Behind the auricle:
External
4.Posterior auricular carotid
5.Occipital
Total 5 arteries
 Scalp Venous drainage
Supratrochlear + Supra
orbital angular vein
facial vein.
Superficial temporal +
Maxillary vein
retromandibular vein
divides into anterior and
posterior division.
- Anterior division + facial vein
common facial veins
internal jugular vein.
- Posterior division +
Posterior auricular vein
external jugular vein
subclavian vein.
Occipital vein sub
occipital plexus.
Scalp Venous drainage
 Scalp Nerve supply
Preauricular region: 5 nerves-
Sensory- 4
- Supraorbital and supratrochlear frontal ophthalmic division
- Zygomatico temporal maxillary division
- Auriculotemporal mandibular division
Motor- 1
- Temporal branch Facial nerve
Post auricular region: 5 nerves-
Sensory-4
- Great auricular C 2,3
- Lesser occipital C 2
- Greater occipital C 2
- Third occipital C 3
Motor-1
- Posterior auricular branch Facial nerve

Total 10 nerves
Scalp-Artery & Nerve
 Scalp lymphatic drainage

Anterior part pre

auricular nodes or
parotid group.
Posterior part -
posterior auricular
nodes and occipital
group.
 Applied anatomy
Skin Numerous sebaceous glands make the scalp one of the most
common sites for sebaceous cysts.
Connective tissue - Blood vessels in this area are unable to retract
when lacerated ( wall are attached to fibrous network) scalp
wounds bleed profusely and scalp wounds heal quickly.
Aponeurotic layer - Wounds of scalp gape if it is divided
Fluid accumulating here can not pass posteriorly or laterally
bony attachments of occipitalis and galea aponeurotica.
However, since the frontalis is inserted
into the skin, fluids can enter the eyelids,to cause black eye.
Loose areolar layer
Infections can be transmitted through bony channels by
emissary and diploic veins to the cranial cavity. Dangerous
area of scalp.
19
Sebaceous cyst Black eye
Summary
 S-C-A-L-P
Extent: between superior orbital margin to superior
nuchal line.
Divisions: hair-bearing & nonhair-bearing (ie,
forehead).
Layers:
S - skin
C - connective tissue or superficial fascia
A - aponeurotic layer - galea aponeurotica /epicranial
aponeurosis - dense fibrous sheet connecting
frontalis and occipitalis muscle.
L - loose areolar connective tissue.
P -pericranium, periosteum of bone.

22
 Blood supply

Branches of the external carotid :

superficial temporal
posterior auricular
occipital

Branches of internal carotid:

via the ophthalmic artery :
Supratrochlear
supraorbital
 Nerve supply

Sensory:
Branches from trigeminal nerve: (5th cranial
nerve)
Supratrochlear,supraorbital.
Zygomatico temporal
Auriculotemporal
Branches from cervical plexus:
Great auricular
Greater occipital
Lesser occipital
Third occipital

Motor:
Branches from facial nerve:(7th cranial nerve)
Temporal branch
Posterior auricular branch
Any questions ?
 Describe the layers, blood supply and
nerve supply of scalp.
Thank you