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Facial Bones Flashcards

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1
Q

SID for facial bones

A

40”

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2
Q

Position for PA Caldwell Facial Bones

A 
Prone or PA Erect
MSP perpendicular to midline of table
Adjust head so that the OML is perpendicular to the IR
Nose and forehead against the IR.
Nasion is at the center of IR
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3
Q

Textbook CR for PA Caldwell Facial Bones

A

Angle 15 degrees caudal

Exits nasion

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4
Q

SFMC CR for PA Caldwell Facial Bones

A

Angle 27 degrees caudal

Exits nasion

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5
Q

Film for PACaldwell

A

10 x 12 LW Bucky

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6
Q

Structures shown PA Caldwell Facial Bones

A 
Orbital rim
Maxillae
Nasal septum
Zygoma
Anterior nasal spine
Looking at floor of orbit
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7
Q

The textbook angle for PA Caldwell shows

A

Petrous pyramids in lower 1/3 of orbits

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8
Q

SFMC angle for PA Caldwell shows

A

Petrous pyramids within the maxillary sinuses; below orbits

This angle will show the orbital floor better.

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9
Q

Rotation for PA Caldwell shows

A

MLOM
Sides of skull are equal distance to lateral borders of orbits
MSP of head aligned with long axis of collimating field.

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10
Q

Routine for facial bones

A

PA Caldwell
Waters
Lateral on affected side
Base view for zygoma

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11
Q

Waters is aka

A

Parietoacanthial Projection

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12
Q

Position for Waters for Facial Bones

A

Prone or PA Erect seated.
MSP to midline of IR.
Adjust head until the OML forms a 37 degree angle with IR.
Place the tip of the Chin up and against IR.
Mentomeatal line is adjusted so it is perpendicular to the IR.
Center the IR at the level of the acanthion.

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13
Q

CR Waters Facial Bones

A

Perpendicular to IR exiting the acanthion.

Acanthion is at center of IR.

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14
Q

Film Waters

A

10 x 12 LW Bucky

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15
Q

Structures Waters Facial Bones

A

Entire rim of orbits
Entire Facial bones
Petrous ridges projected immediately below maxillary sinuses.

Maxillae
Bony nasal septum
Zygoma
Maxillary sinuses

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16
Q

Rotation for Waters

A

MLOM

Sides of skull

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17
Q

Position for Lateral Facial Bones

A

Semi-prone or erect with body in an anterior oblique position.
Place head in a true lateral position.
MSP is parallel to the IR
Interpupillary is perpendicular to the IR.

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18
Q

CR for Lateral Facial Bones

A

CR centered and perpendicular to the zygoma.

Entering lateral surface of zygoma halfway between outer canthus and EAM.

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19
Q

Film for Lateral

A

10 x 12 LW Bucky

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20
Q

Structures for Lateral Facial Bones

A 
Superimposed facial bones and orbital plates.
Sella tursica
Zygoma
Mandible
Maxillae
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21
Q

Rotation for Lateral

A

Look at mandible

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22
Q

How do we tell if there’a any Tilt for Lateral facial bones

A

Look at orbital plates

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23
Q

Base view of Zygoma is aka

A

Submental view or Submentovertical Projection

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24
Q

Base view of Zygoma position

A

Raise chin and hyperextend neck until the IOML is parallel to the IR.
Patient supine and angle sponge to angle neck back.

