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Scalp
Gray's	subject #105 378
Artery	supratrochlear, supraorbital, superficial temporal, occipital
Vein	superficial temporal, posterior auricular, occipital
Nerve	supratrochlear, supraorbital, greater occipital, lesser occipital
Lymph	occipital, mastoid
MeSH	Scalp
Dorlands/Elsevier	s_03/12721502

For other uses of the word, see Scalp (disambiguation)

The scalp is the anatomical area bordered by the face anteriorly and the neck to the sides and posteriorly.

Contents 1 Layers 2 Blood supply 3 Innervation 4 Role in aesthetics 5 Pathology 6 See also 7 Additional images 8 References 9 External links

It is usually described as having five layers, which can be remembered with the mnemonic "SCALP":^[1]

• S: The skin on the head from which head hair grows. It is richly supplied with blood vessels and can be subject to such conditions as dandruff and cutis verticis gyrata.
• C: Connective tissue. a thin layer of fat and fibrous tissue lies beneath the skin
• A: The aponeurosis (or galea aponeurotica) is the next layer. It is a tough layer of dense fibrous tissue which runs from the frontalis muscle anteriorly to the occipitalis posteriorly
• L: The loose areolar connective tissue layer provides an easy plane of separation between the upper three layers and the pericranium. In scalping the scalp is torn off through this layer. It also provides a plane of access in craniofacial surgery and neurosurgery. This layer is sometimes referred to as the "Danger Zone" because of the ease by which infectious agents can spread through it to emissary veins which then drain into the cranium. The loose areolar tissue in this layer is made up of random collage I bundles, collagen III and is highly vascular and cellular. It will also be rich in glycosaminoglycans (GAGs) and will be constituted of more matrix than fibers.
• P: The pericranium is the periosteum of the skull bones and provides nutrition to the bone and the capacity for repair. It may be lifted from the bone to allow removal of bone windows (craniotomy).

The blood supply of the scalp is via four pairs of arteries, two from the external carotid and two from the internal carotid:

• internal carotid
  • the supratrochlear artery to the midline forehead
  • the supraorbital artery to the lateral forehead and scalp as far up as the vertex

• external carotid
  • the superficial temporal artery which gives frontal and parietal branches to supply much of the scalp
  • the occipital artery which runs from posteriorly to supply much of the back of the scalp.

The scalp is innervated by the following:^[2]

• Supratrochlear nerve and the supraorbital nerve from the ophthalmic division of the trigeminal nerve
• Greater occipital nerve (C2) posteriorly up to the vertex
• Lesser occipital nerve (C3) behind the ear.

The scalp plays an important role in the aesthetics of the face. Androgenic alopecia, or male pattern hair loss, is a common cause of concern to men. It may be treated by medication (eg finasteride) or hair transplantation with variable success. If the scalp is heavy and loose, a common change with aging, the forehead may be low, heave and deeply lined. The brow lift procedure aims to address these concerns.

The scalp is a common site for the development of tumours including:

• epidermoid cyst
• pilar cyst
• actinic keratosis and squamous cell carcinoma
• basal cell carcinoma
• merkel cell tumours

• Trichology -- the scientific study of hair and scalp
• Trichodynia -- burning scalp syndrome

Diagrammatic section of scalp.

1. ^ Mnemonic at medicalmnemonics.com 258
2. ^ Mnemonic at medicalmnemonics.com 2046

v • d • e General anatomy of head and neck

HEAD: Face/Occiput: Forehead – Eye – Ear – Temple - Cheek – Chin External nose: Nostril - Nasal septum - Cartilages (Accessory nasal, of the septum, Greater alar, Lateral nasal, Lesser alar, Vomeronasal) - Olfactory glands Nasal cavity: Choana - Turbinate - Sphenoethmoidal recess - Ethmoid bulla - Hiatus semilunaris - Ostium maxillare - Inferior meatus - Vomeronasal organ - Paranasal sinus Mouth/oral cavity: Lip - Philtrum - Jaw - Pterygomandibular raphe Teeth: Permanent (Incisor - Canine, Premolar, Molar) - Deciduous Tongue: Plica fimbriata - Median sulcus - Foramen cecum - Terminal sulcus - Frenulum linguae - Anterior tongue - Posterior tongue Palate/roof of mouth: Hard palate, Soft palate - Palatine raphe - Incisive papilla - Uvula - Pharyngeal recess - Arches: (Palatoglossal, Palatopharyngeal) Salivary glands: (Parotid - Sublingual - Submandibular) - Ducts: Submandibular - Parotid Masseteric fascia - Temporal fascia - Galea aponeurotica - Scalp NECK: Throat – Pharynx - Larynx Cartilages: Cricoid - Thyroid (Adam's apple) - Epiglottis - Arytenoid - Cuneiform - Corniculate Extrinsic ligaments: Thyrohyoid membrane (Lateral thyrohyoid ligament, Median thyrohyoid ligament) - Hyoepiglottic ligament - Cricotracheal ligament Intrinsic ligaments: Cricothyroid ligament Folds: (Glossoepiglottic - Aryepiglottic - Vocal - Vestibular) - Vocal ligament - Ventricle of the larynx - Infraglottic cavity - Vestibule of larynx - Rima glottidis - Glottis Triangles of the neck: Anterior of the neck (Muscular, Carotid, Submandibular, Submental) - Posterior of the neck (Occipital, Subclavian) - Suboccipital Deep cervical fascia (Pretrachial fascia, Prevertebral fascia, Investing layer) - Carotid sheath Retropharyngeal space

• Histology at BU 08601ooa - "Integument: scalp, transverse"
• Histology at BU 08801ooa - "Integument: scalp"
• Norman/Georgetown lesson1