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125 Cards in this Set
- Front
- Back
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MSP
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Midsagittal plane
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IPL
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interpupillary line
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OML
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orbitomeatal line
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AML
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acanthiomeatal line
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LML
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lipmeatal line
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EAM
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external acoustic meatus
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IOML
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infraorbitaomeatal line
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MML
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mentomeatal line
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What is the angle difference in an average adult skull between the OML and the IOML?
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7 DEGREES
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What is the angle difference in an average adult skull between the OML and the GML?
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8 degrees
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Skull shape where the petrous ridges project anteriorly and medially at an angle of 47°
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mesocephalic
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Skull shape where petrous ridges form a wider angle with the MSP of 54°
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brachycephalic
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Skull shape where petrous ridges form a more narrow angle with the MSP of 40°
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dolichocephalic
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Are orbits always symmetric in size and shape?
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No
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T/F: Lower jaw is asymmetric
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Yes
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Are nasal bones and cartilage symmetrical or asymmetrical?
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asymmetrical
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Give 2 reasons why the upright image of the skull will increase diagnostic value in order of importance
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(1.) AIR FLUID LEVELS (indicating a basal fracture) and (2.) Part of interest closer to IR (better detail/no air gap or magnification)
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When examining the paranasal sinuses, what should be the patient position?
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Upright
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What is the number one cause of for repeat examinations?
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motion/rotation of patient because they are in an uncomfortable position. <work quickly>
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To prevent lateral recumbent rotation of the patient, make sure the body is ___ to the table
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parallel
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To prevent tilt, make sure the long axis of the C-spine is at the level of the ___ ___ ___.
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mid foramen magnum
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Which two body habitus may need chest elevation for a PA or Oblique skull view?
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asthenic or hyposthenic (unless they have a boob job)
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Which body habitus may need support under the head to keep the IR/part relationship correcton a PA skull?
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hypersthenic (because they are large and in prone position their head may be in the air)
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How do you shield for infants and children when performing any skull/facial bone exam(3 places)?
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1. Thyroid 2. Thymus gland 3. Gonads (shielding the first two also help with immobilization
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What will indicate that there is NO ROTATION on a lateral projection of the skull?
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superimposed orbital plates
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What is the side of interest on a lateral skull? Part closest or farthest from the IR?
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closest
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Lateral Skull: which plane is parallel to the IR?
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MSP
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Name five positioning errors
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1.wrong tube angle
2.tilt 3.excessive flexion 4. excessive extension 5. rotation |
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What is a CLEAR INDICATION of a basal skull fracture?
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air-fluid levels in the nasal sinuses
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Name 3 skull fractures
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basal, depressed, linear
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What focal spot size is used on all skull exams?
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small
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What is the name of the Caldwell projection?
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PA Axial 15°
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What is the name of the Grashey Projection?
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AP Axial (Towne)
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Name the routine views of the skull(there are 4)
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PA 0°, Lateral, PA Axial 15° (Caldwell), AP Axial Towne (Grashey)
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Name the special views of the Skull
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Submentovertex, PA Axial-HAAS, PA Axial 25-30°
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What is the only skull projection that uses a crosswise IR?
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PA Axial 15°
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Enter/Exit point for PA 0° skull
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OcciputGlabella
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Enter/Exit point for Lateral skull
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2” above EAM2”above EAM on other side (SAME)
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Enter/Exit point for PA Axial 15° Caldwell
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OcciputNasion
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Enter/Exit point for AP Axial Towne (Grashey)
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between the 2 frontal tuberositiesforamen magnum
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Enter/Exit point for Submentovertex
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3/4” anterior to EAM between mandiblevertex
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Enter/Exit point for PA Axial HAAS
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1/2” below inion1/2” above nasion
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Enter/Exit point for PA Axial 25-30°
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occiputnasion
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What is the main area to look for on a PA 0° skull exam?
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Frontal bone
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What is the main area to look for on a Lateral Skull?
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Parietal bone
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What is the main area to look for on the skull PA Axial 15° Caldwell?
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frontal bone
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What is the main area to look for on the skull AP Axial Towne (Grashey)?
