Você está na página 1de 11


SCALP and skull

Layers of SCALP and clinical significance of layers

- covers calvaria, extends from superior nuchal line to the supraorbital margins (back near neck until forehead and eyebrows) and temporal
fossae to level of zygomatic arches
Note: SCA joined together; L and P more attached to skull

Layer of SCALP


Clinical significance


Thickest at occipital area, thin epidermis, thick dermis

Hair follicles (balding may be genetic or

due to pony tailing and braiding)
- so girls, take care of your hair
Sebaceous glands (coolant)

Subcutaneous tissue

Fat binds this to epicranium/aponeurosis

Nerves and blood vessels

bleeding in wounds (does not


rapid wound healing

stop hemorrhage by applying


Aponeurosis (galea aponeurotica)

Occipito-frontalis muscle:

Wrinkling, raise eyebrows and other

Occipital belly from highest nuchal line (innervated by posterior

movements improve blood circulation

auricular branch of facial nerve)

- thats the purpose of face exercises, so

Frontal belly from anterior edge, over forehead, to skin above

keep making faces!

eyebrows (innervated by temporal branch of facial nerve)

Fibers mix with orbicularis oculi and corrugator supercilii

Loose areolar connective tissue

Emissary veins at parietal, mastoid and occipital areas pass

Dangerous area/layer of scalp due to

through foraminae to communicate with diploic veins in diploe


which communicate with dural sinuses

Pericranium or periosteum of

Covers calvaria, attached by Sharpeys fibers

Limited or no osteogenic capablilites


Tight attachment at sutural areas

bone damage may not be repaired

Note: aforementioned may be seen in plate 23 of Netter

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Neurovascular supply and venous drainage
Note: arteries generally accompanied by corresponding, similar named veins and nerves, except one (I think the one in the occipital area)

Blood vessels



Pass through


Supraorbital and

Supraorbital and

Terminal of ophthalmic arteries and nerves

Orbital cavity


supratrochlear vessels

supratrochlear sensory

while veins join to form angular vein


continuing to facial vein


Superficial temporal

Auriculo temporal

Artery terminal branch of external carotid

Artery in front of external auditory



nerve (sensory branch

(considered principal artery for greater part


of mandibular nerve)

of scalp)

(you can feel pulsation)

Vein joined by maxillary vein below

- pulsations are stronger after a

zygomatic arch forming retromandibular

neuroscience lecture or a Llaygo

vein going to parotid gland



Occipital branch of

Sensory branches from

Occipital vein descends into suboccipital


external carotid artery

C2 and 3

region joining vertebral veins

Note: aforementioned may be seen in plate 23 of Netter

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Temporalis muscle lateral, one of four masticator muscles (the others are buccinator, masseter and orbicularis oris)
Origin fan shaped temporal fossa
Insertion coronoid process of mandible
Action elevate and retract jaw
Neurovascular supply innervated by deep temporal branches of mandibular nerve
Note: aforementioned may be seen in plate 15 and 54 of Netter
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Recall 1st what mommy Santos enumerated: cranial bones = 28 = 8 paired (16) + 3 pairs of ear ossicles (6) + 6 single

unfortunately I dont remember them individually; cant get over Jan Di kasi eh. Hahaha

Bones of:

o paired in fetus; fused as one in the adult
o spongy bone in between outer and inner table of compact bone (diploe)

frontal sinus (one of the four paranasal sinuses also making it a pneumatic bone (connected to nasal cavity)

o junction with parietal bones is termed bregma

o junction with 3 other bones (parietal, temporal and sphenoidal) is termed pterion
o supraorbital foramen/notch transmit neurovasculature

o paired

joined at median line by saggital suture

coronally (I believe theres no such word) by fronto-parietal suture intersects bregma

occipito-parietal suture posteriorly that intersects median line termed lambda (opposite of bregma)

recall junction with others as pterion

o parietal foraminae transmit emissary veins from scalp to diploe

o paired at first; single in adult
o external occipital protuberance (inion) ridge along median plane
o superior nuchal line palpable at back of head (finger dips in)
o foramen magnum commencement of spinal cord; transmits bertebral arteries and veins
o occipital condyles two prominences at lateral borders of foramen magnum articulating with 1st CV

hypoglossal canal transmit hypoglossal nerve

condylar canal transmit emissary veins

o jugular foraminae paired openings antero-lateral to each occipital condyle transmits internal jugular vein, IX, X and XI CN

