Chapter 11 Test Flashcards
Occipital
foramen magnum
Inion
Lateral condylar portions
Frontal
Glabella
Superciliary Arch
Sphenoid
Pterygoid hamulus
Anterior Clinoid processes
Foramen ovale
Sella turcicia
Ethmoid
Perpendicular plate
Superior nasal conchae
Cribriform plate
Temporal
Zygomatic process
EAM
Petrous ridge
Linear fracture
Fracture of the skull with jagged or irregular lucent line that lies at a right angle of the axis of the bone.
Paget’s Disease
Condition that begins with bony destruction followed by bony repair.
Depressed Fracture
Tangential view may be helpful to determine extent or degree of this fracture.
Osteolytic neoplasm
Destructive lesion with irregular margin.
Multiple myeoma
Bone tumor originiating in the bone marrow.
Basal fracture
Fracture evident by sphenoid sinus effusion
Which middle ear structures is considered to be most lateral?
Malleus
The aditus is an opening between what?
epitympanic recess and mastoid portion of the temporal bone.e oval window?
Which auditory ossicle attaches to the oval window?
Stapes
Which two projections of the cranium project the dorsum sellae within the foramen magnum?
AP Axial
PA Axial
Nasal bones
Lie just anterior and medial to the frontal process of maxilla.
How much central ray angle is required for the AP axial projection (towne method) for skull with the IOML perpendicular to the image receptor?
37 degrees caudad
How much central ray angle is required for the AP axial projection (towne method) for skull with the OML perpendicular to the image receptor?
30 degrees caudad
Where is the central ray centered for a lateral projection of the cranium?
2 “ superior to the EAM
To prevent tilting of the skull for the lateral projection of the cranium, the _________ line is placed perpendicular to the image receptor.
interpupillary line
Where should the petrous ridges be located (on the image) for a well positioned, 25 degree caudad PA axial (haas method) projection?
Superior to the mastoid processes and symmetrical.
Where is the central ray centered for an SMV projection of the skull?
1.5” inferior to the mandibular symphysis midway between the gonions.
A radiograph of a lateral projection of the cranium reveals that the greater wings of sphenoid are not superimposed. What type of positioning error is present on this radiograph?
Rotation
A radiograph of an AP axial projection for the cranium reveals that the dorsum sellae is projected superior to the foramen magnum. What must be modified during the repeat exposure to correct this problem?
Increase CR angle approximate 7 degrees caudad
A radiographh of a 15 degree caudad PA axial projection of the cranium reveals that the petrous ridges are at the level of the supraorbital margin. Without changing the central ray angle, how must the head position be modified during the repeat exposure to produce a more acceptable image?
Increase extension of the skull to place OML perpendicular to the IR
A patient with a possible basilar skull fracture enters the emergency room. They physician wants a projection to demonstrate a possible sphenoid sinus effusion. Which projection of the cranium is best for this situation?
Horizontal beam lateral skull projection with a 15 degree caphalac angel to the OML
A patient comes to the radiology department for a skull series. Because of the size of the patient’s shoulders, he is unable to flex his neck sufficiently to place the OML perpendicular to the IR for the AP axial projection. His head cannot be raised because of possible cervical trauma. What other options does the technologist have to obtain an acceptable AP axial projection?
Use the IOML (instead of OML), increase angle and add 7 degrees cuadad for a total of 37 degrees.
A radiograph of an AP axial (Town method) projection for cranium reveals that the posterior arch of C1 and dorsum sellae are superimposed. Both are projected into the foramen magnum. What modificaton is needed to correct this error present on the initial radiograph?
decrease CR angle based on the skull line used OML-30 degrees or IOML –37 degrees
A radiograph of a lateral skull demonstrates that the oribital plates (roof) of the frontal bone are not superimposed. What is the positioning error present on this radiograph?
Tilt
A radiograph of a SMV projection of the cranium demonstrates that mandibular condyles are projected into the petrous portion (pyramids) of the temporal bone. How must the position be altered during the repeat exposure to correct his error?
Extend the skull further to place the IOML parallel to the IR.
The majority of the hard plate is formed by
the maxilla
The sphenoid sinus lies directly inferor to the
Sella Turcica
What is the angle between the OML and plane of image receptor with a parietoacanthial (waters method) projection?
This places the _______ positioning line perpendicular to the IR.
37 degrees
MML
The CR is centered to exit at the level of the _________ for a well positioned parietoacanthial projection.
Acanthion
Where are the petrous ridges projected for a properly positioned modified parietoacanthia projection?
lower half of the maxilllary sinuses
The CR should be angled as needed to be parallel to the glabellomeatal line (GML) for the superoinferior tangential projection of the nasal bones.
True
Which positioning line is placed perpendicular to the image receptor for a modified parietoacanthial projection?
Lips Meatal Line (LML)
Where is the CR centered for a lateral projection of the nasal bones?
1/2 inch inferior to the nasion
Where is the CR centered for a lateral projection of the paransal sinuses?
midway between the outer canthius and the EAM
Why should a patient remain in an erect position for at least 5 minutes before sinus radiography?
To allow fluid in the sinuses to settle
Which routine projection is best for demonstrating the maxillary sinuses?
Pareitoananthial (waters) projection
Why should the horizontal CR be used for the erect PA (Caldwell) projection for sinuses rather than the usual 15 degrees caudad angle?
To demonstrate any air/fluid levels w/o distortion
A radiograph of lateral position for sinuses reveals that the greater wings of the sphenoid bone are not superimposed. What specific positioning error is present?
