The scalp consists of 5 layers - skin, connective tissue, aponeurosis, loose areolar tissue, and pericranium. The clinically important layer is the aponeurosis, as lacerations through this layer can cause gaping of the wound requiring suturing. The scalp receives innervation from the trigeminal and cervical nerves and is supplied by the supratrochlear, supraorbital, zygomaticotemporal, auriculotemporal, lesser occipital, and greater occipital nerves.

1. BY
DR UZMA NAJAM

2. Consists of five layers
• S : Skin
• C : Connective tissue
• A : Aponeurosis
• L : Loose areolar connective tissue
• P : Pericranium

6. SKIN
Thick & hair-
bearing and
contains numerous
sebaceous glands

7. CONNECTIVE TISSUE
• The superficial fascia is a fibro fatty
layer
• Connects skin to the underlying
aponeurosis of the
occipitofrontalis muscle
• Provides a passageway for nerves and
blood vessels.
CLINICAL IMPORTANCE:
 If the vessels are cut, this attachment
prevents vasospasm, which could lead
to profuse bleeding after injury.

8. APONEUROSIS
• A thin, tendinous sheet that
unites the occipital and frontal
bellies of the
OCCIPITOFRONTALIS
muscle.
• Lateral margins are attached
to the temporal fascia.
• the sub-aponeurotic space is
the potential space beneath
the epicranial aponeurosis

9. The clinically important layer is the
aponeurosis. 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.

10. • Loosely connects the epicranial aponeurosis to the
pericranium & allows the superficial 3 layers of the scalp
to move over the pericranium.
• Contains Emissary veins which connects the superficial
scalp veins to the Diploic veins of skull and with
intracranial venous sinuses.

11. • is the periosteum covering the outer surface of
skull bones.
• at the sutures between individual skull
bones, the pericranium become continuous with
periosteum (endosteum) on the inner surface of
skull bones.

12. OCCIPITOFRONTALIS:
• consists of four bellies two Occipital & two Frontal connected by
an aponeurosis.
• the Occipital belly is supplied by Posterior Auricular branch &
Frontal belly is supplied by temporal branch of facial nerve.
ACTION:
• The loose areolar tissue (4th layer) allowing the aponeurosis to
move on the pericranium.
• frontal bellies can raise the eyebrows in expression of surprise or
horror.

13. SENSORY NERVE SUPPLY
Six sensory nerve branches of
either the trigeminal nerve or
the cervical nerve supply the
scalp. Can be remembered by
Z-GLASS”
 Zygomaticotemporal nerve
 Greater occipital nerve
 Lesser occipital nerve
 Auriculotemporal nerve
 Supratrochlear nerve
 Supraorbital nerve

14. The SUPRATROCHLEAR NERVE , branch of the ophthalmic
division of the trigeminal nerve & supplies the medial plane at the
frontal region up to the vertex.
The SUPRAORBITAL NERVE , a branch of the ophthalmic
division of the trigeminal nerve supplies the scalp at the
front, lateral to the supratrochlear nerve distribution up to the
vertex.
The ZYGOMATICOTEMPORAL NERVE, branch of the maxillary
division of the trigeminal nerve supplies the hairless temple .
The AURICULOTEMPORAL NERVE, branch of the mandibular
division of the trigeminal nerve supplies the skin over the temporal
region of the scalp.
The LESSER OCCIPITAL NERVE, branch of the cervical plexus
(C2), supplies behind ear.
The GREATER OCCIPITAL NERVE, branch of the posterior
ramus of the second cervical nerve & supplies posteriorly upto the

15.  SUPRATROCHLEAR & SUPRAORBITAL
ARTERIES
 SUPERFICIAL TEMPORAL ARTERY
 POSTERIOR AURICULAR ARTERY
 OCCIPITAL ARTERY

17. The veins of the scalp accompany the arteries and have similar
names.
• The Supratrochlear & Supraorbital Veins
• Superficial Temporal Vein
• The Posterior Auricular Vein
• Occipital Vein

19. LYMPHATIC DRAINAGE
Anterior part of scalp & forehead
drains into submandibular lymph
nodes.
 Lateral part of scalp drains into
superficial parotid lymph nodes.
 Lymph vessels above & behind the
ear drain into mastoid lymph nodes
 Vessels in back drain into occipital
lymph nodes.