See also:

• SCALP (0. Dutch schelpe, a shell)

SCALP (0. Dutch schelpe, a See also:

• SHELL
• SHELL (O. Eng. scell, scyll, cf. Du. sceel, shell, Goth. skalja, tile; the word means originally a thin flake,. cf. Swed. skalja, to peel off; it is allied to " scale " and " skill," from a root meaning to cleave, divide, separate)

shell)  , in See also:

• ANATOMY
• ANATOMY (Gr. avaroyil, from ava-silo c', to cut up)

anatomy, the whole covering of the See also:

• TOP (cf. Dan. top, Ger. Topf, also meaning pot)

top of the See also:

• HEAD (in 0. Eng. heafad; the word is common to Teutonic languages; cf. Dutch hoofd, Ger. Haupt, generally taken to be in origin connected with Lat. caput, Gr. KerbOvi7)
• HEAD, SIR EDMUND WALKER, BART
• HEAD, SIR FRANCIS BOND, BART

head from the skin to the See also:

• BONE (a word common in various forms to Teutonic languages, in many of which it is confined to the shank of the leg, as in the German Bein)
• BONE, HENRY (1755-1834)

bone . Five layers are recognized in the See also:

• SCALP (0. Dutch schelpe, a shell)

scalp, and these, from without inward, are: (1) skin, (2) superficial See also:

• FASCIA (Latin for a bandage or fillet)

fascia, (3) See also:

• APONEUROSIS (Gr. limb, away, and vei pov, a sinew)

aponeurosis or epicranium, (4) See also:

• LYMPH

lymph space, (5) periosteum or pericranium . The skin of the scalp is thick and remarkable for the large number of See also:

• HAIR (a word common to Teutonic languages)

hair follicles contained in it . The superficial fascia consists of dense bundles of fibrous See also:

• TISSUE (Fr. tissu, tissue, participle of tisser, Lat. texere, to weave)

tissue which pass from the skin to the third layer or aponeurosis and bind the two structures together so closely that when one of them is moved the other must needs be moved too . The fibrous bundles are separated by pellets of See also:

• FAT (O.E. fdett; the word is common to Teutonic languages, cf. Dutch vet, Ger. Fett, &c., and may be ultimately related to Greek Irian, and =apos, and Sanskrit pivan)

fat, and it is in this second layer that the vessels and nerves of the scalp are found . Here, as elsewhere, the vessels are See also:

• ARTERIES (Gr. ap-rnpia, probably from a"spew, to raise, but popularly connected by the ancients with ai7P, air)

arteries, See also:

• VEINS

veins and lymphatics, and the arteries are specially remarkable, firstly, for their tortuosity, which is an See also:

• ADAPTATION (from Lat. adaptare. to fit to)

adaptation to so movable a See also:

• PART

part; secondly, for their anastomosing across the See also:

• MIDDLE

middle See also:

• LINE

line with their See also:

• FELLOWS, SIR CHARLES (1799-1860)

fellows of the opposite See also:

• SIDE
• SIDE (mod. Eski Adalia)

side, an arrangement which is not usual in the See also:

• BODY

body; and, thirdly, for the fact that, when cut, their ends are held open by the dense fibrous tissue already spoken of, so that bleeding is more See also:

• FREE

free in the scalp than it is from arteries of the same See also:

• SIZE

size elsewhere in the body . The veins do not follow the twists of the arteries but run a straight course; for this See also:

• REASON (Lat. ratio, through French raison)

reason there is often a considerable distance between an artery and its See also:

• COMPANION (through the O. Fr. compaignon or compagnon, from the Late Lat. companio,—cum, with, and panis, bread,—one who shares meals with another; the word has been wrongly derived from the Late Lat. compagnus, one of the same pages or district)

companion vein . Accompanying the veins are the larger lymphatic vessels, though there are no lymphatic glands actually in the scalp . From the forehead region the lymphatics accompany the facial vein down the side of the See also:

• FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)

face and usually reach their first gland in the submaxillary region, so that in the See also:

• CASE
• CASE, JOHN (d. 1600)

case of a poisoned See also:

