Chapter 11 (Skull) Flashcards
Which of the following bones makes up an aspect of the floor of the cranium?
a. Temporal
b. Occipital
c. Frontal
d. Parietal
Temporal
How many bones make up the facial bone region?
a. 6
b. 8
c. 12
d. 14
14
Which bony landmark represents the highest level of the facial bone mass?
a. Nasion
b. Acanthion
c. Orbital plates
d. Supraorbital notch
Orbital plates
The widest portion of the cranium is found at the level of the:
a. parietal tubercles.
b. right and left pterion.
c. squamous portion of the temporal bone.
d. external acoustic meatus (EAM).
Parietal tubercles
What is the name of the joint found between the lateral condylar processes of the skull and the atlas of C1?
a. Zygapophyseal joint
b. Intervertebral joint
c. Atlanto-occipital joint
d. Cervico-occipital joint
Atlanto-occipital joint
Which cranial bone articulates with the other seven cranial bones?
a. Parietal
b. Ethmoid
c. Sphenoid
d. None of the options
Sphenoid
The slight depression above each eyebrow is termed the:
a. glabella.
b. supraorbital foramina.
c. supraorbital groove.
d. frontal tuberosity.
Supraorbital groove
Which of the following cranial bones does not articulate with the parietal bone?
a. Frontal
b. Sphenoid
c. Occipital
d. All of the options
All of the options
The left mastoid fontanel becomes the ____ in an adult.
a. left asterion
b. left pterion
c. left bregma
d. squamosal suture
Left asterion
There are a total of ____ fontanels in an infant.
a. four
b. two
c. six
d. eight
Six
The frontal bone articulates with ____ cranial bones.
a. four
b. six
c. two
d. five
Four
Which of the following landmarks corresponds with the level of the petrous ridge?
a. EAM
b. Top of ear attachment (TEA)
c. Squamosal suture
d. Inion
Top of ear attachment (TEA)
The pituitary gland (hypophysis cerebri) is associated with and protected by the ____ bone.
a. temporal
b. ethmoid
c. palatine
d. sphenoid
Sphenoid
Which cranial bone contains the foramen ovale?
a. Sphenoid
b. Occipital
c. Ethmoid
d. Temporal
Sphenoid
Which cranial bone contains the cribriform plate?
a. Sphenoid
b. Occipital
c. Temporal
d. Ethmoid
Ethmoid
Which of the following sutures separates the parietal from the occipital bone?
a. Squamosal
b. Sagittal
c. Coronal
d. Lambdoidal
Lambdoidal
Which of the following terms describes the anterior fontanel found in the adult skull?
a. Bregma
b. Pterion
c. Asterion
d. Lambda
Bregma
Which of the following terms describes the small irregular bones occasionally found in the sutures?
a. Asterion
b. Wormian
c. Sesamoid
d. Squamosal
Wormian
The ethmoid notch is part of which cranial bone?
a. Temporal
b. Ethmoid
c. Sphenoid
d. Frontal
Frontal
Which of the fontanels is the last to close at about 18 months of age?
a. Sphenoid
b. Mastoid
c. Anterior
d. Posterior
Anterior
An average-shaped skull with a 47-degree angle between the petrous pyramids and the midsagittal plane is classified as:
a. mesocephalic.
b. brachycephalic.
c. dolichocephalic.
d. morphocephalic.
Mesocephalic
An axiolateral oblique projection (modified Law method) for the temporomandibular joints on a brachycephalic type of skull would require ____ rotation as compared with an average-shaped skull.
a. more
b. less
c. the same
d. rotation depends on the patient’s age
less
Which term describes the small flap of cartilage covering the opening to the ear?
a. Tragus
b. Pinna
c. Acanthion
d. EAM
Tragus
What is the difference, in degrees, between the infraorbitomeatal and orbitomeatal lines?
a. 10 degrees
b. 15 to 22 degrees
c. 7 to 8 degrees
d. 20 to 25 degrees
7 to 8 degrees
Which one of the following technical considerations is most critical for demonstrating air and/or fluid levels within the cranium?
a. Low kVp range
b. Detail image receptor (IR)
c. Short exposure time
d. Erect or horizontal x-ray beam positioning
Erect or horizontal x-ray beam positioning
A radiograph of an anteroposterior (AP) axial projection of the cranium reveals that the dorsum sellae is projected below the foramen magnum, but the posterior arch of C1 is visible within the foramen. Which of the following positioning errors led to this radiographic outcome?
