158 HEAD AND NECK 



In addition to the arteries and veins there are numerous 

 lymph vessels in the scalp, but they cannot be displayed by 

 ordinary dissecting methods. Nevertheless, it is important 

 that the student should remember their usual terminations. 

 The lymph vessels of the anterior area end in small lymph 

 glands which are embedded in the superficial surface of the 

 parotid gland. Those of the posterior area terminate either 

 in lymph glands which lie superficial to the mastoid part of 

 the temporal bone, or in occipital lymph glands, which lie in 

 the neighbourhood of the superior nuchal line. 



Dissection. After the vessels and nerves of the scalp have been traced, 

 the dissector should cut through the fibres of the orbicularis oculi and the 

 frontalis over the medial part of the supra-orbital eminence and display the 

 corrugator supercilii muscle. It springs from the medial end of the 

 supra-orbital ridge of the frontal bone and passes anteriorly and laterally, 

 through the fibres of the orbicularis oculi, to its insertion into the skin of 

 the eyebrow. It is supplied by the temporal branch of the facial nerve. 



Galea Aponeurotica (O.T. Epicranial Aponeurosis). The 

 galea aponeurotica is fully exposed as soon as the superficial 

 fascia of the scalp is completely removed. It is a strong 

 layer of aponeurosis connected anteriorly with the frontal 

 bellies of the epicranius, posteriorly with the occipital bellies, 

 and between the occipital bellies, with the external occipital 

 protuberance and the medial parts of the superior nuchal lines, 

 or with the supreme nuchal lines when they are present. 

 Laterally it becomes thinner, descends over the upper part of 

 the temporal fascia, and gives origin to the anterior and 

 superior auriculares muscles. It is so closely connected 

 with the superjacent skin, by the dense superficial fascia, 

 that the two cannot be separated, except with the aid of 

 the cutting edge of the scalpel ; but above the supra-orbital 

 ridges, the temporal ridges, and the superior nuchal lines it 

 is only loosely connected to the pericranium by the layer 

 of loose areolar tissue ; therefore the three closely connected 

 superficial layers, the skin, superficial fascia, and the galea 

 aponeurotica, can easily be torn from the pericranium, a 

 circumstance taken advantage of by the Indians who scalped 

 their defeated foes. The looseness of the areolar tissue 

 beneath the galea aponeurotica permits the latter to be 

 drawn forwards and backwards by the alternate contractions 

 of the occipitalis and frontalis muscles, and, as it moves, it 

 carries with it the skin and superficial fascia with which 

 it is so closely blended. 



