In today’s micro lecture, APC Hon. Snr. Lecturer Sam Willis talks about scalp injuries which can occur when people have fallen over in the home, or have been involved in fights, road traffic collisions and all sorts of other situations that you can’t even imagine.
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Hey guys. In today’s micro lecture, we’re going to talk about scalp injuries. As a paramedic, you will get called to lots of patients who present with scalp wounds, or scalp injuries. Think about the types of situations that occur. You’ll have people who have fallen over accidentally in the home and has sustained a scalp wound. You have people who have been involved in fights, road traffic collisions, and all sorts of other types of situations that you can’t even imagine.
The scalp is a very interesting place to injure. It is highly vascular, and it’s made up of lots of different layers, as you can see here. The scalp itself is made up of five different layers. As you can see here, you’ve got the outer layer, the periosteum, the bone, and then directly under that, you’ve got the lower levels, but the scalp itself is made up generally of five layers.
Underneath all of the scalp layers is the actual cranium itself, or the actual bone, or the skull. Directly below this, you’ve got all the different dura mater, pia mater and arachnoid mater, well the DAP, in that order, D-A-P. I’d like to just draw your attention to a couple of things. The first thing is look how thick the skull is. The skull bone itself is actually pretty dense, pretty thick. Likewise, look how thick the scalp layers actually are.
What that means for you is when you guys are assessing a patient, try not to overestimate, or I suppose even underestimate, to some extent, how strong the scalp and the skull actually are.
Sometimes you can go to patients, you can arrive on scene, and patients have got huge edematous swellings on their head and think to yourself, wow, this really is going to impact on the brain. It may have impacted on the brain, but generally speaking, on most occasions, you’ll find that there’s some kind of damage to the scalp layers, which has caused local tissue swelling, rather than any serious underlying damage to the brain.
Then when we look a little bit further at the layers underneath the skull, below the skull, you’ve got the dura mater, which is this top one, then the arachnoid mater, and then the pia mater. D-A-P, pia mater. You’ve got these three layers from the outside, D-A-P, followed very quickly, directly below that, is the actual brain itself.
As you can see here, you’ve got circulation. What you’ll find in this layer here is the cerebral, spinal fluid, which actually acts as a shock absorber, and nourishment provider to the brain.
As you will probably have read by now, when you take a direct hit to the head, the brain has some space to be able to move around. It’s the cerebral spinal fluid that allows the brain to actually move in that cranial cavity.
Anyway, that’s the micro-lecture on the different layers of the scalp and the different sub arachnoid processes. I hope you’ve enjoyed this session. My name is Sam Willis, and I look forward to talking to you again shortly.
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