13. 13
The first three layers are firmly united
together and considered as one layer
14. Anatomy of SCALP
2007
-
2008
DR. HASSAN REZK
14
OCCIPITO-FRONTALIS MUSCLE
=Has two bellies:-
(1)- Frontal belly [frontalis]
(2)- Occipital belly [occipitalis]
15. 15
ORIGIN:-
1)-Frontal bellies:- two in number.
=longer & wider.
=arises from skin of forehead opposite eye brows.
2)-Occipital bellies:- two in number.
=small & separate.
=arises from lateral part of H.N.L. of occipital bone.
INSERTION:- Epicranial aponeurosis. how?
NERVE SUPPLY:- All by FACIAL NERVE
=Frontalis:- temporal branch.
=Occipitalis:-posterior auricular branch.
ACTION:-
=Both muscles move the SCALP.
=Frontalis:-elevates eyebrows as in surprise.
=Occipitalis:-draws the SCALP backwards.
26. 26
Loose areolar C.T.:-
(Sub-aponeurotic space)
Dangerous area of SCALP
=Extends:-
Anteriorly:- eyelids
(because frontalis has no bony attachement)
Laterally:- to [STL]
Posteriorly:- [HNL]
=Contains:- small arteries & emissary veins
=known as Dangerous area of SCALP *
=Applied anatomy:- Black eye
= Allow free movement to the upper 3 layer
34. Sensory supply of the scalp
In front of the auricle (from before
backwards)
Behind the auricle (from before
backwards)
1. Supratrochlear, a branch of frontal
nerve from ophthalmic division of
trigeminal nerve
Great auricular, derived from ventral
rami of 2nd and 3rd
cervical nerves
2. Supraorbital, a branch of fontal
nerve from ophthalmic division of
trigeminal nerve
Lesser occipital, derived from ventral
ramus of 2nd cervical nerve
3. Zygomaticotemporal, a branch of
zygomatic nerve from maxillary
division of trigeminal nerve
Greater occipital, derived from dorsal
ramus of 2nd cervical nerve
4. Auriculotemporal, a branch of
mandibular division of trigeminal
nerve
Third occipital, derived from dorsal
ramus of 3rd cervical nerve
34
35. Motor supply of the scalp
35
1. Nerve in front of the
ear is temporal branch of
the facial nerve. It supplies
frontal belly of
occipitofrontalis muscle.
2. Nerve behind the ear
is the posterior auricular
branch of the facial nerve. It
supplies occipital belly of
occipitofrontalis muscle.
36. 36
Site Nerves Type Origin Exit to SCALP
In
Front
Of Ear
1.Temporal MOTOR Facial nerve Upper border of parotid glan.
2.Supra- trochlear SENSORY T
R
I
G
E
M
I
N
A
L
OPHT Above trochlea
3.Supra-orbital From supra-orbital foramen
4.Zygomatico-
temporal
MAXI From zygomatico-temporal
formen
5.Auriculo-temporal MAND Upper border of parotid
gland
Behin
d Ear
1.Posterior auricular MOTOR Facial nerve SEE FACIAL N.
2.Great auricular
(C 2 . 3)
SENSORY Cervical
plexus
SEE BELOW
3.Lesser occipital
(C 2)
4.Greater occipital
( C 2 )
5.Third ociipital
( C 3 )
43. 43
ARTERIAL SUPPLY:-
=SCALP has the richest blood suuply in the whole body.
=Two important notes that should be remembered:-
The arteries are derived from:-
A]=Internal carotid artery:- small anterior part of SCALP
B]=External carotid artery:- large posterior part of SCALP
The arteries enter SCALP from periphery and ramify in the
centre.
=Each half (right & left) is supplied by FIVE arteries.
=Classified as 3 S + P + O [SPO]
44. 44
Arteries
According to
ORIGIN
According to
SITE
1=Supra- trochlear
Internal
carotid
artery
medial
In front
Of
auricle
2=Supra-orbital
lateral
3=Superficial temporal
External
carotid
artery
At level of auricle
4=Posterior auricular
anterior
Behind
the
auricle
5=Occipital
posterior
48. 48
Superficial temporal artery
Origin:-
=smaller terminal branch of E.C.A.
=given off behind neck of mandible
=under cover of parotid gland.
Course:-
=Leaves the gland at its upper border.
=runs vertically upwards.
=crossing posterior root zygoma where its pulsation can be felt.
=at 5 c.m. above zygomatic arch it divides into:-
1)anterior branch. [FRONTAL] 2)posterior branch. [PARIETAL]
=Accompanied with :=
1-superficial temporal vien.
2-auriculo-temporal nerve.
49. 49
Branches:- Z , A , T , M , A , P
1-Zygomatico-orbital:-
2-Anterior auricular:-
3-Transverse facial artery:-
=arises inside parotid gland.
=runs forwards over masseter between parotid duct below &
zygomatic arch above.
=accompanied by upper buccal branch of facial nerve.
=supplies:-parotid gland, masseter, overlying skin.
=anastmose with neighbouring arteries in face.
4-Middle temporal artery:-
=pierces temporal fascia and temporalis muscle.
5-Anterior terminal branch:-
6-Posterior terminal branch:-
54. 54
Veins
According to Termination
According to SITE
1=Supra-trochlear
=Unite together.