a. Excessive central ray (CR) angulation
b. Insufficient CR angulation
c. Insufficient flexion of the head and neck
d. Tilt of the skull
Excessive central ray (CR) angulation
Which one of the following positioning errors most often results in a repeat exposure of a cranial position?
a. Incorrect rotation and tilt
b. Incorrect central ray placement
c. Slight flexion
d. Slight extension
Incorrect rotation and tilt
A radiograph of a posteroanterior (PA) axial projection (Caldwell method) of the cranium reveals that the petrous ridges are located at the level of the lower one-third of the orbits. The technologist performed this projection with the CR angled 15-degree caudad to the orbitomeatal line (OML). How must positioning be altered if a repeat exposure is performed?
a. Increase the extension of the skull.
b. Increase the flexion of the skull.
c. Increase the CR angulation.
d. None of the options; positioning was correct.
None of the options; positioning was correct.
A radiograph of a submentovertex projection of the cranium reveals that the mandibular mentum are projected into the ethmoid sinuses. What must be altered during the repeat exposure to produce a more diagnostic radiograph?
a. Increase the extension of the skull.
b. Increase the flexion of the skull.
c. Decrease the CR angulation.
d. None of the options; it is an acceptable image.
Increase the extension of the skull
A radiograph of a lateral projection of the cranium reveals that the orbital roofs (plates) are not superimposed—one is slightly superior to the other. Which of the following positioning errors led to this radiographic outcome?
a. Rotation
b. Tilt
c. Excessive flexion
d. Excessive extension
Tilt
A radiograph of a lateral cranium reveals that the mentum of the mandible was cut off from the bottom of the radiograph. A 10 × 12-inch (24 × 30-cm) IR was used, and it was placed landscape. What must be altered if a repeat exposure is performed?
a. Center the CR at the EAM.
b. Increase SID to reduce magnification.
c. Place the 10 × 12-inch (24 × 30-cm) IR portrait.
d. None of the options; all of the critical structures were demonstrated.
None of the options; all of the critical structures were demonstrated
A patient comes to radiology for a routine study of the cranium. He is unable to flex his head and neck sufficiently to place the OML perpendicular to the IR for the AP axial projection. What should the technologist do to compensate for this problem without creating excessive magnification of the occipital bone?
a. Place the IOML parallel to IR and increase the CR angulation by 7 degrees.
b. Perform the Haas method.
c. Perform a submentovertex projection in place of the AP axial projection.
d. Use the AML and increase the CR angulation by 10 degrees.
Place the IOML parallel to IR and increase the CR angulation by 7 degrees
A patient enters the emergency department (ED) with a possible basilar skull fracture. Which of the following skull projections would best demonstrate any blood present in the sphenoid sinus?
a. AP with a 15-degree cephalic angle
b. Haas method
c. Submentovertex
d. Horizontal beam lateral projection
Horizontal beam lateral projection
A patient comes to radiology with a history of a possible erosion of the superior orbital fissures. Which of the following projections would best demonstrate this structure?
a. PA axial with a 15-degree caudad angle to OML
b. Submentovertical
c. PA axial with a 25- to 30-degree caudad angle to OML
d. AP axial with a 37-degree caudad angle to OML
PA axial with a 25-to 30- degree caudad angle to OML
A patient comes to radiology with a possible bone cyst within the squamous portion of the frontal bone. Which of the following projections would best demonstrate this region with a minimal amount of distortion of the frontal bone?
a. AP axial with a 30-degree caudad angle to OML
b. PA axial with a 30-degree caudad angle to OML
c. PA axial with a 15-degree caudad angle to OML
d. PA with no CR angulation to OML
PA with no CR angulation to OML
A PA axial projection with a 25-degree caudad angle of the cranium reveals that the petrous ridges are at the level of the superior orbital margins. Which of the following modifications is required to correct this error?
a. Decrease CR angle.
b. Increase extension of cranium.
c. Increase flexion of cranium.
d. No corrections are required; this is an acceptable position.
