Clinical Anatomy of Head and Neck By Essam
Clinical Anatomy of Head and Neck By Essam Eldin Abdelhady Salama
Scalp • Skin, (hairs) subcutaneous tissue and epicranial aponeurosis are adherent together, (first 3 layers). • Sebaceous cyst of scalp are common due to presence of numerous sebaceous glands.
Scalp • Scalp infection • localized and painful because of large amount of fibrous tissue. • May spread to dural venous sinuses through emissary veins causing venous thrombosis. • Osteomyelitis when infection spread to the skull bones (Diploic veins)
Scalp • Rich blood supply to hair follicles. • Small laceration of scalp causes sever blood loss. • Arteries of the scalp are unable to contract easily so ligation of scalp wound is important to stop bleeding. • Necrosis of the scalp is uncommon.
Scalp • Blood or pus beneath epicranial aponeurosis tends to spread over skull vault, limited by orbital margin, nuchal and temporal lines. • Subperiosteal blood or pus is limited to one bone due to attachment of the periosteum to the sutural ligaments.
Fractures base of the skull • The anterior cranial fossa; is manifested by epistaxis and cerebrospinal rhinorrhea. • The middle cranial fossa; fracture is common due to numerous foramina, cavities and air sinuses, it is manifested by leakage of blood and CSF from the external auditory meatus. • The posterior cranial fossa; fracture is manifested by escape of blood into nape of neck , later it appears in the posterior triangle.
Extradural Hemorrhage • Injuries to ant. division of middle meningeal artery, artery of extradural hemorrhage, (Pterion). • Hematoma will press on motor area in precentral gyrus.
Subdural Hemorrhage • Results from tearing of superior cerebral veins as they inter the superior sagittal sinus. • It is caused by excessive displacement of the brain, or trauma to front or back of head.
Subarachnoid Hemorrhage • Results from leak of blood in the subarachnoid space. • Sudden sever headache, and loss of consciousness.
Cerebral Hemorrhage • Caused by cerebral artery hemorrhage. • The patient losses his consciousness, muscle paralyzed is manifested later.
Arterial pulsation • The superficial temporal artery can be felt as it crosses the zygomatic arch in front of the ear. • The facial artery can be felt as it crosses the lower border of the mandible at the anterior border of masseter muscle.
Dangerous triangle • Infection in the dangerous area of the face may spread through communication of superficial veins to dural sinuses. • Cavernous sinus thrombosis may be fatal unless adequately treated by massive antibiotics.
Parotid gland • Facial nerve lies between superficial and deep parts of the gland. • Malignant tumors are invasive and causing facial palsy. • Benign tumors rarely causes facial palsy.
Facial nerve • Supplying muscles of the face. • Idiopathic acute inflammation of the facial nerve in the facial canal or in the stylomastoid foramen. • Tumor in the internal acoustic meatus, or parotid gland, leads to Bell’s palsy distortion of the face. • Bell’s palsy is manifested by, dropping of the angle of the mouth. inability to close the eye in the affected side.
Trigeminal nerve • Supplying skin of the face except angle of mandible. • Trigeminal neuralgia is a common condition. • The patient complains of severe pain in area of mandibular nerve distribution.
Surgical Incisions • Karl Langer’s lines in the skin. • Surgical incisions made in the direction of these lines lead to minimal scar tissue. • As it runs in the direction of the dermal collagen bundles.
Developmental failure • Cleft upper lip may be accompanied by cleft palate. • It is usually unilateral, but it could be bilateral. • It is due to failure of fusion of the maxillary process to the medial nasal process.
Developmental failure
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