• WOUND (O. Eng. wund,connected with a Teutonic verb, meaning to strive, fight, suffer, seen in O. Eng. winnan, whence Eng. " win ")

wound of the forehead sympathetic swelling or suppuration would take See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place below the See also:

• JAW (Mid. Eng. jawe, jowe and geowe, O. Eng. cheowan, connected with " chaw " and " chew," and in form with " jowl ")

jaw . From the region of the See also:

• TEMPLE
• TEMPLE, FREDERICK (1821-1902)
• TEMPLE, RICHARD
• TEMPLE, SIR RICHARD, BART
• TEMPLE, SIR WILLIAM, BART

temple the lymphatics drain into a small gland lying just in front of the See also:

• EAR (common Teut.; O.E. are, Ger. Ohr, Du. oor, akin to Lat. auris, Gr. ovs)

ear, while those from the region behind the ear drain into some glands lying See also:

• CLOSE
• CLOSE (from Lat. clausum, shut)
• CLOSE, MAXWELL HENRY (1822-1903)

close to the mastoid See also:

• PROCESS

process . In the occipital region a small gland (or glands) is found at the edge of the scalp close to the point at which the occipital artery reaches it, that is to say about a third of the distance from the See also:

• EXTERNAL

external occipital protuberance to the tip of the mastoid process (see See also:

• SKULL

SKULL) . The See also:

• NERVE (Lat. nervus, Gr. vevpov, a bowstring)

nerve See also:

• SUPPLY (through Fr. from Lat. supplere, to fill up)

supply of the scalp in its anterior part is from the fifth See also:

• CRANIAL

cranial or trigeminal nerve (see NERVES, CRANIAL); in the forehead region the supratrochlear and supraorbital branches come out of the See also:

• ORBIT (from Lat. orbita, a track, orbis, a wheel)

orbit from the first or ophthalmic See also:

• DIVISION (from Lat. dividere, to break up into parts, separate)

division of the fifth, while farther back, in the anterior part of the temporal region, the temporal See also:

• BRANCH (from the Fr. branche, late Lat. branca, an animal's paw)

branch of the second or maxillary division of the same nerve is found .

Farther back still, in front of the ear, is the See also:

• AREA

area of the auriculo-temporal nerve, a branch of the third or mandibular division of the fifth cranial . Behind the ear the scalp is supplied with sensation by two branches of the cervical plexus of nerves, the See also:

• GREAT

great auricular and the small occipital (see NERVES, See also:

• SPINAL

SPINAL), while behind these, and reaching as far as the See also:

• MID

mid line posteriorly, the great occipital, derived from the posterior See also:

• PRIMARY

primary division of the second cervical nerve, is distributed . Sometimes the posterior primary division of the third cervical nerve reaches the scalp still nearer the middle line behind . The third layer of the scalp or epicranium is formed by the two fleshy bellies of the occipito-frontalis muscle and the flattened tendon or aponeurosis between them . Of these two bellies the anterior (frontalis) is the larger, and, when it acts, throws the skin of the forehead into those transverse puckers which are characteristic of a puzzled See also:

• FRAME

frame of mind . The much smaller (occipitalis or posterior) belly usually merely fixes the aponeurosis for the frontalis to See also:

• ACT (Lat. actus, actum)

act, though some See also:

• PEOPLE

people have the See also:

• POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power of alternately contracting the two muscles and so wagging their scalps backward and forward as monkeys do . Both fleshybellies of the occipito-frontalis are innervated by the seventh or facial nerve which supplies all the muscles of expression . Deep to the occipito-frontalis and its aponeurosis or epicranium is the See also:

• FOURTH

fourth layer, which consists of very lax areolar tissue constituting what is now known in anatomy as a lymph space . The length and laxity of this tissue allow great freedom of See also:

• MOVEMENT

movement to the more superficial layers, and it is this layer which is torn through when a Red See also:

• INDIAN

Indian scalps his foe . So lax is the tissue here that any collection of See also:

• BLOOD

blood or pus is quickly distributed throughout its whole area, and, owing to the See also:

• ABSENCE (Lat. absentia)

absence of tension as well as of nerves, very little See also:

• PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
• PAIN, BARRY (1867– )

pain accompanies any such effusion . The fifth and deepest layer of the scalp is the pericranium or the external periosteum of the skull bones . This, until the sutures of the skull close in middle See also:

• LIFE

life, is continuous with the dura mater which forms the See also:

• INTERNAL

internal periosteum, and for this reason any subpericranial effusion is localized to the area of the skull bone over which it happens to See also:

• LIE, JONAS LAURITZ EDEMIL (1833—1908)
• LIE, MARIUS SOPHUS (1842–1899)

lie .