Increase extension of cranium
Which one of the following cranial projections will best demonstrate a possible basilar fracture?
a. PA axial (Caldwell method)
b. Lateral recumbent
c. Horizontal beam lateral
d. AP axial (Towne method)
Horizontal beam lateral
Which positioning line should be perpendicular to the plane of the IR for the AP axial (Towne) projection with a 37-degree caudad CR angle?
a. OML
b. IOML
c. AML
d. LML
IOML
Which division of the temporal bone contains the organs of hearing and equilibrium?
a. Petrous
b. Mastoid
c. Squamous
d. Antrum
Petrous
Which one of the following structures is part of the middle ear?
a. Tragus
b. Cochlea
c. Ossicles
d. Vestibule
Ossicles
To which aspect of the ear does the eustachian tube attach?
a. External ear
b. Middle ear
c. Inner ear
d. Cochlea
Middle ear
The aditus is defined as a(n):
a. large chamber containing the mastoid air cells.
b. thin plate of bone separating the mastoid air cells from the brain.
c. passageway for the auditory nerve.
d. opening between the epitympanic recess and the mastoid air cells.
Opening between the epitympanic recess and the mastoid air cells
The mastoid air cells communicate with the:
a. inner ear.
b. middle ear.
c. external ear.
d. base of the brain.
middle ear
Which of the following structures of the inner ear is responsible for hearing?
a. Vestibule
b. Semicircular canals
c. Cochlea
d. Round window
Cochlea
Where is the CR centered for a lateral projection of the cranium?
a. EAM
b. 3/4-inch (2-cm) anterior and 3/4-inch (2-cm) superior from EAM
c. 2-inch (5-cm) superior to EAM
d. Midway between EAM and nasion
2-inch (5 cm) superior to EAM
Which cranial bone possesses the sella turcica?
a. Temporal
b. Sphenoid
c. Ethmoid
d. Occipital
Sphenoid
Which cranial bone possesses the superior nasal conchae?
a. Ethmoid
b. Sphenoid
c. Frontal
d. Temporal
Ethmoid
Which cranial bone possesses the zygomatic process?
a. Frontal
b. Sphenoid
c. Temporal
d. Ethmoid
Temporal
Which of the following modalities best demonstrates early signs of Paget disease of the skull?
a. CT
b. Nuclear medicine
c. MRI
d. Sonography
Nuclear medicine
A patient comes to radiology with a clinical history of an acoustic neuroma. Which of the following imaging modalities will provide the best assessment for this tumor?
a. Radiography
b. Ultrasound
c. Nuclear medicine
d. MRI
MRI
A patient comes to radiology with acute mastoiditis. Which one of the following imaging modalities will best demonstrate possible bony destruction within the mastoid region?
a. CT
b. Nuclear medicine
c. Ultrasound
d. PET
CT
A patient comes in with a clinical history of a possible pituitary adenoma. Because this is a rural hospital, CT and MRI are not available. Which radiographic projection or position of the cranium would best demonstrate signs of bony erosion of the sella turcica because of the tumor?
a. SMV
b. PA axial (Caldwell method)
c. Lateral position
d. Both SMV and lateral position
Lateral position
What is the largest immovable bone of the face?
a. Vomer
b. Mandible
c. Maxilla
d. Zygomatic
Maxilla
Which facial bone forms the majority of the hard palate?
a. Mandible
b. Palatine
c. Maxilla
d. Zygomatic
Maxilla
Which three cranial bones articulate directly with the zygomatic bone?
a. Frontal, ethmoid, temporal
b. Frontal, sphenoid, temporal
c. Sphenoid, frontal, occipital
d. Ethmoid, parietal, frontal
Frontal, sphenoid, temporal
Which of the following terms describes the junction of the two nasal bones?
a. Nasion
b. Acanthion
c. Glabella
d. Supraorbital groove
Nasion
Which of the following structures is described as scroll-like projections found in the nasal cavity?
a. Perpendicular plate
b. Pterygoid processes
c. Septal cartilage
d. Conchae
Conchae
Which two bones form the bony nasal septum?
a. Superior and inferior nasal conchae
b. Ethmoid and vomer
c. Vomer and maxilla
d. Sphenoid and ethmoid
Ethmoid and vomer
The upper and lower teeth are embedded in the:
a. symphysis menti.
b. condyloid processes.
c. palatine processes.
d. alveolar processes.
Alveolar processes
The point of union between both halves of the mandible is termed:
a. gonion.
b. ramus.
c. symphysis menti.
d. mental foramina.
Symphysis menti
What primary type of joint movement occurs with the temporomandibular joint?
a. Plane
b. Gomphosis
c. Spheroidal
d. Bicondylar
Bicondylar
What is the classification of the joint found between the teeth and maxilla?
a. Synovial
b. Fibrous
c. Cartilaginous
d. Synarthrodial
Fibrous
The posterior aspect of the orbit is termed the:
a. apex.
b. base.
c. sphenoid strut.
d. crown.
