Surgical applied anatomy / by Sir Frederick Treves.

  • Sir Frederick Treves, 1st Baronet
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Surgical applied anatomy / by Sir Frederick Treves. Source: Wellcome Collection.

    20/602
    general indisposition of the pericranium tQ..form new bone in other circumstances is frequently illustrated. Abscess in the scalp region may be situated (1) above the aponeurosis, (2) between the aponeurosis and the pericranium, and (3) beneath the pericranium. Abscesses in the first situation must always be small and comparatively insignihcant, since the derisity of t]ie scalp tissue here is such that suppuration can only extend witli the greatest difficulty. Suppuration, however, in the second situation (in the loose tissue beneath the aponeurosis) may prove very serigus. ^The laxity of this tissue offers every inducement to ^the abscess to extend when once pus has found its way between the aponeurosis and the pericranium. Suppuration in this area may undermine the entire scalp, which in severe and unrelieved cases may rest upon the abscess beneath as upon a kind of water- bed. As in scalp wounds the aponeurosis is often ' clivided, and as suppuration may follow the injury, it will be seen that the chief danger of those lesions depends upon the spreading of such suppuration to ' the area of lax connective tissue now under notice. The significance of a small amount of bare bone in a scalp wound is not so much that evils will happen to the bone, but that the aponeurosis has been certainly divided, and the dangerous area of the scalp opened up. Suppuration, when it occurs in this area, is only limited Ijy the attachments of the occipito-frontalis muscle and its aponeurosis, and therefoi'e the most depe-.ident places through which pus can be evacuated are along a line drawn round tlie head, commencing in front, above the eyebrow, passing at the side a little above the zygoma,, and ending behind at the superior curved line of the occipital bone. The scalp, even Avhen extensively dissected up by such abscesses, docs not perish, since it carries, as above explained, its blood supply with it. The abscess is