Moreover, any suppurative process may extend through the sutures to the meninges of the See also:

• BRAIN (A.S. braegen)

brain . (F . G . P.) See also:

• SURGERY
• SURGERY (Fr. chirurgie, from Gr. Xetpoupyfa, i.e. hand-work)

Surgery of the Scalp.—In connexion with the treatment of surgical and other wounds of the scalp, it used to be thought that it was dangerous to treat them by suturing, because of the See also:

• RISK

risk of the intervention of See also:

• ABSCESS (from Lat. abscedere, to separate)

abscess or See also:

• ERYSIPELAS

erysipelas . Now that one knows, how-ever, that these two conditions are dependent upon the presence of septic micro-organisms, the surgeon deals with the scalp as with other parts of the body, cleansing the See also:

• SURFACE

surface before performing an operation upon it, and doing his best to free the region of all germs when he is called upon to treat a wound already inflicted on it . Unless the surgeon could render the scalp aseptic, it would be almost impossible for him to undertake any operation upon the interior of the skull . Before opening the skull, therefore, the scalp is cleanly shaved and dealt with by See also:

• TURPENTINE (in M. Eng. turbentine, adapted through the O. Fr. turbentine or terebentine from Lat. terebinthina, sc. resina, resin of the terebinth, Gr. eepiOtvOos or eippavOos)

turpentine, See also:

• SOAP

soap and See also:

• WATER

water and other See also:

• ANTISEPTICS (Gr. avrl, against, and 6177rrnKor, putrefactive)

antiseptics . A large See also:

• HORSE (a word common to Teutonic languages in such forms as hors, hros, ros; cf. the Ger. ross)

horse-See also:

• SHOE (a word appearing in the Teutonic languages in various forms, as Ger. Schuh, Swed. and Dan. sko, sometimes supposed to come from an unknown root ska or sku, cover)

shoe shaped flap is then turned down by an incision right to the bone, and on the conclusion of the operation the flap is replaced in position and secured by stitches . As the result of septic infection by an accidental wound, abscess is likely to See also:

• FORM (Lat. forma)

form beneath the scalp, and if it is See also:

• LEFT

left to increase in size unchecked it may detach a large area of the scalp . As soon, there-fore, as it is thought that See also:

• MATTER

matter is forming beneath the scalp, an incision should be made down to the bone, and See also:

• PROVISION (Lat. provisio)

provision taken for insuring free drainage . Naevi of the scalp are best treated by See also:

• ELECTROLYSIS (formed from Gr. Xbety, to loosen)

electrolysis or by removal by See also:

• DISSECTION (from Lat. dissecare, to cut apart)

dissection . If they are supplied by large blood-vessels, each artery should be under-pinned or tied before the removal by dissection is undertaken .

Sebaceous cysts of the scalp should be removed by incision under the See also:

• ETHER, (C2H5)2O

ether-spray whilst they are still small, the whole of the cyst-See also:

• WALL (O. Eng. weal, weall, Mid. Eng. wal, wane, adapted from Lat. vallum, rampart; the original O. Eng. word for a wall was wag or tenth)
• WALL, RICHARD (1694-1778)

wall being torn out, for unless the cys: is entirely removed, the See also:

• TUMOUR (Lat. tumor, a swelling)

tumour is likely to reform . If the sebaceous cyst is left it may cause a thinning of the overlying skin and, effecting its own See also:

• DISCHARGE (adapted from the O. Fr. discharge, modern decharge, from a med. Lat. discargare, to unload, dis- and earn care, to load, cf. " charge ")

discharge, may become the source of chronic suppuration . In some cases the chronic abscess of a sebaceous cyst becomes the starting-point of See also:

• MALIGNANT (Lat. malignus, evil-disposed, from maligenus)

malignant disease . (E .