It is a lecture class of "Scalp Anatomy" delivered in the Department of Anatomy, Sir Salimullah Medical College, Mitford, Dhaka. Here scalp layers and their description with clinical importance, blood supply, nerve innervation, venous drainage, muscle of the scalp were described. The lecture was delivered by Dr Zobayer Mahmud Khan, MS Anatomy. He is the lecturer of the Department of Anatomy.

1. SCALP ANATOMY
Dr. Zobayer Mahmud Khan
MS Anatomy
Lecturer, Department of Anatomy
Sir Salimullah Medical College, Dhaka.

2. Objectives
Layers of scalp
Blood supply
Nerve innervation
Lymphatic drainage
Muscle of the scalp
Applied anatomy

3. What is it?
Soft tissue which covers the calvaria of skull

4. Extension
 Front : Supraorbital margin
 Behind : External occipital protuberance &
superior nuchal line
 On each side : Zygomatic arch

6. LAYERS OF SCALP
S – Skin
C – Cutaneous tissue (subcutaneous tissue)
A - Aponeurosis (Galea aponeurotica covering
the occipito- frontalis muscle)
L – Loose areolar tissue (subaponeurotic tissue)
P – Pericranium (outer periosteum)

8. Scalp proper
‘Scalping‘

10. S - SKIN
 Hairs
 Sebaceous glands
 Sweat glands

11. C – CUTANEOUS TISSUE
(Subcutaneous tissue)
 Composed of fibro-fatty tissue
 Contains blood vessels & nerves

13.  Walls of blood vessel adherent to fibrous tissue –
(minor scalp injury causes profuse bleeding)
 To arrest bleeding- apply firm pressure over the
underlying bone
Clinical Importance

15.  Subcutaneous hemorrhage – localized in extent
 Inflammation painful
 Good healing

16. A – APONEUROSIS
 Thin, tendinous sheet that unites the occipital
and frontal bellies of the occipitofrontalis muscle
 Lateral margins of the aponeurosis are attached
to the temporal fascia

18. Clinical Importance
Scalp lacerations through this layer mean
that the anchoring of the superficial
layers is lost and gaping of the wound
occurs and this requires suturing.
anchoring
gaping
suturing

19. L – LOOSE AREOLAR TISSUE
 Loose subaponeurotic tissue
 Potential space contains emissary vein
 Emissary vein are devoid of valves and
communicates the veins of scalp with
intracranial venous sinuses

21.  Infection in the Loose subaponeurotic tissue with
pus collection readily spread to intracranial
sinuses through emissary veins (valve less)
 Collection of blood in the subaponeurotic space
produce generalized swelling affecting the whole
dome of skull
 Blood slowly gravitates into the eye lids because
the frontalis has no bony attachments
Clinical Importance
Black eye
Dangerous layer
of the scalp

22. Fracture of cranial vault in children with
tearing of duramatter & pericranium
Blood from Intra cranial haemorrhage
communicate with subaponeurotic space
(4th layer) through the line of fracture
Cerebral compression do not develop.
Safety - Valve
Haematoma

23. P-PERICRANIUM
 Outer peroisteum of skull
 Loosely covers the bone
 At the sutures it is continuous with
endocranium through sutural membrane

24. ARTERIAL SUPPLY
 5 sets of arteries on each side of scalp
 3 in front of auricle
 2 behind the auricle
Out of 5,
2 arteries (indirectly) from Internal Carotid Artery
3 arteries (directly) from External Carotid Artery

26. Scalp is the site of free anastomosis between the
branches of internal & external carotid arteries

28. Emissary vein
 The veins connect the extracranial venous
system with the intracranial venous sinuses.
 They connect the veins outside the cranium
to the venous sinuses inside the cranium.

29. Diploic vein
The diploic veins are large, thin-walled valveless
veins that channel in the diploe between the inner
and outer layers of the cortical bone in the skull.

31. EMISSARY & DIPLOIC VEINS
Parietal emissary vein through parietal foramen
communicates the scalp veins with Superior
sagittal sinus
Mastoid emissary vein through mastoid foramen
communicates the scalp veins with sigmoid
sinus
Frontal diploic vein drains into supra-orbital vein
Occipital diploic vein drain into occipital vein by
piercing outer table or drains into transverse

32. Temporary swelling in newborn
Edematous condition of a portion of scalp
Due to interference of venous return while
passage through birth canal
CAPUT
SUCCEDANEUM

33. Nerve innervation
10 nerves on each side of scalp
5 in front of auricle
5 behind the auricle
4 is sensory 1 is motor

34. Lymphatic drainage
The lymphatics in the occipital region
initially drain to occipital nodes which
drain into upper deep cervical nodes.
Lymphatics from the upper part of the
scalp drain in two directions:
– Posterior to the vertex of the head they
drain to mastoid nodes.
– Anterior to the vertex of the head they
drain to pre-auricular and parotid nodes.

35. Muscle of the scalp
Occipitofrontalis
Frontal belly anteriorly
Occipital belly posteriorly
Aponeurotic tendon
(epicranial aponeurosis)
connecting the two.

36. Occipital belly
Highest nuchal line of occipital bone
Epicranial aponeurosis
Facial nerve
Moves scalp on skull and
Frontal belly
Skin and superficial fascia of eyebrow
Epicranial aponeurosis
Facial nerve
raise the eyebrows in expression of
surprise or horror.

38.  Mandibular branch of the trigeminal nerve
 Elevates the lower jaw in order to bite or close the
jaws. It also functions to retract the lower jaw as
well as move the lower jaw from side-to-side.

39. Thank
You