sphenoid surrounded by aforementioned bones (palpable at the side of your head; your finger dips in as you go posterior from your eye)
o pterygoid processes on each side of posterior nares
o greater wings of sphenoid
o lesser wings

temporal paired bones at each side of the cranium

o mandibular fossa articulates with mandible by temporo-mandibular joint
o external auditory meatus behind mandibular fossa; leads into an osseo-cartilaginous canal
o zygomatic process connects temporal bone to zygomatic bone (cheek area)
o mastoid process posterior to meatus; internally connects with the chamber of the middle ear

o mastoid foramen transmits emissary veins

o stylo-mastoid foramen transmits facial nerve (innervates all facial muscles)
o syloid process inferior to to external auditory meatus, close to antero-medial of mastoid process
o petrous portion of temporal bone houses the auditory vestibular apparatus
o external carotid opening/foramen antero-medial to styloid and transmits internal carotid artery

ethmoid most internal bone; between nasal bone anteriorly, the sphenoid posteriorly and frontal bone laterally
o lamina papyracea
o lamina perpendicularis
o lamina cribriformis cribriform plate of ethmoid; tiny openings transmit fibers of olfactory nerve
o superion and middle nasal concha

Note: aforementioned may be seen in plate 4 and 7 of Netter

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Viscerocranium (facial bones)

nasal paired; junction with frontal bone is termed nasion

maxilla paired; separated by nasal cavity, joined below nares

palatine paired; roof of mouth/above the tongue

lacrimal one in each orbital cavity; drains tears into nasal cavity

vomer single; articulates inferiorly with the floor of the nose and superiorly with the perpendicular plate of ethmoid

inferior nasan conchae one in each nasal cavity; articulates with ethmoid, lacrimal, palatine and maxillary bones

zygomatic paired; cheek area

o foramen:




mandible (jaw) paired at first, united and ossified (synostosis) at median plane (symphysis menti)

hyoid below mandible; U shaped; landmark for neck

Note: aforementioned may be seen in plate 2 of Netter

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Bony landmarks demarcating three cranial fossae

o orbital plates of frontal
o cribriform plate of ethmoid
o lesser wing of sphenoid (separates anterior from middle cranial fossae)

o sphenoid bone

clinoid process to sella turica

lesser wing of sphenoid (separates anterior from middle cranial fossae)

o part of temporal bone

clivus (separates middle from posterior cranial fossae)

o part of temporal bone

clivus (separates middle from posterior cranial fossae)

o occipital bone

Note: aforementioned may be seen in plate 9 of Netter

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Neurovascular structures through foraminae

those below may be seen in plate 10 and 11 of Netter (a cross section of the skull in a superior and anterior view)

some structures are repeated in both views

Superior view

Inferior view

foramen cecum - emissary vein to superior sagittal sinus

ethmoidal foramen (anterior and posterior) ethmoidal artery,

o Nasopalatine nerve

vein and nerve

o Sphenopalatine vessels

Incisive fossa

foramina of cribriform plate olfactory nerve bundles

Palatine foramen (greater and lesser) palatine nerve and vessels

optic canal

Foramen lacerum greater petrosal nerve

Foramen ovale

o optic nerve (II)

o ophthalmic artery

o Lesser petrosal nerve

o Mandibular nerve (V3)

superior orbial fissure

o Accessory meningeal artery

o oculomotor nerve (III)

o trochlear nerve (IV)

o lacrimal, frontal, and nasociiary branches of ophthalmic

o Middle meningeal vessels

nerve (V1)
o abducent nerve (VI)

Foramen spinosum

o Meningeal branch of mandibular nerve (V3)

o superior ophthalmic vein

Carotid canal internal carotid artery and carotid autonomic


foramen rotundum maxillary nerve (V2)

Petrotympanic fissure chorda tympani of facial nerve (VIII)

foramen ovale

Tympanic canaliculus tympanic branch of glossopharyngeal

o mandibular nerve (V3)

o accessory meningeal atery

foramen spinosum
o middle meningeal artery and vein

nerve (IX)

Mastoid canaliculus auricular branch of vagus nerve (X)

Stylomastoid foramen facial nerve (VII)

