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Home Anatomy

Anatomy of Scalp in a Nutshell

siva guru by siva guru
June 4, 2021
in Anatomy, Pre-Clinical
0 0
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Anatomy of Scalp


Scalp: A structure that begins at the supraorbital margins (superior aspect of the orbit)

  • Includes the eyebrows, forehead, and continues till reaching the level of the occipital protuberance.
  • Laterally, it blends with the fascia around the temporalis muscles (temple region).
  • 5 layers of the scalp: “SCALP”
    • S: Skin
      • Has sebaceous and sweat glands, is covered with hair
      • Tightly bound to underlying CT
    • C: Connective tissue
      • Dense, tightly affixed to skin
      • Is where we find the nerves and blood vessels supplying the scalp
      • Bands of collagen in the CT cause vessels to remain patent- clinically important as this causes extensive bleeding during scalp lacerations.
    • A: Aponeurosis
      • Flat tendinous sheet
      • Run between the frontalis muscle (anterior muscle of facial expression) and the occipitalis muscle (posterior lying)
      • Galea Aponeurotica: aponeurotic helmet.
      • All three layers (skin, CT, aponeurosis) are fused together
    • L: Loose areolar tissue
    • P: Periosteum
      • Also known as pericranium
      • Periosteum on the internal aspect is the endocranium
  • This arrangement of layers makes operations on scalp easy
    • Relevant to surgery for easy manipulation in opening / closing
    • Also relevant to scalping- after making incision, scalp can be pulled away easily due to loose areolar tissue.
  • Blood supply to the scalp
    • Branches of the ophthalmic artery (branch of internal carotid coming off in orbit) supplies anterior portion
      • Supratrochlear artery
      • Supraorbital artery
    • External carotid branches: supplies posterior portion
      • Superficial temporal
      • Posterior auricular
      • Occipital artery
    • All of these branches form large anastomotic network. Surgery to scalp repairs well due to great collateral circulation
  • Veins: follow the exact same path as the arteries (there is a named vein for each artery as well as a venous anastomosis)
    • Primary venous drainage is via vein by the same name
    • Emissary veins:
      • Another system (not the primary system) of small veins provide a pathway from the scalp to the dural venous sinuses (go through bone)
      • Function similar to diploic veins in providing this conduit
      • Blood may go in either direction (no valves), thus infection may find a pathway back / forth from dural venous sinuses to scalp.
  • Innervation of the scalp
    • CN V1: First division of trigeminal (ophthalmic)
      • Supertrochlear nerve (medial
      • Superorbital nerve (lateral)
        1. Goes through superorbital foramen
        2. Both go on to superior aspect of scalp up past vertex
    • CN V2: zygomaticotemporal
      • Second division of trigeminal
      • Along the temple
    • CN V3: auriculotemporal nerve
      • Third part of trigeminal
      • Supplies temple region
    • Lesser occipital nerve
      • From the cervical plexus
      • A ventral ramus combination from C2 + C3
    • Greater occipital nerve (C2)
      • Is a dorsal ramus
      • Innervates posterior scalp
    • Third occipital nerve- is a dorsal ramus
    • Dermatome does not include C1 (has no sensory component).
      • C2 supplies posterior scalp, back of head (overlaps with C3)
      • C4 supplies back of neck / shoulder (also overlaps with C3)
      • C3 supplies nearly the same as C2 + C4 plus small area on it’s own in between neck / shoulder
      • Branches of trigeminal nerve supply face
        1. V1 = forehead / nose
        2. V2 = cheek / upper lip
        3. V3 = chin / lower cheek

Also read:


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