HEENT pt. 2

Question 1

Radiopaque

Answer 1

describes density
prevents X-rays from passing through freely
Higher atomic numbers
white shadow

Question 2

radiolucent

Answer 2

density
X-rays pass freely
small atomic numbers
dark shadow

Question 3

mandibular series

Answer 3

PA view
lateral
towns
bilateral oblique

Question 4

Panorex

Answer 4

one plane

Question 5

PA view (posterior anterior)

Answer 5

entire mandible
symphysis is obscured by spine
condyles are superimposed against mastoid or occ. bones
BEAM SHOOTS POSTERIOR TO ANTERIOR

Question 6

away from the film

Answer 6

less white

Question 7

toward the film

Answer 7

more white

Question 8

Towns view

Answer 8

bone overlap is common

used to evaluate condyles

Question 9

Oblique views

Answer 9

mandibular groove best seen

Question 10

waters view

Answer 10

occipitomental view

Question 11

basal view

Answer 11

submentovertex view

Question 12

considerations: 1st, 2nd, 3rd

Answer 12

1st: evaluate the adequacy if the films
2nd: trace all cortical margins and evaluate for discrepancy
3rd: if one fracture is present, look for more!
“ring bone rule”

Question 13

if the condyles are injured or broken then what else could be?

Answer 13

symphysis

Question 14

if the angle of the mandible is broken or injured then what else could be broken ?

Answer 14

contralateral body or condyle

Question 15

Facial series

Answer 15

caldwell view - chin down
waters view - chin up
submental vertex (basal) - through sub mental area
lateral view - lateral

Question 16

lines of dolan

Answer 16

if they are misaligned then it indicate a fracture
1 = base of orbit
2 = lateral part of orbit
3 = superior part of maxillary

Question 17

what is the best view for imaging the nasal bones?

Answer 17

lateral

Question 18

Direct signs of facial fracture

Answer 18

nonanatomic linear lucency’s
cortical defect
bone fragments overlapping - more white
asymmetry of face

Question 19

Indirect signs of facial fracture

Answer 19

soft tissue swelling
periorbital or intracranial air
fluid in a sinus - fracture of orbit bone

Question 20

whats the most common fracture of the face?

Answer 20

nasal bone

Question 21

Computed Tomography

Answer 21

uses a computer to reconstruct cross-sectional imaging

Question 22

CT - IV contrast

Answer 22

enhances the density differences between lesions and surrounding parenchyma (tumor in the lung use contrast and abscess in throat)
Vascular anatomy

Question 23

CT - Oral/Rectal contrast

Answer 23

given to opacify bowel
LOOKING FOR A PIECE OF SHITTT!
stones will light up on their own w/o contrast so using contrast could hide them

Question 24

Ct is good for what parts of the afce?

Answer 24

sinuses and soft tissue

Question 25

Xray sinus

Answer 25

waters view

Question 26

Indications for CT of sinuses

Answer 26

persistent sinusitis recurrent sinusitis intraorbital or intracranial spread of infection

Question 27

Indications for CT of facial bones and mandible

Answer 27

complex facial fractures trauma benign films

Question 28

why is a CT the gold standard over an Xray for the face?

Answer 28

Xray miss a lot of facial fractures because of overlapping

Question 29

Le Fort I

Answer 29

floating palate

Question 30

Le Fort II

Answer 30

pyramidal

Question 31

Le Fort III

Answer 31

craniofacial dysfunction

Question 32

CT orbit is best seen when using?

Answer 32

CT (coronal view) | WithOUT contrast

Question 33

Retropharyngeal abscess location?

Answer 33

anterior to C3, >3mm (increased in crying children)

Question 34

Epiglottitis best seen with what view?

Answer 34

soft tissue lateral (88-100% sensitive) (96% specific)

Question 35

what is it called when the epiglottis looks swollen and enlarged?

Answer 35

thumb print sign | aryepiglottic folds are thickened and Vallecula is thickened

Question 36

Croup virus?

Answer 36

RSV

Question 37

Croup will show what on the Xray?

Answer 37

distended hypo pharynx and laryngeal vesicle HAZINESS OR NARROWING OF SUBGLOTTIC SPACE NARROWING TRACHEA = STEEPLE SIGN (93& sensitive) (92% specific)

Question 38

Narrowing of the airway (subglottic larynx)

Answer 38

Steeple Sign

Question 39

Indications for CT of soft tissue neck

Answer 39

W/ contrast: mass, swelling, adenopathy W/O contrast: no helpful W/ & W/O contrast: salivary stones / ducts

Question 40

what is the pre test for CT

Answer 40

creatinine if contrast is to be used cause the kidney does not like the contrast dye and can cause renal failure

Question 41

Peritonsilar abscess (seen with CT of the neck)

Answer 41

W/ contrast - pus that lies between the tonsillar capsule and superior pharyngeal constrictor muscle (75% specific) (100% sensitive) rim enhancing fluid collection within an enlarged and inflamed tonsil

Question 42

what is the gold standard for visualizing a retropharyngeal abscess?

Answer 42

CT, W/ contrast (90% sensitive) fat planes obliterated enhanced by ring