Jugular fossa

o meningeal branch of mandibular nerve

o Glossopharyngeal nerve (IX)

carotid canal internal carotid artery and nerve plexus

o Vagus nerve (X)

hiatus (lesser and greater) petrosal nerve

o Spinal roots of accessory nerves (XI)

internal acoustic meatus

o Internal jugular vein

o Inferior petrosal sinus

o facial nerve (VII)

o vestibulocochlear nerve (VIII)

o Mastoid emissary vein

o labyrinthine artery

vestibular aqueduct endolymphatic duct

jugular foramen
o inferior petrosal sinus

Mastoid foramen

o Posterior meningeal artery

Hypoglossal canal hypoglossal nerve (XII)

Foramen magnum

o glossopharyngeal nerve (IX)

o Medulla oblongata

o vagus nerve (X)

o Vertebral arteries and venous plexus

o accessory nerve (XI)

o Spinal roots of accessory nerves (XI)

o sigmoid sinus
o posterior meningeal artery

hypoglossal canal hypoglossal nerve (XII)

foramen magnum
o medulla oblongata
o meninges
o vertebral arteries
o spinal roots of accessory nerves

From Wiki (http://en.wikipedia.org/wiki/Foramina_of_skull)

List of foramina




supraorbital foramen


anterior cranial

foramen cecum



anterior cranial
anterior cranial

foramina of cribriform
anterior ethmoidal
posterior ethmoidal
optic canal




supraorbital artery,
supraorbital vein
emissary veins to superior
sagittal sinus
anterior ethmoidal artery
anterior ethmoidal vein
posterior ethmoidal artery
posterior ethmoidal vein
ophthalmic artery

supraorbital nerve
olfactory nerve bundles (I)
anterior ethmoidal nerve
posterior ethmoidal nerve
optic nerve (II)
oculomotor nerve (III)
trochlear nerve (IV)
lacrimal, frontal and nasociliary branches of
ophthalmic nerve (V1)
abducent nerve (VI)


middle cranial

superior orbital fissure

superior ophthalmic vein

inferior ophthalmic vein


middle cranial

foramen rotundum

maxillary nerve (V2)


incisive foramen/incisive

nasopalatine nerve


greater palatine foramen

palatine and maxilla

lesser palatine foramina

greater palatine artery

greater palatine vein
lesser palatine artery

greater palatine nerve

lesser palatine nerve

sphenoid and maxilla

inferior orbital fissure


infraorbital foramen

lesser palatine vein

inferior ophthalmic veins
infraorbital artery
infraorbital vein
infraorbital artery
infraorbital vein


middle cranial
middle cranial

sphenoid and palatine

sphenopalatine foramen

sphenoid, temporal,
and occipital

middle cranial
posterior cranial

foramen lacerum
(or carotid canal)

internal carotid artery

internal acoustic meatus

labyrinthine artery

stylomastoid foramen
mastoid foramen
petrotympanic fissure

stylomastoid artery
emissary vein
posterior meningeal artery
ascending pharyngeal artery
inferior petrosal sinus
sigmoid sinus
internal jugular vein
occipital emissary vein
vertebral arteries
meningeal branches of
vertebral arteries
emissary vein
mental artery
mental vein



zygomatic nerve and infraorbital nerve of

maxillary nerve (V2)
orbital branches of pterygopalatine ganglion
infraorbital nerve

foramen ovale

accessory meningeal artery

mandibular nerve (V3)

lesser petrosal nerve (occasionally)

foramen spinosum

middle meningeal artery

meningeal branch of the mandibular nerve

pterygoid canal

artery of the pterygoid canal nerve of pterygoid canal

superior nasal nerve
sphenopalatine artery
nasopalatine nerve

occipital and temporal

posterior cranial
jugular foramen



posterior cranial
foramen magnum


parietal foramen


mental foramen

hypoglossal canal
condylar canal

internal carotid nerve plexus

facial nerve (VII)
vestibulocochlear nerve (VIII)
facial nerve
chorda tympani
glossopharyngeal nerve (IX)
vagus nerve (X)
accessory nerve (XI)
hypoglossal nerve (XII)
medulla oblongata
spinal roots of accessory nerves
mental nerve




inferior alveolar artery

inferior alveolar vein
zygomaticofacial foramen zygomaticotemporal
mandibular foramen

inferior alveolar nerve

zygomaticofacial nerve
zygomaticotemporal nerve