=At inner angle of orbit
=To form facial (anterior facial)
vein
medial
In front
Of
auricle 2=Supra-orbital
lateral
3=Superficial temporal
=Unite with maxillary vein
=Inside parotid gland.
=To form posterior facial vein
[RETRO-MANDIBULAR VEIN]
This vein at apex of
parotid gland it divides into:-
1)-Anterior division.
2)-Posterior division.
At level of auricle
4=Posterior auricular
=Unite with posterior division of
retro-mandibular vein
=forming External jugular v.
=Drain in subclavian vein.
anterior
Behind the
auricle
5=Occipital
Either
a)-Sub-occipital venous plexus
then into vertebral vein
OR
b)-Directly into I.J.V.
posterior
58. 58
1)-Anterior part of SCALP:-
[In front level of auricles]
=drain into submandibular L.N.
2)-Middle part of SCALP:-
[At level of auricles]
=drain into pre-auricular L.N.
3)-Posterior part of SCALP:-
[Behind level of auricles]
=drain into mastoid (occipital) L.N.
64. 64
*Is area between the temporal line and zygomatic arch.
*The soft stuctures covering this region of the skull are
arranged, from without inwards, as follows :
1. Skin.
2. Superficial fascia:- containing the blood vessels and nerves.
3. An extension from the epicranial aponeurosis:-
in which the extrensic muscles of the auricle are embedded.
4. The temporalis muscle and its covering fascia:-
which replace the layer of the loose areolar tissue of scalp.
5. Pericranium:- which is the periostium of the skull.
65. ANATOMY OF THE
FACE
2007
-
2008
DR. HASSAN REZK
65
All of the following is true about
occipito-frontalis muscle E X C E P T :
A. All parts have bony origin.
B. All parts are supplied by 6th cranial nerve.
C. All moves hair follicles.
D. All inserted in subaponeurotic space.
E. All of the above.
66. ANATOMY OF THE
FACE
2007
-
2008
DR. HASSAN REZK
66
Frontalis muscle , E X C E P T :
A. Originates from skin of forehead.
B. Supplied by temporal branch of 7th nerve.
C. Moves scalp.
D. Muscle of surprise.
E. Supplied by auriculo-temporal nerve.
67. ANATOMY OF THE
FACE
2007
-
2008
DR. HASSAN REZK
67
All are layers of scalp EXCEPT :
A. Pericranium.
B. Subaponeurotic space.
C. Pericradium.
D. Epicranial aponeurosis.
E. Superficial fascia.
68. ANATOMY OF THE
FACE
2007
-
2008
DR. HASSAN REZK
68
The following are contents of scalp
EXCEPT :
A. Hair follicles.
B. Sebaceous gland.
C. Salivary gland.
D. Emissary veins.
E. Nerves.
69. ANATOMY OF THE
FACE
2007
-
2008
DR. HASSAN REZK
69
Ophthalmic nerve shares in
sensory innervation of scalp by :
A. Supre-trochlear nerve.
B. Auricuo-temporal nerve.
C. Supra-orbital nerve.
D. A & B.
E. A & C.
70. ANATOMY OF THE
FACE
2007
-
2008
DR. HASSAN REZK
70
Trigeminal nerve supplies only:
A. Anterior part of scalp.
B. Middle part of scalp.
C. Posterior part of scalp.
D. Lateral part of scalp.
E. Medial part of scalp.
150. Development of the Face
a) Formation of five facial processes around the stomodeum.
The stomodeum is surrounded by five facial processes.
Produced by proliferation of the neural cells of the neural
tube.as follows.
a) The frontonasal process:
A median cranial prominence.
It arises form head fold.
a) Two maxillary prominences:
One on each side.
Arises form Dorsal part of first pharyngeal arch.
a) Two mandibular prominences:
Caudally.
Arises form Ventral part of first pharyngeal arch
152. 152
a) developmental changes of
the frontonasal process
At the end of the 4th
week, on each side of the
frontonasal process an
oval thickening of the
surface ectoderm has
developed (the nasal
placodes).
Each nasal placode
becomes invaginated to
form a nasal pit.
The margins of the nasal
pit proliferates producing
medial and the lateral
nasal folds.
153. a) developmental changes of
maxillary processes:
At the end of 4th week,
maxillary processes undergo
enlargement due to
proliferation of their
mesenchyme.
They grow medially toward
each other and toward medial
and lateral nasal folds.
During the following two
weeks, maxillary process
enlarges and fuses with lateral
and medial nasal processes.
154. 154
a) The maxillary processes and the
medial nasal folds fuses and lead
to the formation of the upper lip.
b) The maxillary processes and the
lateral nasal folds:
The Maxillary processes grow
toward the lateral nasal folds and
are separated from them by the
nasolacrimal grooves.
Each maxillary process fuses with
lateral nasal fold along the line of
the nasolacrimal groove.
This establishes continuity between
the side of the nose formed by
the lateral nasal folds and the
cheek region formed by the
maxillary processes.
155. a)developmental changes of the
mandibular processes:
The mesenchyme of each process fuses with
that of maxillary process to form the cheek
region .
They fuse with each other medially to form the lower lip
and chin
155