Apex
How many facial bones help make up the bony orbit?
a. Three
b. Four
c. Five
d. Seven
Four
What is the only paranasal sinus not contained within a cranial bone?
a. Maxillary
b. Sphenoid
c. Ethmoid
d. Frontal
Maxillary
The term antrum of Highmore is an older term for the:
a. frontal sinuses.
b. ethmoid sinuses.
c. maxillary sinuses.
d. nasal cavity.
Maxillary sinuses
Which sinus often produces an air/fluid level indicating a basilar skull fracture?
a. Ethmoid
b. Maxillary
c. Sphenoid
d. Frontal
Sphenoid
Where are the ethmoid sinuses located within the ethmoid bone?
a. Perpendicular plate
b. Pterygoid processes
c. Cribriform plate
d. Lateral masses
Lateral masses
The ____ passageway drains the maxillary sinus into the middle nasal conchae.
a. ethmoid bulla
b. infundibulum
c. uncinate process
d. inferior nasal concha
Infundibulum
The ____ sinuses develop last and are not fully developed until the teenage years.
a. ethmoid
b. sphenoid
c. nasal
d. maxillary
Ethmoid
Which bone is involved with a tripod fracture?
a. Maxilla
b. Ethmoid
c. Temporal
d. Zygomatic
Zygomatic
A fracture involving the facial bones where a blow to one side causes a fracture to the opposite side is termed a ____ fracture.
a. tripod
b. blow-out
c. Le Fort
d. contrecoup
Contrecoup
Which of the following imaging modalities is utilized to determine the degree of skeletal metastases especially in the cranium?
a. CT
b. MRI
c. Nuclear medicine
d. Radiography
Nuclear medicine
Where is the CR centered for a lateral projection of the facial bones?
a. Outer canthus
b. Acanthion
c. Midway between the glabella and the EAM
d. Zygoma, midway between the EAM and the outer canthus
Zygoma, midway between the EAM and the outer canthus
What is the angle between the OML and the plane of the IR for the parietoacanthial (Waters) projection?
a. 40 degrees
b. 37 degrees
c. 42 degrees
d. 15 to 20 degrees
37 degrees
Where does the CR exit for a modified parietoacanthial (modified Waters) projection of the facial bones?
a. Nasion
b. Glabella
c. Acanthion
d. Midorbits
Acanthion
Which of the following technical factors do NOT apply to lateral nasal bone projections?
a. The technologist should not use automatic exposure control (AEC).
b. The technologist should use a small focal spot.
c. The technologist should use medium kVp.
d. All of the options.
All of the options
Which positioning line is placed perpendicular to the plane of the IR with a true lateral nasal bone projection?
a. OML
b. AML
c. Interpupillary
d. Midsagittal
Interpupillary
Which of the following projections will best demonstrate deviation of the bony nasal septum?
a. Parietoacanthial
b. Lateral nasal bone
c. AP axial projection
d. Lateral facial bone
Parietoacanthial
The CR must be placed parallel to the ____ positioning line for the superoinferior tangential (axial) projection of nasal bones.
a. glabellomeatal
b. mentomeatal
c. lips-meatal
d. glabelloalveolar
Glabelloalveolar
How much skull tilt and rotation are required for the oblique inferosuperior (tangential) projection for zygomatic arches?
a. 10 degrees
b. 15 degrees
c. 25 degrees
d. None of the options
15 degrees
What can the technologist do if the patient cannot extend the head and neck adequately for the routine submentovertical projection of the zygomatic arches?
a. Perform the Haas method.
b. Use a short SID to magnify the arches.
c. Angle the CR to place it perpendicular to the IOML.
d. Rotate the skull 15 degrees away from the affected side.
Angle the CR to place it perpendicular to the IOML
Which positioning line is parallel to the IR for the oblique inferosuperior (tangential) projection of the zygomatic arches?
a. Midsagittal plane
b. Infraorbitomeatal
c. Orbitomeatal
d. Glabelloalveolar
Infraorbitomeatal
Which of the following points is NOT true about the oblique inferosuperior (tangential) projection of the zygomatic arches?
a. It requires both rotation and tilt of the skull.
b. A small focal spot should be used.
c. The AEC should not be used.
d. A grid must be used.
