Fascial Planes, Muscles and Triangles Quiz

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Which description matches the epicranial aponeurosis, one of the layers of the scalp?

A A highly vascular layer containing arteries, veins and nerves
B A tough fibrous sheet linking the frontal and occipital bellies of occipitofrontalis ✓
C A loose layer of areolar tissue that lets the scalp slide over the skull
D The outer skin layer containing hair follicles and sebaceous glands
E A thin layer of periosteum tightly adherent to the cranial bones

The answer is B: A tough fibrous sheet linking the frontal and occipital bellies of occipitofrontalis

Explanation

Why B is correct

See Epicranial Aponeurosis. Option B is correct because the epicranial aponeurosis is a tough, flat sheet of fibrous tissue that forms a broad tendon between the frontal belly and the occipital belly of occipitofrontalis, the muscle that raises the eyebrows. An aponeurosis is simply a flat, sheet-like tendon, and in this case it covers the top of the skull like a cap. It is the third layer of the scalp, which has five layers in total. The memory aid SCALP lists them from the outside inwards: Skin, dense Connective tissue, Aponeurosis (the epicranial aponeurosis), Loose areolar connective tissue, and Pericranium (the periosteum, the membrane covering the skull). The first three layers are firmly bound together and move as one unit over the skull. The layer beneath it is loose, so the scalp can slide over the skull. This anatomy is the reason scalp wounds bleed heavily and why infection in the loose layer can spread easily.

Structure: tough, flat sheet of fibrous tissue, a flat tendon.
Attachments: joins the frontal and occipital bellies of occipitofrontalis.
Position: third of the five scalp layers (SCALP).

Why the other options are incorrect

A. A highly vascular layer containing arteries, veins and nerves: This describes the dense connective tissue layer under the skin. It is richly supplied with blood vessels and nerves, and its vessels cannot constrict fully when cut, which is why scalp wounds bleed heavily.
C. A loose layer of areolar tissue that lets the scalp slide over the skull: This is the loose areolar connective tissue layer, which lies deep to the aponeurosis and allows the scalp to move. It contains emissary veins and is called the danger area of the scalp.
D. The outer skin layer containing hair follicles and sebaceous glands: This is the skin, the most superficial layer. It contains hair follicles and sebaceous glands and is not a fibrous tendon-like sheet.
E. A thin layer of periosteum tightly adherent to the cranial bones: This describes the pericranium (periosteum), the deepest scalp layer, which covers the skull bones. It lies beneath the loose areolar layer, so it cannot be the aponeurosis.

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1
Which structure is classically found within the anterior triangle of the neck?
2
Which fascial layer forms a collar around the neck and encloses both sternocleidomastoid and trapezius?

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