What Is the Parietal-Temporal-Occipital Area?

The frontal parietal occipital region is preceded by the superior orbital margin, posterior by the occipital bulge and the superior line, and the sides are borrowed by the superior temporal line and the temporal boundary.

Forehead occipital region

The frontal parietal occipital region is preceded by the superior orbital margin, posterior by the occipital bulge and the superior line, and the sides are borrowed by the superior temporal line and the temporal boundary.

Partition location

Frontal region: the upper orbital margin is backward, and the bone surface is delimited by the coronal suture.

Parietal area: the front is the coronal suture, the lower is the upper temporal margin on both sides, and the bone surface is delimited by the herringbone suture.

Occipital area: the upper part is a herringbone suture, the front is the posterior margin of the two sides of the temporal, and the lower is the occipital bulge.

The layers of soft tissue covering this area, from shallow to deep, are: skin, superficial fascia, cap aponeurosis, and occipitofrontalis muscle, loose tissue under the aponeurosis, and adventitia of the skull. Among them, the three superficial layers are closely connected and it is difficult to separate them, so these three layers are often referred to as the "scalp". The deep two layers are loosely connected and easy to separate.

(1) Skin: The skin in this area is thick and dense, and has two prominent features. One is that it contains a large number of hair follicles, sweat glands, and sebaceous glands. Swelling or sebaceous gland cysts are the most common sites. Second, they are rich in blood vessels, which can cause bleeding during trauma, but the wounds heal faster.

(2) Superficial fascia: It is composed of dense connective tissue and adipose tissue, and there are many connective tissue trabeculae, which tightly connect the skin and the cap-shaped aponeurosis, separating the fat into countless small cells with blood vessels and nerves running inside. Exudate is not easy to spread when infected, and can compress nerve endings early and cause severe pain. In addition, the blood vessels in the small cell are mostly fixed by the surrounding connective tissue. When the wound is broken, the stump of the blood vessel is not easy to contract and close, so it has a lot of bleeding, and it often requires compression or suture to stop the bleeding. The blood vessels and nerves in the superficial fascia can be divided into anterior and posterior groups. Anterior group: about 2cm away from the midline, there are upper arterioles, veins and upper nerves of the tackle. About 2.5 cm from the midline, there were still superior orbital arteries, veins, and superior orbital nerves. Both arteries are the terminal branches of the ophthalmic artery; the concomitant vein ends converge into the internal iliac vein; the nerve with the same name is the branch of the first trigeminal nerve of the ocular nerve. Posterior group: occipital arteries, veins and occipital nerves are distributed in the occipital area. The occipital artery is a branch of the external carotid artery; the occipital vein flows into the external jugular vein; and the great occipital nerve comes from the posterior branch of the second cervical nerve. Because the nerves at the cranial apex overlap with each other, during local anesthesia, if only one nerve is blocked, satisfactory results are often not obtained, and the range of nerve block needs to be enlarged.

(3) Cap-shaped aponeurosis: the frontal abdomen with the occipitofrontalis muscle and the posterior occipital abdomen, gradually thinning on both sides, continuing to the temporal fascia. Scalp laceration, accompanied by lateral rupture of the cap-shaped aponeurosis, due to the contraction of the occipitofrontalis muscle, the wound was severed. When suture the scalp, the aponeurosis should be carefully sutured to reduce skin tension and facilitate wound healing.

(4) Loose connective tissue under the aponeurosis: This layer, also called the subaponeurotic space, is a thin layer of loose connective tissue located between the cap-shaped aponeurosis and the periosteum. This gap has a wide range, from the front to the upper orbital edge, and back to the upper line. The scalp is loosely connected to the adventitia of the skull through this layer, so it has great mobility. When the craniotomy is opened, the flap can be freed up after this gap. Bleeding under the aponeurosis can easily spread extensively, forming large hematomas, and petechiae can appear on the nose and subcutaneously on the upper eyelid. The veins in this space communicate with the venous veins of the skull and the dural sinus in the skull. If infection occurs, secondary osteomyelitis or spread to the skull can be caused by the above methods. It is the "danger zone" at the top of the skull.

(5) Skull epithelium: It consists of dense connective tissue, which is connected to the surface of the skull by a small amount of connective tissue, and the two are easy to peel off. Severe avulsion of the scalp, the scalp can be peeled together with part of the periosteum. The periosteum is tighter with the cranial suture, and the subperiosteal hematoma is often limited to the scope of a skull

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