The Scalp Flashcards

1
Q

what does the scalp refer to?

A

layers of skin and subcutaneous tissue that cover the bones of cranial vault

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2
Q

what are the layers of the scalp?

A
Skin
dense Ct
epicranial Aponeurosis
Loose areolar ct
Periosteum
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3
Q

which layers are tightly bound together?

A

first 3 - move together as a unit

skin, dense Ct, epicranial Aponeurosis

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4
Q

what does the skin contain?

A

numerous hair follicles and sebaceous glands - site for sebaceous cysts

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5
Q

what does the dense Ct do?

A

connects the skin to the epicranial aponeurosis

richly vascularised and inervated

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6
Q

why can the scalp be a site of profuse bleeding?

A

the blood vessels within the dense Ct are high adherent to the Ct
this renders them unable to fully constrict if lacerated

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7
Q

what is the epicranial aponeurosis?

A

a thin, tendon-like structure that connects the occipitalis and frontalis muscle

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8
Q

describe the loose areolar ct

A

a thin ct layer that separates the periosteum of the skull form the epicranial aponeurosis

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9
Q

what does the loose areolar ct consist of?

A

numerous blood vessels - including emissary veins which connect the veins of the scalp to the diploic veins and intracranial venous sinuses

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10
Q

describe the periosteum

A

outer layer of skull bones

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11
Q

what does the periosteum become continuous with? where?

A

becomes continuous with the endosteum at the suture lines

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12
Q

Clinical: scalp infections, where is the danger area of the scalp?

A

loose CT

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13
Q

clinical: why is the loose CT the danger area of the scalp?

A

because pus and blood spreads easily within it, and can pass into the cranial cavity along the EMISSARY veins
therefore, infection can spread from scalp to meninges - can lead to meningitis

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14
Q

where does the scalp receives its rich blood supply via?

A

external carotid artery and opthalmic artery

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15
Q

what is the opthalmic artery a branch of?

A

internal carotid

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16
Q

how many branches of the external carotid artery are involved? what are they?

A

3
superficial temporal
posterior auricular
occipital

17
Q

what is the mnemonic for remember the branches of the external carotid artery?

A

some anatomists like freaking out poor medical students

18
Q

what are the all the branches of the external carotid artery?

A
S: superior thyroid artery
A: ascending pharyngeal artery
L: lingual artery
F: facial artery
O: occipital artery
P: posterior auricular artery
M: maxillary artery
S: superficial temporal artery
19
Q

what does the superficial temporal artery supply?

A

frontal and temporal regions

20
Q

what does the posterior auricular artery supply?

A

area superiorly and posteriorly to the auricle

21
Q

what does the occipital artery supply?

A

back of the scalp

22
Q

anterior and superiorly, where else does the scalp receive blood supply from?

A

2 branches of the opthalmic artery:
supraorbital artery
supratrochlear artery

23
Q

how is the venous drainage of the scalp divided?

A

into superficial and deep components

24
Q

what does the superficial venous drainage follow?

A
the arteries: (SOP,SS)
superficial temporal
occipital
posterior auricular
supraorbital 
supratrochlear
25
what is the deep region of the skull drained by?
deep (temporal) region | drained by pterygoid venous plexus
26
what does the pterygoid venous plexus drain to?
maxillary vein
27
where is the pterygoid venous plexus situated?
between the temporalis and lateral pterygoid muscles
28
what is the innervation of the scalp?
cutaneous innervation from 6 main nerves | arise from trigeminal or cervical nerves
29
what are the branches of the trigeminal nerve which innervates the scalp?
supratrochlear nerve supraorbital nerve zygomaticotemporal nerve auriculotemporal nerve
30
what are the branches of the cervical nerve which innervates the scalp?
lesser occipital nerve | greater occipital nerve
31
what are main branches of the trigeminal nerve?
``` tri = 3 (OMM) ophthalmic nerve (V1) maxillary nerve (V2) mandibular nerve (V3) (all converge on the trigeminal ganglion) ```
32
what is the supratrochlear nerve (trigeminal) a branch of? supplying where?
branch of opthalmic nerve (V1) | supplies anteromedial forehead
33
what is the supraorbital nerve (trigeminal) a branch of? supplying where?
branch of opthalmic nerve (V1) | supplies large portion of scalp between anterolateral forehead and vertex
34
what is the zygomaticotemporal nerve (trigeminal) a branch of? supplying where?
branch of maxillary nerve (V2) | supplies temple
35
what is the auriculotemporal nerve (trigeminal) a branch of? supplying where?
branch of mandibular nerve (V3) | supplies skin anterosuperior to the auricle
36
what is the lesser occipital nerve (cranial) a branch of? supplying where?
branch of anterior rami of C2 & C3 | supplies behind the ear
37
what is the greater occipital nerve (cranial) a branch of? supplying where?
branch of anterior rami of C2 & C3 | supplies posterior scalp up to vertex (top)
38
clinical: why do lacerations to the scalp bleed profusely?
1. pull of occipitofrontalis muscle prevents the closure of the bleeding vessel and surrounding skin 2. blood vessels to the scalp are adhered to dense CT, preventing vasoconstriction that normally occurs in damage response 3. blood supply to the scalp is made up of many anastomoses - contribute to profuse bleeding
39
what can loss of blood supply to scalp lead to? why?
bone necrosis | as most of blood supply to skull comes from *middle meningeal artery*