A 55-year-old man is admitted to the hospital after an injury sustained at work in a factory. He presents with severe scalp lacerations, which were sutured. After three days the wound is inflamed, swollen, and painful. Between which tissue layers is the infection most likely located?
- The periosteum and bone
- The aponeurosis and the periosteum
- The dense connective tissue and the aponeurosis
- The dense connective tissue and the skin
- The dermis and the epidermis
The scalp is divided into five layers: skin, dense connective tissue, aponeurosis, loose connective tissue, and periosteum. Typically, infections will be located in the loose connective tissue because of the ease with which infectious agents spread via the many veins located in this region. This area is usually referred to as the “danger zone” of the scalp mainly because scalp infections here can be transmitted into the skull via emissary veins, then via diploic veins of the bone to the cranial cavity. The periosteum and bone are almost inseparable; thus, it is not likely to find infections between these layers. The areas between the dense connective tissue and aponeurosis and between the connective tissue and the skin layers do not include connecting veins but mainly superficial veins of the head. The skin provides a very strong barrier against infections; the epidermis and dermis layers are rarely seen separated, and thus the likelihood of an infection between these areas would be rare.
GAS 797, 874-878; GA 442
GAS 797, 874-878; GA 442
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