wound - zkadhem

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8-8. A 28-year-old man is treated in an emergency room for a superficial gash on his forehead. The wound is bleeding profusely, but examination reveals no fracture. While the wound is being sutured, he relates that while he was using an electric razor, he remembers becoming dizzy and then waking up on the floor with blood everywhere. The physician suspects a hypersensitive cardiac reflex. The patient™s epicranial aponeurosis (galea aponeurotica) is penetrated, which results in severe gaping of the wound.The structure overlying the epicranial aponeurosis is
a. A layer containing blood vessels
b. Bone
c. The dura mater
d. The periosteum (pericranium)
e. The tendon of the epicranial muscles (occipitofrontalis)

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e?

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d?

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dd?

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8-8. The answer is a.
A mnemonic device for remembering the order in which the soft tissues overlie the cranium is
SCALP: Skin, Connective tissue, Aponeurosis, Loose connective tissue, and Periosteum. The scalp proper is composed of the outer three layers, of which the connective tissue contains one of the richest cutaneous blood supplies of the body. The occipitofrontal muscle complex inserts into the epicranial aponeurosis, which forms the intermediate tendon of this digastric
muscle. This structure, along with the underlying layer of loose connective tissue, accounts for the high degree of mobility of the scalp over the pericranium. If the aponeurosis is lacerated transversely, traction from the muscle bellies will cause considerable gaping of the wound. Secondary to trauma or infection, blood or pus may accumulate subjacent to the epicranial
aponeurosis.

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AAA

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