CHAPTER XXXIX. 



HEAD AND NECK. 

 THE SCALP. THE SKULL. 



Structures Forming. Diploic and Emissary 



Landmarks for Nerves Veins. 



and Bloodvessels. Fractures of the Skull. 

 Ligation of Arteries. 

 Injuries and Diseases. 



The Scalp. The tissues forming the scalp are, from 

 without inwards: The integument, superficial fascia, oc- 

 cipito-frontalis muscle and its aponeurosis, delicate are- 

 olar tissue, and, lastly, pericranium. (1) The superficial 

 fascia, like the superficial fascia of the palm of the hand 

 or of the sole of the foot, is composed of a considerable 

 quantity of fibrous tissue which is arranged in bands and 

 connects the integument to the tissues beneath, while in the 

 interstices, so formed, are lodged pellets of fat, hair bulbs, 

 sebaceous glands, nerves and bloodvessels. These fibrous 

 bands firmly unite the overlying skin to the occipito- 

 frontalis muscle and its aponeurosis, and protect the deli- 

 cate vessels and nerves of the scalp from injury, to which 

 their exposed position and the underlying convex surface 

 of bone would incline them. Besides, the close union of 

 these structures permits, much less gaping, in wounds of 

 this portion of the superficial fascia, than is usually found 

 in similar wounds of the superficial fascia elsewhere in the 

 body, and, lastly, in such inflammatory affections of the 

 scalp, as erysipelas, etc., there is very little swelling pres- 

 ent (although the pain is severe), because of this intimate 

 connection between the integument and the aponeurosis. 

 The hair bulbs, so numerous in this fascia, are directed, 

 with a forward slant, behind, and, with a backward slant, 