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25
CR for Base view of Zygoma
CR perpendicular to IOML at level of zygomatic arches | CR entering the MSP of the throat at the level approximately 1" posterior to the outer canthi.
26
Film for Base view of Zygoma
10 x 12 LW out of Bucky | Prop up a cassette so it is touching top of head.
27
Structures seen for Base view of Zygoma
Zygomatic arches and symmetrical.
28
How do we adjust technique for Base view of Zygoma
Since it they are thin bones, decrease technical factors. | 5 mAs at 70 kVp
29
If we can only see one of the zygomatic arches well during, base view of Zygoma then what do we do?
Oblique Inferosuperior (tangential).
30
Describe Oblique Inferosuperior (tangential) for zygomatic arch
SMV position Rotate MSP patient head toward affected side 15 degrees. Tilt top of head 15 degrees away from side being examined. Skim CR through zygomatic arch on affected side.
31
What view shows orbits better?
Modified Waters | With OML 55 degrees to IR
32
What is an optional Zygomatic Arch view
AP Axial
33
Position for AP Axial Zygomatic arches
Position like AP Axial Townes: Patient seated upright or supine position. MSP centered to midline of the grid. OML is perpendicular to IR
34
CR for AP Axial Zygomatic arches
CR to 1" above glabella Textbook says CR to enter the glabella 1" above the nasion at an angle 30 degrees caudal. and CR passed directly through Zygomatic Arches CR 30 degrees to OML If patient cannot flex neck enough, then CR 37 degrees to IOML.
35
Orbits Routine
PA Caldwell Modified Waters Erect if possible Lateral of Affected Side
36
SID and Film for Orbits
40" SID 10 x 12 LW Bucky
37
Position for Modified Waters Orbits
PA erect if possible. IR centered at level of center of orbits. Rest chin on IR. Adjust head until the OML forms a 55 degree angle with the IR. Lips-meatal line is perpendicular to IR. lips against IR
38
CR for Modified Waters Orbits
CR directed perpendicular through mid-orbits; exits the acanthion.
39
Structures seen Modified Waters Orbits
Good for blow-out fx. Orbital floors are projected less distorted than water's. Petrous projected in lower half of maxillary sinuses. See entire orbits Close beam restriction to orbital region.
40
Position for Lateral Orbits
Semi-prone or erect. RAO or LAO body with head lateral against IR. MSP parallel to the IR. Interpupillary Line is perpendicular to IR. IPL is centered to IR
41
CR for lateral orbits
CR directed perpendicular through the outer canthus
42
Structures seen lateral orbits
Superimposed facial bones and orbital plates
43
What optional view is used to see Optic Foramen?
Rhese Oblique
44
Position for Rhese Oblique Orbits
Prone or PA Oblique Chin, cheek, and nose on IR MSP 53 degrees to IR AML perpendicular to IR
45
CR for Rhese oblique
CR perpendicular to downside orbit CR will go directly through optic foramen 40" SID Bucky and Grid
46
Structures for Rhese Oblique
Optic Foramen in lower outer quadrant | Looking for destruction of sphenoid strut from a tumor.
47
Mandible routine
``` PA Axial (Caldwell position) Both obliques ```
48
PA Axial (Caldwell Position) mandible positioning
PA or prone Forehead and nose against table or vertical Bucky. OML perpendicular to IR Open mouth at center of IR
49
CR for PA Axial (PA Caldwell) mandible
CR is 10 degree cephalic to exit open mouth. | Textbook: CR directed 20 to 25 degrees cephalic to exit at the acanthion.
50
Structures PA Axial (PA Caldwell) Mandible
Mandibular Rami , body, mentum, and condyles Condyles and coronoids superimposed. Not including the whole skull. This image used to show medial or lateral displacement of fragments in fractures of the Rami.
51
Position for right and left Axiolateral Posterior obliques Mandible
Place pt in Posterior oblique with head in true lateral position. Tilt top of head 15 degrees to IR. Angle the tube 25 degrees cephalic.
52
CR for right and left obliques Mandible
Angle tube 25 degrees cephalic. CR perpendicular to submentum between gonion and mentum. Total degrees of angle is 40.