A grid must be used
How much difference is there between the OML and IOML positioning lines?
a. 7 to 8 degrees
b. 8 to 9 degrees
c. 10 to 11 degrees
d. 5 to 6 degrees
7 to 8 degrees
Which projection best demonstrates the floor of the orbits with minimal distortion?
a. Parietoacanthial (Waters)
b. Modified parietoacanthial (modified Waters)
c. PA axial (Caldwell)
d. Lateral facial bones
Modified parietoacanthial (modified Waters)
Which positioning line must be used with a 30-degree caudad angle for an AP axial projection of zygomatic arches?
a. IOML
b. AML
c. OML
d. GAL
OML
What is the angle between the midsagittal plane and the plane of the IR for a parieto-orbital oblique (Rhese method) projection of the optic foramen?
a. 45 degrees
b. 12 degrees
c. 30 degrees
d. 53 degrees
53 degrees
Which positioning line is placed perpendicular to the IR for the parieto-orbital oblique (Rhese method) projection of the optic foramina?
a. OML
b. AML
c. MML
d. IOML
AML
What is the maximum CR angulation used for the axiolateral/axiolateral oblique projection of the mandible?
a. 10 to 15 degrees
b. 25 degrees
c. 30 degrees
d. 45 degrees
25 degrees
How much skull rotation (from a lateral position) is required to place the ramus parallel to the IR for the axiolateral/axiolateral oblique projection of the mandible?
a. None. The skull should be kept in a lateral position.
b. 30 degrees
c. 45 degrees
d. 53 degrees
None. The skull should be kept in a lateral position
Why is the chin extended for an axiolateral/axiolateral oblique projection of the mandible?
a. To open up the TMJ
b. To profile the condylar process
c. To prevent superimposition upon the cervical spine
d. To better visualize the mentum
To prevent superimposition upon the cervical spine
Where does the CR exit for the optional PA axial projection of the mandible?
a. Junction of the lips
b. Nasion
c. Mentum
d. Acanthion
Acanthion
Which positioning line is perpendicular to the IR for a PA projection of the mandible?
a. OML
b. AML
c. IOML
d. GAL
OML
Which aspect of the mandible is best demonstrated with an AP axial projection?
a. Body
b. Mentum
c. Ramus
d. Condyloid process
Condyloid process
Where is the CR centered for an AP axial (Towne method) projection for the mandible?
a. At the nasion
b. 2-inch (5 cm) superior to glabella
c. 1-inch (2.5 cm) superior to glabella
d. At the mentum
1-inch (2.5 cm) superior to glabella
Which of the following projections will best demonstrate the entire mandible with one exposure?
a. AP axial
b. Submentovertical
c. Axiolateral oblique
d. Tomography
Submentovertical
What CR angle is required for the AP axial projection for the temporomandibular joints (TMJs) with the IOML perpendicular to the image receptor?
a. 30 degrees
b. 37 degrees
c. 25 degrees
d. 42 degrees
42 degrees
The axiolateral oblique projection (modified Law method) for TMJs requires a ____ rotation of the skull and a ____ caudad angle of the CR.
a. 15-degree; 15-degree
b. 10-degree; 15-degree
c. 5-degree; 0-degree
d. 0-degree; 25- to 30-degree
15-degree; 15-degree
What is the position of the skull for an axiolateral projection (Schuller method) of the TMJ?
a. Midsagittal plane at a 53-degree angle to the image receptor
b. Skull rotated 15 degrees toward the IR from the lateral position
c. True lateral position
d. OML is at a 37-degree angle to the image receptor
True lateral position
What CR angle is required for the axiolateral (Schuller method) projection of the TMJs?
a. None. The CR should be perpendicular to the film
b. 25- to 30-degree caudad
c. 15-degree caudad
d. 20- to 25-degree cephalad
25- to 30- degree caudad
Where should the optic foramen be located with a well-positioned parieto-orbital oblique (Rhese method) projection of the optic foramina?
a. Inner, lower quadrant of orbit
b. Center of orbit
c. Lower, outer quadrant of orbit
d. Inner, upper quadrant of orbit
Lower, outer quadrant of orbit
Along with the use of erect positions, what other technical factor is important to demonstrate air/fluid levels in paranasal sinuses?
a. Use of high kVp
b. Horizontal CR
c. Use of IR without a grid
d. Large focal spot
Horizontal CR
Where is the CR centered for a lateral projection of the sinuses?
