1. SCALP and MENINGES

2. Layers of the Scalp Skin Skin Connective Tissue Connective Tissue Aponeurosis: Aponeurosis:Frontalis.Occipitalis. Loose Areolar Tissue Loose Areolar Tissue Pericranium Pericranium

3. Cutaneous Nerve Supply CN V: (Trigeminal Nerve) CN V: (Trigeminal Nerve) Ophthalmic, maxillary, mandibular. Cervical spinal nerves: Cervical spinal nerves: Ventral rami of C2, C3: Great auricular nerve (C2,3). Lesser occipital nerve (C2). Dorsal ramus of C2: Dorsal ramus of C2: Greater occipital nerve.

4. Vascular Supply Branches of external carotid: Branches of external carotid:Occipital. Posterior auricular. Superficial temporal. Branches of internal carotid: Branches of internal carotid:Supratrochlear.Supraorbital.

5. Meninges: Vascular Supply Anterior meningeal arteries: Anterior meningeal arteries: From ethmoidal arteries and internal carotid. Middle meningeal artery: Middle meningeal artery: From maxillary artery. Emissary veins: Emissary veins: Between dural venous sinuses and external veins. Diploic veins. Diploic veins. Cerebral veins. Cerebral veins.

6. Meninges: Dura Mater Tough outer connective tissue layer that forms sac around brain. Tough outer connective tissue layer that forms sac around brain. No epidural space in skull. No epidural space in skull. Encloses dural venous sinuses. Encloses dural venous sinuses.

7. Meninges: Dura Mater Reflections: Reflections: Falx cerebri: Midline fold of dura mater extending between two cerebral hemispheres. Tentorium cerebelli: Dural fold located between cerebellum and occipital lobes of cerebral hemispheres.

8. Meninges: Dura Mater Reflections: Reflections: Falx cerebelli: Dural fold between two cerebellar hemispheres. Diaphragma sellae Dural fold over hypophyseal fossa.

9. Meninges: Dura Mater Dural venous sinuses: Dural venous sinuses: Superior sagittal sinus: Lies along superior margin of falx cerebri. Inferior sagittal sinus: Lies along inferior margin of falx cerebri.

10. Meninges: Dura Mater Dural venous sinuses: Dural venous sinuses: Straight sinus: Lies at intersection of falx cerebri and tentorium cerebelli. Confluence of sinuses: Common confluence of superior sagittal sinus and straight sinus.

11. Meninges: Dura Mater Dural venous sinuses: Dural venous sinuses:Transverse: Begins at confluence of sinuses. Extends along edges of tentorium cerebelli. Right receives blood from superior sagittal sinus. Left receives blood from straight sinus.

12. Meninges: Dura Mater Dural venous sinuses: Dural venous sinuses:Sigmoid: Continuation of straight sinus. “S”-shaped. Ends at jugular foramen: Joins internal jugular vein.

13. Meninges: Pia Mater Innermost layer. Innermost layer. Closely applied to surface of brain. Closely applied to surface of brain. Dips into fissures and sulci. Dips into fissures and sulci. Forms sheath around blood vessels as they penetrate surface of brain. Forms sheath around blood vessels as they penetrate surface of brain.

14. Meninges: Arachnoid Intermediate layer. Intermediate layer. Attached to dura mater and pia mater: Attached to dura mater and pia mater: Separated from pia mater via: Subarachnoid space: Contains cerebrospinal fluid.

15. Meninges: Arachnoid With many arachnoid villi: With many arachnoid villi: For reabsorption of cerebrospinal fluid. Arachnoid granulations may pit surrounding bone: Fovea granulares.

16. Meninges: Arachnoid Subarachnoid cisterns: Subarachnoid cisterns: Choroid plexuses. Flow of CSF: Arachnoid villi. Arachnoid granulations. Hydrocephalous: Hydrocephalous:Obstructive.Communicating.