The scalp consists of 5 layers - skin, connective tissue, aponeurosis, loose areolar tissue, and pericranium. The skin is thick and contains numerous hair follicles, sebaceous glands, and sweat glands. The connective tissue below is dense and fibrous, containing a rich blood supply where vessels are adherent. Below this is the aponeurosis layer, containing two muscle bellies connected by the epicranial aponeurosis. The loose areolar tissue below forms a potential space containing emissary veins that can allow spread of infection to intracranial sinuses. The outermost pericranium layer is loosely attached to skull bones and firmly

1. Scalp
• Soft tissue covering
vault of skull

2. Scalp - Extent
• Anteriorly
– Supraorbital
margin
• Posteriorly
– External occipital
protuberance &
superior nuchal
line
• On each side
– Zygomatic arch
and temporal lines

3. Scalp - Layers
• Consists 5 layers
• Skin
• Connective
• Aponeurosis
• Loose areolar tissue
• Pericranium

4. Skin
• Thick
• Contains
– Numerous hair follicles
– Sebaceous glands
– Sweat glands
Sebaceous cysts of the scalp are common why?
Ducts of sebaceous glands are prone to infection and
damage by combs

5. Connective tissue
• More fibrous and dense
• Contains
– Blood vessels
– Nerves
Richest cutaneous blood supply of body
Walls of blood vessels adherent to fibrous connective tissue
During Injury to blood vessels – vessels can’t retract

6. Aponuerosis
• Muscular in front and back
– Connected by aponeurosis
• Muscle is
– Frontal belly of oocipito
frontalis
– Occiital belly of
occipitofrontalis

7. • Frontal belly
– O: Skin of the forehead (no
bony attachment)
– Ins: Epicranial aponeurois
• Occipital belly:
– O: Lateral part of highest
nuchal line
– Ins: Epicranial aponeurosis
– Nerve supply: Posterior
auricular branch of facial nerve
• Nerve Supply
– Frontal belly
• Temporal branch of facial nerve
– Occiptal belly
• Posterior Auricular of Facial
nerve

9. Loose areolar tissue
• Forms potential space
• Contains
– Emissary veins
– Blood vessels & nerves
• Dangerous area of scalp
– Emissary veins
• Have no valves
• Connecting
– Intracranial venous sinuses
with
– Veins of scalp
• Infection may spread into
intracranial venous sinuses

10. Black eye
• Collection of fluid can
spreads only into the eye
lids and the root of the nose
• Because of the attachment
of frontalis into the skin
• Posteriorly
– Attachment of occipitalis
muscle to the occipital and
temporal bones
• Laterally
– Attachment of aponeurosis to
the temporal fascia

11. Pericranium
• Loosely attached to the
surface of the bones
• At sutures between
individual skull bones
– Periosteum on the outer
surface of the bones is
continuous with
– Endosteum on the inner
surface of the skull bones
• Firmly adherent to the
sutures

12. Arteries
• In front of auricle
– Supratrochlear
– Supraorbital
– Superficial
temporal
• Behind the auricle
– Posterior auricular
– Occipital

13. Veins
• Superficial temporal
– Joins with maxillary
• In parotid gland
– Forms retromandibular
– Divides into
• Anterior division of
retromandibular
• Posterior division of
retromandibular

14. Veins
• Supra trochlear & supra
orbital
– Joins at medial angle of eye
– Forms angular vein
– Continues as facial
• Facial vein meets
– Anterior division of
retromandibular
– Forms common facial vein
• Drains into IJV

15. Veins
• Posterior auricular
– Unites with
• Posterior division of
retromandibular
– Forms external jugular vein
• Occipital vein
– Drains into
• Suboccipital venous plexus

16. Nerves
• In front of auricle
– 4 sensory
• Supratrochlear
• Supraorbital
• Zygomatico temporal
• Auriculotemporal
– One motor
• Temporal branch of facial

17. Nerves
• Behind auricle
– 4 sensory
• Great auricular (C1&2)
• Lesser occipital (C2)
• Greater occipital (C2 DPR)
• Third occipital (C3 DPR)
– One motor
• Posterior auricular
– Facial