Head & neck-scalp - GMCH
Transcript of Head & neck-scalp - GMCH
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SCALP
May be defined as soft tissue covering of the skull including skin.
Extent: Anteriorly- up to the region of eyebrows up to supraorbital margin.
Posteriorly- Up to ext. occ. protuberance and superior nuchal lines.
Laterally- up to superior temporal line
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S Skin
C Connective tissue (Dense)
A Aponeurotic (epicranial aponeurosis)
L Loose connective tissue
P Pericranium
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Skin: Thin epidermis, thick dermis
Epidermo-dermal junctions contain hair follicles
Numerous sebaceous glands
Richly vascularised, sensitive to touch, pain and temp.
Connective tissue layer:
Collagen bundles
form caverns, also
adherent to vessels
Neurovascular plane
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Musculo-aponeurotic layer: Broad musculo-fibrous layer having two muscular bellies- Occipital and frontal.
Frontal- No bony attachment, fibres 8-10 cm long
Fibres continue with facial muscles ( Procerus, corrugator supercilli, Orbicularis oculi)
Bellies anteromedially blend with each other, posteriorly diverge.
N. supply- Temporal br. of facial nerve
Action- raise the eyebrows ( surprise, horror, fright)
Throwing forehead into transverse wrinkles.
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Occipital belly-Origin from lateral two third of highest nuchal line and mastoid part of temporal bone. Smaller fibres of 3-4 cm length N. supply- Posterior auricular br. of facial nerve Action- draws scalp backwards
Galea aponeurotica-Attatched to superior temporal lines
Loose areolar tissue-Reticular and elastic fibres Allows the first three layers to glide over it Large intercommunicating spaces
Pericranium-Periosteum on the outer surfaces of bones Continuous with endosteum through the sutures Loosely attached over the skull bones except in the temporal fossa
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Applied Anatomy Sebaceous cysts in the skin
2nd layer- Inflammation painful but self limiting
Profuse bleeding/Heals well
3rd layer- Wounds gape if there is a transverse cut
4th layer- Dangerous layer
Easily separated from other layers
Inflammation- less painful, spreads fast and throughout the layer
Black eye-accumulation of pus/blood in this layer trickles down till the attachments of 3rd layer.
Emissary veins pass through this layer on their way to the sinuses 5th layer- Safety valve haemotoma/ Cephalo- haemotoma
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Nerve supply • Motor (Facial nerve)
Temporal branch Post. auricular
• Sensory (trigeminal nerve; C2, C3, Cervical spinal nerves) In front of ear - trigeminal nerve; behind ear- cervical nerves
Supratrochlear Supraorbital Zygomatico-temporal Auriculo-temporal Posterior – C2, C3 Postero superior part - Greater occipital, Third occipital Antero inferior part - Greater auricular, Lesser occipital
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Muscles of facial expression
• Embryologically - Mesoderm of 2nd branchial arch • Morphologically – Remnants of panniculus
carnosus • Functionally – Regulators of three openings
Every opening has single sphincter (circular) and variable number of dilators (radial)
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Muscles of facial expression
• Muscles of eyelids – Orbicularis oculi Corrugator supercilli Levator palpabrae sup.
• Muscles of nose – Procerus Compressor naris Dilator naris Depressor septi
• Muscles of neck – Platysma
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Muscles of facial expression • Muscles around mouth –
Orbicularis oris Levator labii superioris et alaque nasi Levator labii superioris Levator anguli oris Zygomaticus minor Zygomaticus major Depressor anguli oris Depressor labii inferioris Mentalis Risorius Buccinator
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Common Facial Expressions • Surprise/horror – Frontal belly of occipitofrontalis • Winking – Orbicularis oculi • Frowning – Corrugator supercilii, Procerus • Anger – Dilator naris, Depressor septi • Sadness – Depressor labii inferioris, Depressor anguli oris • Smiling/laughing – Zygomaticus major • Grief – Depressor anguli oris • Doubt – Mentalis, Depressor labii inferioris • Grinning – Risorius
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• Origin Orbital part –
Palpebral part – Lacrimal part –
• Insertion –
• Action –
Orbicularis Oculi
medial palpebral ligament adjacent orbital margin medial palpebral ligament posterior margin of lacrimal fossa sheath of lacrimal sac skin lateral palpebral raphe upper and lower tarsal plates Closing of eyes Protection from sunlight/danger/expiratory efforts Promotes the flow of tears towards lacrimal canaliculi
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Orbicularis Oris • Interlacing fibres which converge on the mouth • Other muscles fibres mingle and sweep in curves
through the lips • Buccinator fibres also converge • Origin
Intrinsic part – very thin sheet Superior part from maxilla Inferior part from mandible
• Insertion – Angle of mouth
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Platysma
Origin - Upper part of pectoral fascia
Deltoid fascia
Insertion – Base of mandible
Skin of lower face/lip
Action – Releases pressure on veins
Pull angle of mouth downwards
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