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scalp rishi naihs nepal

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scalp scalp rishi naihs nepal

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scalp rishi naihs nepal

  1. 1. SCALP MAJ RISHI POKHREL DEPT OF ANATOMY NAIHS
  2. 2. Scalp • Soft tissue covering skull vault • Extension – Eyebrows to occipital protuberance – Zygomatic arch to temporal lines
  3. 3. Layers S : Skin C : dense Connective tissue A : Aponeurosis of occipito-frontalis L : Loose connective tissue P : Pericranium First 3 layers forms a single functional layer
  4. 4. Layers
  5. 5. Skin – Thickest , 3-7 mm – Abundance of hair, sebaceous, sweat glands Dense Connective tissue – Corresponds to superficial fascia – Dense fibro fatty tissue – Numerous blood vessels and nerves – Connects layer of skin with aponeurosis
  6. 6. • Aponeurosis of occipeto-frontalis muscle Attachments of muscle • Frontal belly – Ant: Skin of eyebrows, skin of root of nose & orbicularis oculi – Post: aponeurosis • Occipital belly – Behind : to lat ½ half of superior nuchal line – Front : aponeurosis • Functions – Occipital belly : pulls scalp back, anchors aponeurosis – Frontal belly : elevate eyebrow, transverse wrinkles • Nerve supply: facial nerve Occipitalis is attached to bone, frontalis is not Aponeurosis (galea aponeurotica)
  7. 7. Loose connective tissue • Loose areolar tissue • Contain emissary veins • Potential space over which layer 1 to 3 move Pericranium • Periosteum of bone of skull • Intimately adherent to endocranium • Firmly attached to suture lines, loose elsewhere
  8. 8. Nerve supply of head & neck
  9. 9. Nerve supply of scalp
  10. 10. Nerve supply of scalp
  11. 11. Arterial supply & venous drainage of scalp
  12. 12. SCALP – NERVE & BLOOD SUPPLY
  13. 13. 1 2 3 4 5 6 8 7 9 10 1. Supratrochlear (V1) 2. Supraorbital (V1) 3. Z-T (V2) 4. Temp br CN VII (supply frontalis) 5. Auriculotemp N (V3) 6. Great auricular ( C1,C2) 7. Post auricular (CN VII N- supply occipital belly)) 8. Lesser occipital (C2, C3) 9. Greater occipital (C2) 10. Third occipital (C3) Supratrochlear – br of opth art Supraorbital – br of opth art superficial temporal art- terminal br of ECA post auricular art – br of ECA occipital art – br of ECA SCALP Nerve supply Blood supply
  14. 14. Venous Drainage – Veins accompany the artery – Emissary vein from scalp to intracranial venous sinus – Diploic vein • Drain frontal and occipital diploe and enter main vein of scalp Lymphatic Drainage – In front of ear : pre- auricular group – Behind ear : post auricular
  15. 15. EMISSARY VEINS Emissary veins along with layers of skull
  16. 16. Clinical anatomy
  17. 17. Applied Anatomy • Black eye – Spread thro subaponeurotic space • Scalp lacerations • Sebaceous cysts • Gaping wounds – Due to incisional wound of galea in coronal plane • Cephalhaematoma • Bone flaps • Dangerous area of scalp – Loose areolar tissue – infection spread to intracranial venous sinus thro emissary vein • Caput succedaneum • Safety valve mechanism • Scalp avulsion
  18. 18. BLACK EYE Blood tracks down below frontalis to eye lid
  19. 19. Hematoma in Scalp • Caput succadeum : haematoma bt skin and aponeurosis • Sub galeal haematoma :b/w aponeurosis and periosteum • Cephalhaematoma :b/w skull bone and its periosteum (limited by suture lines)
  20. 20. Scalp Avulsionpreoperative postperative Hair removed After some time……
  21. 21. Sebaceous cyst Gaping wound of scalp
  22. 22. ?

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