The document provides an extensive overview of the anatomy of the scalp, detailing its layers: skin, connective tissue, aponeurosis, loose areolar tissue, and pericranium, along with their functions, including blood supply and nerve innervation. It also discusses clinical applications, such as the dangerous area of the scalp, various hematomas, and associated blood and venous drainage. Additionally, the document describes conditions like caput succedaneum and cephalhematoma that present in clinical scenarios related to childbirth and cranial injuries.

1. SCALP
ABDULLAH, ABHIJITH, ABHIRAMI, ADHITHYA, ADILA,
ADITHI

2. Extent
 Anterior- superciliary arches
 Posterior- Superior nuchal line
 Lateral- Superior temporal line

3. Layers of
Scalp  Skin
 Connective tissue
 Aponeurosis
 Loose areolar tissue
 Pericranium

4.  Skin-
 Connective Tissue-
 Thicker at center.
 Adherent to Epicranial aponeurosis via
underlying dense superficial fascia.
 Has a large amount of sweat and sebaceous
glands
 More fibrous and dense in center of scalp
than the periphery.
 Binds the superficial skin to underlying galea
aponeurotica.
 Contains origin of blood vessels in large
number.
 Provides medium for passage of blood
vessels and nerves to scalp.

5.  Aponeurosis-  It is a tough fibrous sheath of connective tissue
underlying the superficial fascia.
 It covers the scalp forming third layer of scalp.
 It forms the last layer of surgical layers of scalp.
 It is freely movable on pericranium.
 Anteriorly it receives insertion of frontalis muscle
 Posteriorly it receives the insertion of occipitalis
muscle.
 Posteriorly it is attached to superior nuchal lines; on
either side to superior temporal lines where it sends
down an expansion which is attached to the
zygomatic arch.
 It provides pathway for passage of emissary veins
which links the extracranial and Dural venous
sinuses.

6. • Loose areolar tissue-
Made up of loose areolar tissue
 Natural plane of cleavage during craniotomy
Traversed by emissary veins
Emissary veins connects veins of scalp with intracranial dural
venous sinuses
 Pericranium-
Formed by periosteum of bones of vault of skull
Loosely attached to bones,can be easily stripped
Firmly attached to sutural membranes at sutures,which inturn
attached to endocranium

7. Applied
Aspects
SURGICAL LAYERS OF SCALP
 First three layers of scalp are firmly adherent to each other
and is inseparable.
 These form the scalp proper and is known as the surgical
layers of scalp.
DANGEROUS AREA OF SCALP
 Loose areolar tissue layer is the dangerous layer of scalp.
 Blood or pus can easily collect in this region and can
travel readily through emissary veins into intracranial
dural venous sinus.

8. Applied
aspects
BLACK EYE
 The swelling caused due to blood accumulation following
a blow on head cannot pass into occipital or temple
region due to bony attachment of occipitofrontalis.
 But blood can track down through eyelids where there is
no bony attachments
 This cause black discoloration of skin around eye due to
hematoma.

9. Blood Supply
Arterial Supply
On each side, supplied by 5 arteries.
• In front of auricle.
i. Supratrochlear – Branch of ophthalmic
artery from ICA
ii. Supraorbital – Branch of ophthalmic
artery from ICA
iii. Superficial Temporal – Branch of ECA
• Behind the auricle.
i. Posterior Auricular Artery – Branch of
ECA
ii. Occipital Artery – Branch of ECA

10. Venous Drainage
On each side, drained by 5 veins
1. Supratrochlear + Supraorbital Veins - Join at medial
angle of eye to form the Angular vein, which
continues down as Facial vein
2. Superficial Temporal Vein - Enter parotid gland
where it join maxillary vein to form retromandibular
vein. Anterior division unites with facial vein to form
common facial vein, which drains into Internal jugular
vein
3. Posterior Auricular Vein - unite with posterior
division of retromandibular vein to form External
jugular vein, which drains into subclavian vein
4. Occipital Vein - Terminates in the suboccipital venous
plexus

11. • Emissary Veins
The veins of scalp communicate with intracranial dural venous sinus through emissary veins.
On each side of midline,
1. Parietal emissary veins - pass through parietal foramen and communicates with superior
sagittal sinus
2. Mastoid emissary vein- pass through mastoid foramen and communicates with sigmoid sinus

12. Nerve
Supply
IN FRONT OF AURICLE BEHIND THE AURICLE
SENSORY From TRIGEMINAL NERVE
● Supratroachlear
(Opthalmic)
● Supraorbital
(Opthalmic)
● Zygomaticotemporal
(Maxillary)
● Auricotemporal
(Mandibular)
From CERVICAL NERVE
● Great auricular (C2 ,C3)
● Lesser occipital(C2)
● Greater occipital(C2)
● Third occipital(C3)
MOTOR ● Temporal branch of the
facial nerve
● Posterior auricular branch of the
facial nerve

14. Applied
aspects
SAFETY VALVE HEMATOMA
#Blood from intracranial haemorrhage communicates with sub
aponeurotic space of scalp through fracture lines .
#The signs of cerebral compression does not develop until the sub
aponeurotic space is fully filled with blood.
#So collection of blood in fourth layer is called safety valve hematoma .
CEPHALHYDROCELE
#CSF collects in sub aponeurotic space.
CEPHALHEMATOMA
#Sub periosteal collection of blood.
#Hematoma is surrounded by sutural lines ,so take up the shape of related
bones .

15. APPLIED
ASPECTS
CAPUT SUCCEDANEUM
#Sub cutaneous oedema over the presenting part of head
at delivery.
#Takes place during passage of head through birth canal
due to interference of venous return.
# Usually occurs over the occiput and crosses the suture
lines .
#Scalp feels soft and margins are partly defined.
#Oedema subsides in few days.