a. Upside EAM (side away from image receptor)
b. At the level of the nasion
c. Midway between the acanthion and the EAM
d. Midway between the outer canthus and the EAM
Midway between the outer canthus and the EAM
Which sinuses are best demonstrated with the PA axial projection?
a. Maxillary and sphenoid
b. Frontal and ethmoid
c. Sphenoid and ethmoid
d. Frontal and maxillary
Frontal and ethmoid
Which sinuses are best demonstrated with a parietoacanthial (Waters) projection?
a. Maxillary
b. Frontal and maxillary
c. Frontal, maxillary, and ethmoid
d. Sphenoid and maxillary
Maxillary
Which plane or perspective is most often produced for a CT scan of the sinuses?
a. Sagittal
b. Transverse
c. Coronal
d. Axial oblique
Coronal
Which sinus is projected through the oral cavity with a parietoacanthial transoral (transoral Waters) projection?
a. Ethmoid
b. Maxillary
c. Sphenoid
d. Frontal
Sphenoid
A radiograph of a lateral projection of the facial bones reveals that the mandibular rami are not superimposed. What specific positioning error is present on this radiograph?
a. Tilt
b. Excessive flexion
c. Excessive extension
d. Rotation
Rotation
The recommended digital systems kVp range for the superoinferior tangential (axial) projection of the nasal bones is:
a. 40 to 50.
b. 50 to 60.
c. 70 to 80.
d. 75 to 85.
70 to 80
How much skull rotation, from a lateral position, is recommended to best demonstrate the body of the mandible for an axiolateral/axiolateral oblique projection?
a. None. Keep skull in true lateral position
b. 10 to 15 degrees toward the IR
c. 30 degrees toward the IR
d. 45 degrees toward the IR
30 degrees toward the IR
A radiograph of a parietoacanthial (Waters method) projection reveals that the petrous ridges are superimposed over the lower 30% of the maxillary sinuses. What specific positioning error (if any) led to this radiographic finding?
a. Insufficient extension of skull and neck
b. Excessive extension of skull and neck
c. Excessive CR angulation
d. No error exists; accept the initial radiograph
Insufficient extension of skull and neck
A radiograph of a PA Caldwell (15-degree caudad) projection for cranium reveals that the petrous ridges are projected into the lower one-third of the orbits. Which of the following modifications should be made during the repeat exposure to produce a more diagnostic image?
a. Increase the extension of the head and neck.
b. Decrease the extension of the head and neck.
c. Nothing; accept the initial radiograph.
d. Angle the CR 10-degree caudad.
Nothing; accept the initial radiograph
A radiograph of a parieto-orbital oblique (Rhese method) projection for the optic foramen reveals that the optic foramen is projected below the inferior orbital margin. Which of the following modifications is necessary to produce a more diagnostic image?
a. Decrease the extension of the head and neck.
b. Increase the extension of the head and neck.
c. Increase the CR angulation.
d. Decrease the CR angulation.
Decrease the extension of the head and neck
A radiograph of an axiolateral oblique projection of the mandible reveals that the mandibular body is greatly foreshortened. Which of the following modifications is necessary to produce a more diagnostic image?
a. Increase the rotation of skull toward the image receptor.
b. Decrease the rotation of skull toward the image receptor.
c. Decrease the CR angulation.
d. Increase the CR angulation.
Increase the rotation of skull toward the image receptor
A patient enters the ED with facial bone injuries. The physician is concerned about a possible blow-out fracture of the left orbit. Which one of the following projections would best diagnose this injury?
a. Parietoacanthial (Waters method) projection
b. Submentovertical projection
c. Superoinferior (tangential) projection
d. Modified parietoacanthial (modified Waters) projection
Modified parietoacanthial (modified Waters) projection
A patient enters the ED with a possible nasal bone fracture. The physician is concerned about a possible bony nasal septum deviation and fractured nasal bones. Which of the following routines would best diagnose these injuries?
a. 15-degree PA Caldwell and lateral facial bone projections
b. Parietoacanthial, lateral nasal bone, and superoinferior (axial) projections
c. Modified parietoacanthial and lateral nasal bone projections
d. Modified parietoacanthial, submentovertex, and oblique-axial projections
Parietoacanthial, lateral nasal bone, and superinferior (axial) projections
A patient enters the ED with a possible fracture of the right zygomatic arch. Which of the following routines would best diagnose a possible fracture of this structure?
