scalp rishi naihs nepal
TRANSCRIPT
![Page 1: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/1.jpg)
SCALP
MAJ RISHI POKHRELDEPT OF ANATOMY
NAIHS
![Page 2: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/2.jpg)
Scalp• Soft tissue covering skull vault
• Extension– Eyebrows to occipital protuberance
– Zygomatic arch to temporal lines
![Page 3: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/3.jpg)
Layers
S : Skin
C : dense Connective tissue
A : Aponeurosis of occipito-frontalis
L : Loose connective tissue
P : Pericranium
First 3 layers forms a single functional layer
![Page 4: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/4.jpg)
Layers
![Page 5: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/5.jpg)
Skin
– Thickest , 3-7 mm
– Abundance of hair,
sebaceous, sweat glands
Dense Connective tissue
– Corresponds to superficial
fascia
– Dense fibro fatty tissue
– Numerous blood vessels and
nerves
– Connects layer of skin with
aponeurosis
![Page 6: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/6.jpg)
• Aponeurosis of occipeto-frontalis muscle
Attachments of muscle
• Frontal belly
– Ant: Skin of eyebrows, skin of root of nose &
orbicularis oculi
– Post: aponeurosis
• Occipital belly
– Behind : to lat ½ half of superior nuchal line
– Front : aponeurosis
• Functions
– Occipital belly : pulls scalp back, anchors aponeurosis
– Frontal belly : elevate eyebrow, transverse wrinkles
• Nerve supply: facial nerve
Occipitalis is attached to bone, frontalis is not
Aponeurosis (galea aponeurotica)
![Page 7: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/7.jpg)
Loose connective tissue
• Loose areolar tissue
• Contain emissary veins
• Potential space over which
layer 1 to 3 move
Pericranium
• Periosteum of bone of skull
• Intimately adherent to
endocranium
• Firmly attached to suture
lines, loose elsewhere
![Page 8: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/8.jpg)
Nerve supply of head & neck
![Page 9: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/9.jpg)
Nerve supply of scalp
![Page 10: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/10.jpg)
Nerve supply of scalp
![Page 11: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/11.jpg)
Arterial supply & venous drainage of scalp
![Page 12: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/12.jpg)
SCALP – NERVE & BLOOD SUPPLY
![Page 13: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/13.jpg)
1
2
3
4
5
6
8
7
9
10
1. Supratrochlear (V1)
2. Supraorbital (V1)
3. Z-T (V2)
4. Temp br CN VII (supply frontalis)
5. Auriculotemp N (V3)
6. Great auricular ( C1,C2)
7. Post auricular (CN VII N- supply occipital belly))
8. Lesser occipital (C2, C3)
9. Greater occipital (C2)
10. Third occipital (C3)
Supratrochlear – br of opth art
Supraorbital – br of opth art
superficial temporal art-
terminal br of ECA
post auricular art – br of ECA
occipital art – br of ECA
SCALP
Nerve supplyBlood supply
![Page 14: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/14.jpg)
Venous Drainage
– Veins accompany the
artery
– Emissary vein from scalp to
intracranial venous sinus
– Diploic vein
• Drain frontal and occipital
diploe and enter main vein
of scalp
Lymphatic Drainage
– In front of ear : pre-
auricular group
– Behind ear : post auricular
![Page 15: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/15.jpg)
EMISSARY VEINSEmissary veins along with layers of skull
![Page 16: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/16.jpg)
Clinical anatomy
![Page 17: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/17.jpg)
Applied Anatomy• Black eye
– Spread thro subaponeurotic space
• Scalp lacerations
• Sebaceous cysts
• Gaping wounds
– Due to incisional wound of galea in coronal plane
• Cephalhaematoma
• Bone flaps
• Dangerous area of scalp
– Loose areolar tissue – infection spread to intracranial venous sinus thro
emissary vein
• Caput succedaneum
• Safety valve mechanism
• Scalp avulsion
![Page 18: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/18.jpg)
BLACK EYE
Blood tracks down below frontalis to eye lid
![Page 19: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/19.jpg)
Hematoma in Scalp
• Caput succadeum : haematoma bt skin and aponeurosis
• Sub galeal haematoma :b/w aponeurosis and periosteum
• Cephalhaematoma :b/w skull bone and its periosteum (limited by suture lines)
![Page 20: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/20.jpg)
Scalp Avulsionpreoperative
postperative
Hair removed
After some time……
![Page 21: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/21.jpg)
Sebaceous cyst
Gaping wound of scalp
![Page 22: scalp rishi naihs nepal](https://reader031.vdocuments.us/reader031/viewer/2022032012/55c35877bb61eb4a1f8b466b/html5/thumbnails/22.jpg)
?