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occipital bone
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What is the main area to look for on the submentovertex skull projection?
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base of skull
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What is the main area to look for on the PA Axial HAAS?
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occipital bone
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What is the main area to look for on the PA Axial 25-30° skull?
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frontal bone
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What IR size is used for the facial bones?
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8x10
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What IR size is used for the Skull?
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10x12
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Name the 3 routine views of the Facial bones
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1.Lateral, 2.Parietocanthial (Waters), 3.PA Axial (Caldwell)
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Name the 2 Special Views of the facial bones
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1.Acanthioparietal (reverse waters), 2.Modified Parietocanthial (Modified Waters)
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What is the main area to look for on a Lateral Projection of the facial bones?
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superimposed facial bones
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Enter/Exit point on the Lateral Facial bone
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zygomazygoma
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What line is perpendicular to the IR on a Lateral face projection?
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What line is perpendicular to the IR on a Lateral face projection?
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What line is perpendicular to the IR on a Lateral face projection?
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IPL
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What is the only difference between skull and facial projections?
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the entire skull is shown on a skull projection and not on a facial projection (hence the smaller IR size used for facial)
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Which projection will give you an oblique projection of the facial bones?
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parietoacanthial (Waters)
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What is the SID on all Skull and Facial Projections?
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48”
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What are the patient positions used for the parietoacanthial(Waters) view?
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erect or PRONE
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Which projection calls for the neck to be adjusted so that the OML forms a 37° angle with the IR?
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Parietaoacanthial (Waters)
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Which projection calls for the neck to be adjusted so that the OML forms a 55° angle with the IR?
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Modified Parietoacanthial (Modified Waters)
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On the Parietoacanthial (Waters), what LINE should be perpendicular to the IR?
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MML
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On the Parietoacanthial (Waters), what PLANE should be perpendicular to the IR?
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MSP
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Enter/Exit for the Parietoacanthial (waters)
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halfway between occiput and vertexacanthion
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How is the tube angled on the parietoacanthial (Waters) view?
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none, silly
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On the Modified Parietoacanthial (Modified Waters), what LINE should be perpendicular to the IR?
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LML
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On the Modified Parietoacanthial (Modified Waters), what PLANE should be perpendicular to the IR?
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MSP
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Enter/Exit point for Modified Parietoacanthial (Modified Waters)
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occiputacanthion
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How is the tube angled on a Modified Parietoacanthial (Modified Waters)?
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none, silly
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How is the tube angled for the skull PA Axial (Caldwell)?
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15° caudad
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How is the tube angled for the Skull AP Axial Towne (Grashey)?
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30° caudad for the OML or 37°caudad for the IOML
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Is there a tube angulation for the Skull Submentovertex projection?
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usually none UNLESS patient can’t hyperextend the neck
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How is the tube angled for the PA Axial HAAS Skull?
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25° cephalad
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How is the tube angled for the PA Axial 25-30° skull?
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25-30° caudad
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What is the main area of interest on the Modified Parietoacanthial (Modified Waters)?
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orbital floors
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Where are the petrous ridges shown on the Modified Parietoacanthial (Modified Waters)?
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lower ½ of maxillary sinuses
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What type of fractures is does the modified waters method tend to show best?
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blowout fractures (inferior displacement of the orbital floor) note: and maxillary sinuses
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Why has the Modified Waters been nicknamed the “shallow” waters view?
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less extension of the neck is used to increase the angulation of the OML by placing it more perpendicular to the IR (55° angle instead of the regular 37°)
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What is the difference in patient position from the regular waters view when performing the Acanthoparietal (reverse waters)?
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patient is supine rather than prone (TRAUMA)
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Enter/Exit for the Acanthoparietal (reverse waters)
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acanthionmidway between the vertex and the occiput
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Name five function of the sinuses
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1. Resonating chamber for voice, 2. Decrease weight of skull, 3. Warms/moisturizes inhaled air, 4. Acts as shock absorber during trauma, 5. Possibly controls immune system
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Why are we supposed to delay the exposure on the sinuses?