a. Submentovertical, parietoacanthial, and bilateral tangential superoinferior
projections
b. Parietoacanthial, parieto-orbital, and lateral facial bone projections
c. Modified parietoacanthial, 15-degree PA Caldwell, and lateral facial bone
projections
d. Submentovertical, oblique inferosuperior (tangential), and AP axial (Towne
method) projections
Submentovertical, oblique inferosuperior (tangential), and AP axial (towne method) projections
A patient enters the ED with a possible fracture of the proximal ramus of the mandible. Which of the following routines would best diagnose this fracture?
a. Parietoacanthial projection, axiolateral oblique projection with a 30-degree skull rotation toward IR, and lateral facial bone projection
b. PA mandible projection, axiolateral oblique projection with a 45-degree skull rotation toward IR, and 35-degree AP axial projection
c. PA axial mandible projection, axiolateral projection with no skull rotation, and a 35-degree AP axial projection
d. PA mandible projection, axiolateral oblique projection with a 45-degree skull rotation toward IR, and submentovertex projection
PA axial mandible projection, axiolateral projection with no skull rotation, and a 35-degree AP axial projection
A radiograph of a PA projection of the sinuses reveals that the petrous ridges are projected over the ethmoid sinuses. Which of the following modifications will eliminate this superimposition while not compromising diagnostic quality of the study?
a. Increase extension of the head and neck slightly.
b. Angle the CR 5- to 10-degree caudad.
c. Increase flexion of the head and neck slightly.
d. Have the patient open his mouth.
Increase extension of the head and neck slightly
A radiograph of a parietoacanthial (Waters) projection for sinuses reveals that the petrous pyramids are projected into the maxillary sinuses. What positioning error is present on this radiograph?
a. Excessive flexion of head and neck
b. Excessive extension of head and neck
c. Excessive CR angulation
d. Rotation of the head
Excessive flexion of head and neck
A radiograph of a submentovertical projection reveals that the mandible is superimposed over the ethmoid and sphenoid sinuses. Which of the following modifications will eliminate this problem?
a. Perform the projection with the patient supine.
b. Perform the axiolateral oblique instead of the submentovertical projection.
c. Increase the flexion of the head and neck.
d. Increase the extension of the head and neck.
Increase the extension of the head and neck
A radiograph of a parietoacanthial transoral (open mouth Waters) projection reveals that the mouth is open but the sphenoid sinus is superimposed over the maxilla and upper teeth. What positioning error led to this radiographic outcome?
a. Insufficient flexion of the head and neck
b. Excessive CR angulation
c. Insufficient CR angulation
d. Insufficient extension of the head and neck
Insufficient extension of the head and neck
A patient comes to radiology for a sinus series on a cart (gurney). She is unable to stand or sit erect for any of the projections. Which of the following projections will best detect any air/fluid levels present in the maxillary sinuses?
a. PA
b. Parietoacanthial
c. Parietoacanthial transoral
d. Horizontal beam lateral
Horizontal beam lateral
A patient comes to radiology for a sinus series. She cannot fully extend her head and neck for the submentovertical projection. What else can the technologist do to produce a diagnostic submentovertical projection?
a. Angle the CR to place it perpendicular to the OML.
b. Angle the CR to place it perpendicular to IOML.
c. Perform the projection with the patient recumbent.
d. Place sandbags on the forehead to extend the skull.
Angle the CR to place it perpendicular to IOML
The pathway of communication between the frontal, maxillary, and ethmoid sinuses that provides drainage between them is termed:
a. paranasal meatus.
b. osteomeatal complex.
c. labyrinths.
d. lateral chambers.
Osteomeatal complex
The most common radiographic sign for secondary osteomyelitis of the paranasal sinuses is:
a. polyps.
b. mucosal thickening.
c. deviation of the bony nasal septum.
d. erosion of the bony margins.
Erosion of the bony margins
A pediatric patient enters radiology for a paranasal sinus series. Because of her age, the child is unable to hold still for the projections even with the use of immobilization devices. The decision is to hold the child during each exposure. Which of the following individuals should be asked to hold the child?
a. Technologist
b. Erring physician
c. Guardian
d. Student
Guardian
Which of the following structures passes through the superior orbital fissure?
a. Optic nerve
b. Olfactory nerve
c. Cranial nerves III to VI
d. Maxillary branch of the fifth cranial nerve
Cranial nerves III to VI
