PROFESSOR DOCTOR
MOHAMED EL-BADRY
PROFESSOR OF HUMAN ANATOMY AND EMBRYOLOGY
SCALP
THE SCALP
CONSISTS OF:
5 layers forming the word SCALP:
1) Skin
2) Connective tissue
3) Aponeurosis (epicranial)
4) Loose areolar tissue
5) Pericraneum
1. SKIN:
Thick and hair-bearing
Contains many sebaceous glands
2. CONNECTIVE TISSUE:
Beneath the skin
Fibrofatty, fibrous septa uniting skin to underlying aponeurosis of
occipitofrontalis
Has numerous arteries and veins
The arteries: Branches of external and internal carotid arteries and have free
anastomosis between them
3. EPICRANIAL APONEUROSIS:
Thin tendinous sheet
Unites occipital and frontal bellies of occipitofrontalis muscle
Its lateral margins: Attached to temporal fascia
Subaponeurotic space:
Potential space beneath the aponeurosis
Limited in front and behind by origins of occipitofrontalis
Extends laterally as far as attachment of the aponeurosis to temporal fascia
4. LOOSE AREOLAR TISSUE:
Occupies the subaponeurotic space
Loosely connects epicranial aponeurosis to periosteum of the skull
(pericranium)
Contains few small arteries and some important emissary veins
Emissary veins:
Valveless and connect superficial veins of the scalp with diploic veins of
the skull bones and with intracranial venous sinuses
Direction of blood: According to venous pressure outside and inside the
skull
Give passage to infection
5. PERICRANIUM:
Periosteum covering outer surface of the skull bones
Continuous with endosteum on inner surface of the skull bones
Note:
First 3 layers of the scalp are bound together and move as a unit
OCCIPITOFRONTALIS MUSCLES
Origin:
4 bellies (2 occipital and 2 frontal)
Connected by an aponeurosis(insertion)
Each occipital belly: Highest nuchal line
on occipital bone
Each frontal belly: Skin and superficial
fascia of the eyebrow
Insertion: Aponeurosis
Nerve supply:
Occipital belly: Posterior auricular branch
of facial nerve
Frontal belly: Temporal branch of facial
nerve
Action:
Move the first 3 layers of the scalp
forward or backward
Loose areolar tissue: Allows aponeurosis
to move on pericranium
Frontal bellies: Raise eyebrows in
surprise or horror
SENSORY NERVE SUPPLY OF THE SCALP
1)
2)
3)
4)
5)
6)
Supratrochlear nerve
Supraorbital nerve
Zygomaticotemporal nerve
Auriculotemporal nerve
Lesser occipital nerve
Greater occipital nerve
SENSORY NERVE SUPPLY OF SCALP
1) SUPRATROCHLEAR NERVE:
 Branch of ophthalmic division
of trigeminal nerve
 Winds around superior orbital
margin
 Supplies: The scalp
 Passes backward close to
median plane
 Reaches as far as vertex of the
skull
2) SUPRAORBITAL NERVE:
 Branch of ophthalmic division of
trigeminal nerve
 Winds around superior orbital
margin
 Ascends over the forehead
 Supplies: Scalp as far backward as
vertex
3) ZYGOMATICOTEMPORAL NERVE:
 Branch of maxillary division of
trigeminal nerve
 Supplies: Scalp over the temple
4) AURICULOTEMPORAL NERVE:
Branch of mandibular division of
trigeminal nerve
Ascends over side of the head from
in front of auricle
Its terminal branches supply skin
over temporal region
5) LESSER OCCIPITAL NERVE:
Branch of cervical plexus (C2) and
supplies:
Scalp over lateral part of occipital
region
Skin over medial side of the auricle
6) GREATER OCCIPITAL NERVE:
Branch of: Post. ramus of 2nd
cervical nerve
Ascends over back of the scalp
Supplies: Skin as far as vertex of the
scalp
ARTERIAL SUPPLY OF THE SCALP
1)
2)
3)
4)
5)
Supratrochlear artery
Supraorbital artery
Superficial temporal artery
Posterior auricular artery
Occipital artery
ARTERIAL SUPPLY OF THE SCALP
1) SUPRATROCHLEAR ARTERY:
2) SUPRAORBITAL ARTERY:
Branches of: Ophthalmic artery
Ascend over forehead in company with supratrochear and supraorbital
nerves
3) SUPERFICIAL TEMPORAL ARTERY:
Smaller terminal branch of: External carotid artery
Ascends in front of auricle in company with auriculotemporal nerve
Divides into: Ant. and post. branches
Supplies: Skin over frontal and temporal regions
4) POSTERIOR AURICULAR ARTERY:
Branch of: External carotid artery
Ascends behind the auricle
Supplies: Scalp above & behind auricle
5) OCCIPITAL ARTERY:
Branch of: External carotid artery
Ascends from apex of posterior triangle
In company with greater occipital nerve
Supplies: Skin over back of scalp and reaches as high as vertex of skull
VENOUS DRAINAGE OF THE SCALP
1)
2)
3)
4)
5)
Supratrochlear vein
Supraorbital vein
Superficial temporal vein
Posterior auricular vein
Occipital vein
VENOUS DRAINAGE OF THE SCALP
1) SUPRATROCHLEAR VEIN:
2) SUPRAORBITAL VEIN:
Unite at medial margin of the orbit to form the facial vein
3) SUPERFICIAL TEMPORAL VEIN:
Unites with maxillary vein in substance of parotid gland to form
retromandibular vein
4) POSTERIOR AURICULAR VEIN:
Unites with posterior division of retromandibular vein just below parotid
gland to form: External jugular vein
5) OCCIPITAL VEIN:
Drains into: Suboccipital venous plexus (lies beneath floor of upper part
of posterior triangle) or into internal jugular vein
Suboccipital venous plexus drains into: Vertebral veins
LYMPH DRAINAGE OF THE SCLAP:
Lymph vessels from:
1) Anterior part of scalp and forehead drain into: Submandibular nodes
2) Lateral part of scalp above ear drain into: Superficial parotid (preauricular)
nodes
3) Part of scalp above and behind the ear drains into: Mastoid nodes
4) Back of scalp drains into: Occipital nodes
The Bottom Line
- The scalp is somewhat mobile soft tissue mantle
covering the calvaria. Primary subcutaneous
component of the scalp is musculoaponeurotic
epicranius to which overlying skin is firmly
attached but is separated from periosteum
(pericranium) by loose areolar tissue.
- Areolar layer enables mobility of the scalp over
the calvaria and permits traumatic separation of
the scalp from the cranium.
-Attachment of the skin to epicranial aponeurosis
keeps edges of superficial wounds together, but a
wound that also penetrates epicranial aponeurosis
gaps widely.
-Blood may collect in areolar space deep to the
aponeurosis after a head injury.
THANK YOU