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to ensure fluid has settled in the cavity
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Name the three routine views of the sinuses
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1. Lateral, 2. PA Axial (Caldwell Method), 3. Parietoacanthial (Waters Method)
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Name the two special views of the sinuses
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1. Parietoacanthial (Waters Open-mouth Modification) (PIRIE), 2. Submentovertex
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Which sinuses can be demonstrated at birth?
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maxillary
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Which two sinuses can be radiographed between ages 6-7?
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frontal and sphenoidal
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Which sinuses develop during puberty, but aren’t complete until age 17-18?
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ethmoidal air cells
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What are the largest sinuses?
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maxillary
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Which sinuses are pyramidal in shape?
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maxillary
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The maxillary sinuses appear rectangular on the ___ projection
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lateral
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T/F the maxillary sinuses only have 2 walls
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FALSE they only have 3
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T/F Maxillary sinuses are symmetrical
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true
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What are the second largest sinuses?
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frontal sinuses
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T/F The frontal sinuses are symmetrical
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False they vary considerably in size and form
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Is it possible for a person to not have any frontal sinuses?
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yes
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Is it possible for a person to not have any maxillary sinuses?
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no, everyone has them at birth
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How many ethmoidal sinuses are there?
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2
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Name the ethmoidal air cells
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anterior, middle, posterior
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How many anterior and middle air cells exist in the ethmoid sinses?
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2-8
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The posterior air cells of the ethmoid sinuses vary in number from ___-___ or more?
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2-6
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T/F The sphenoid sinuses are symmetric
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false
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What can overpenetration of the sinuses do?
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diminish/obliterate existing pathologic conditions
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What can underpenetration of the sinuses do?
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trick you into seeing pathologies that DO NOT exist
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Why should the mAs and kVp be carefully balanced?
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to show both soft tissue structures AND the bony ones
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Who pointed out the value of demonstrating the sinuses in the upright position
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Cross and Flecker
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What is respiration for the examination of the skull, facial bones, and sinuses?
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suspend
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What is fluid in the sinuses called?
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exudate
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What is the most effective way to shield a patient from unnecessary radiation?
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collimation
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For facial and skull projections the kVp is at least above 70 (usually between 70-80). What is the kVp range for sinuses?
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60-70 kVp
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Enter/Exit point of the Lateral sinuses
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horizontal) ½-1inch behind outer canthusexit same???
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For pre-op, what is the SID suggested for the lateral sinues and why?
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72 inches; to minimize magnification and distortion
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On the lateral sinuses projection, you can see ALL four sinus groups. Which one of these is the most important
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sphenoidal sinus
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With the PA Axial Sinus (Caldwell method), the OML forms a ___° with the IR or OML is perpendicular and you can tilt the IR ___°.
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15; 15
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What is the main area wanted for the PA Axial sinus (Caldwell method)?
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frontal sinuses (lying superior to the frontonasal suture) and to demonstrate anterior ethmoidal air cells
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What is the goal of the Parietoacanthial Projection of the sinues (waters method)?
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to hyperextend the patient’s neck just enough to place the dense petrosae immediately below the maxillary sinus floors
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What happens if the neck isn’t extended enough for the Parietoacanthial Projection of the sinuses (waters method)?
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the petrosae get projected of the maxillary sinuses and obscure pathological conditions
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What happens if the neck is extended too much for the Parietoacanthial Projection of the sinuses (waters method)?
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the maxillary sinuses are foreshortened and the antral floors are not well demonstrated
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What is most important part sought for the Parietoacanthial Projection of the sinues (waters method)?
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maxillary sinus
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The Parietoacanthial Open-Mouth Waters Method provides an excellent demonstration of the ___ sinuses projected through the ___ ___.
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sphenoidal; open mouth
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The submentovertex projection of the skull uses a 10x12 image receptor. What size IR does the Submentovertex projection of the sinuses use?
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8x10
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What is the main area of interest when imaging the Submentovertex projection of the sinus?
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sphenoid sinus
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what is more important for soft tissue radiography spatial resolution or contrast resolution?
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contrast resolution
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