53
Structures for right and left obliques Mandible
``` Mandibular Rami Condylar process Coronoid process Body, and mandibular notch You see the side closest to the IR ```
54
Optional Mandible
AP Axial | Submentalvertex
55
Position for AP axial mandible.
OML perpendicular to IR. Center at glabella Patient recumbent supine with wedge under head so chin is tucked down.
56
CR for AP Axial Mandible
35-40 degrees caudally At glabella CR passes through mandible
57
Structures for AP Axial Mandible
Looking for Fx of Condyloid processes or Ramus Elongates Mandible
58
Position for submentovertex of mandible
IOML parallel to IR | Positioned the same as other SMV
59
CR for submentovertex of mandible
CR perpendicular to IOML and midway between the angles of mandible (submentum)
60
Structures for submentovertex of mandible
Entire Mandible
61
Routine for Nasal Bones
Modified Waters | Both Laterals
62
CR for nasal bones modified waters
CR perpendicular to and exits acanthion.
63
Film for nasal bones modified waters
Grid | 10 x 12 LW
64
Structures nasal bones modified waters
Bony Nasal Septum Petrous pyramid appears in lower half of maxillary sinuses Orbital floors seen very well Orbits are more true to size and shape. Blow-out fx seen BC floor of orbits seen well.
65
Nasal bones Both Laterals position
Erect or semi-prone If on table, have patient in RAO or LAO body position and arm of affected side, at pt side Head is lateral position MSP parallel to IR Inter pupillary Line is perpendicular to IR
66
CR Nasal bones Both Laterals
CR perpendicular to 1/2" inferior to nasion | CR perpendicular to IR
67
Film for Nasal bones Both Laterals
10 x 12 LW table top Collimate 3-4" square No Grid if in Bucky
68
Structures Nasal bones Both Laterals
Nasal bone with soft tissue | Anterior nasal spine
69
Technique for nasal bones
1.6-2 mAs at 55kVp
70
Optional for nasal bones
Superoinferior Axial
71
Position for nasal bone Superioinferior Axial
Sitting or prone With GAL perpendicular to IR Table top
72
CR for nasal bone Superioinferior Axial
CR parallel to GAL
73
Structures for nasal bone Superioinferior Axial
To see if there is any shift side to side ( medial or lateral deviation) Nasal bones not superimposed See septal cartilage
74
Modified Waters aka
Modified Parietoacanthial Projection
75
Limitation to see nasal bone Superioinferior Axial
OID If frontal bone is not flat Bucky teeth Prominent chin
76
Panorex
It rotates around or head and it is a long exposure so keep finger on button.
77
Using a Panorex for mandible, what line is parallel to floor
IOML
78
Structures seen Panorex
Entire mandible and all teeth and roots, Condyloid, coronoid, ramus, body Evaluate teeth fx or disruption Fx mandible
79
Limitations of mandible
Broad shoulders | bun in hair
80
What are modifications if pt can't tilt head for Axiolateral Posterior Obliques Mandible?
1. Angle tube 40 degrees cephalic | 2. Pt recumbent semi-prone or semi-supine; tilt IR 15 degrees with sponge; CR 25degrees cephalic
81
Position for Modified Waters Nasal Bones
Patient prone or PA Erect. Adjust the patient's head so the OML forms a 55 degree angle with the IR. Lipsmeatal line in perpendicular to IR
82
Position for PA Caldwell Orbits
Patient prone or PA Erect. MSP is perpendicular to midline of table. Rest forehead and nose on IR. Adjust head so that the OML is perpendicular to the IR.
83
CR textbook version for PA Caldwell Orbits
Angle CR 15 degrees caudal, exits nasion.
84
CR SFMC for PA Caldwell Orbits
Angle CR 27 degrees caudal, | Exits nasion
85
Structures seen PA Caldwell Orbits
Orbital rim, maxillae, bony nasal septum, Zygoma Textbook 15 angle: Petrous pyramid in lower 1/3 of orbits SFMC 27 angle: Petrous pyramid within maxillary sinuses
86
Right and Left Lateral Oblique for mandible is AKA
Axiolateral Mandible
87
Caldwell Method aka
PA Axial projection
88
Evaluation criteria for AP Axial Zygomatic Arches
Zygomatic arches project lateral to mandibular rami.

Positioning (7 decks)

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