Rotation of the skull
A superinferior, tangential projection for the nasal bones was taken with the following analog exposure factors: 18x24 cm (8x10), IR crosswise, 85 kv, 13 MAS, 40 inch SID. The resultant radiograph was unsatisfactory because of poor visibility of the nasal bones. Which technical factors should be changed for the repeat exposure?
Reduce Kvp to 50 or 60 and increase MAS accordingly
A patient with a clinical history of secondary osteomyelitis comes to the radiology department. Which imaging modalities or procedures can be performed to demonstrate the extend of damage to the sinuses.
Routine radigraphic sinus series or CT if the sinuses can best demonstrate bony erosion.
Special method which requires the skull to be placed in a true lateral position.
Schuller method
Amount of skull rotation from the lateral position toward the IR that is required for the axiolateral oblique projection of the mentum.
45 degrees
Positioning line which ensures adequate extension of the head for the SMV projection, when it is placed perpendicular to the IR
Infraorbitomeatal line (IOML)
Proper CR centering for a lateral projection of the nasal bones
1/2 inch inferior to the nasion
Positioning line which is placed perpendicular to the IR for a modified parietoacanthial projection?
Lips-meatal line (LML)
Positioning line to which the CR should be adjusted parallel for the superinferior projection for the nasal bones
Glabelloalveolar line (GAL)
Location of the petrous ridges for a properly positioned modified waters (modified parietoacanthial) projection.
Lower half of the maxillary sinuses
Structure which is the exit point for the CR on a properly positioned Waters.
Acanthion
Positioning line which is perpendicular to the IR for the parietoacanthial (Waters) projection
Mentomeatal LIne (MML)
Angle between the OML and the IR for the parietoacanthial (Waters) projection
37 degrees
Proper anatomy and location shown for the parietoacanthial (waters) projection
Dense petrous pyramids are projected below the maxillary sinuses
Imaging modality which would best demonstrate bony erosions of the maxillary sinus due to acute sinusities
CT
Modality that can be performed to rule out sinusitis of the sphenoid sinus
Ultrasound
Structure that lies directly superior to the sphenoid sinus
Sella Turcica
Aspect of the ethmoid bone that contains the ethmod air cells
Lateral masses or labrynth
The largest of the paranasal sinuses
Maxillary sinuses
Sinuses which develop during puberty
Ethmodal air cells
Age at which only the frontal and sphenoidal sinuses become distinguishable
6 or 7
Age at which all paranasal sinuses are fully developed
17 years
Paranasal sinuses which communicate with the nasal cavity
All paranasal sinuses communicate with the nasal cavity
The only paranasal sinuses which are not contained within cranial bones
Maxillary sinuses
On average amount of cavities that make up the frontal sinus
1 to 2 sinuses
Best sinus routine for a patient with a possible sphenoid sinus polyp.
Basic-lateral
PA Caldwell,
Parietoacanthial,
SMV Special–PA transoral
Positioning error occuring during a parietoacanthial which shows the petrous ridges just below the maxillary sinuses
No Error shown, petrous ridges should be below the floors of the maxillary sinuses during the waters
Correction to be made during a PA transoral which shows the sphenoid sinus superimposed over the upper teeth and nasal cavity
Increase extension of the head and neck to project the entire sphenoid isnus throught the oral cavity
Positioning error shown during an SMV sinus in which the distance between the mandibular condyles and lateral border of the skull is not equal.
Tilt of the head
Positioning error shown during a parietoacanthial (waters) which the distance between the MSP and the outer orbital margin is not equal
Rotation of the head
Correction to be made durng a PA (Caldwell) sinus x-ray when the petrous ridges are projected into the lower half of the orbits, obscuring the ethmoid sinuses
head and neck must be extended more to project the petrous ridges below the ethmod sinuses
Best radiographic routine for an ER patient with possible fracture of the nasal bones with concern of deviation of the bony nasal septum.
PA Waters, and right and left laterals (superinferior only if requsted)
Correction to be made during a superinferior projection of the nasal bones which shows the glabella superimposed over the nasal bones
Decrease flexion of the head and neck or fix CR angle so GAL (glabelloalveolar line) is parallel to CR
Anatomy best seen with the PA transoral sinus projection
Sphenoid sinus in the oral cavity
Anatomy best seen with the SMV sinus projection
Inferosuperior view of the sphenoid and ethmoid sinuses
Anatomy best seen with the PA Caldwell sinus projection
Best view of the frontal and ethmoid sinuses
Anatomt best seen with the parietoacanthial (waters) projection of the sinuses
maxillary sinuses
Anatomy best seen with the lateral sinus projection
all four paranasal sinuses
Sinuses which are projected through the oral cavity with the PA Axial transoral projection
Sphenoid sinuses
The one major difference in positioning between the PA parietoacanthial (waters) and PA axial transoral projections
The mouth (oral cavity) is open with the PA transoral projection
Proper Cr exit point for both the PA parietoacanthial (waters) and the PA axial transoral (open mouth waters) projection
level of acanthion
Three paranasal sinuses which are demonstrated with an SMV projection of the paranasal sinuses
Sphenoid sinus
Ethmoid sinus
Maxillary sinus
Location of the petrous ridges on a well positioned parietoacanthial projection
just below the maxillary sinuses
Positioning line which is placed perpendicular to the IR for a parietoacanthial (Waters) paranasal sinus projection
Mentomeatal line (MML)
Amount of angel of the OML to the IR for the parietoacanthial (waters) projection
37 degrees
Group of paranasal sinuses which is best demonstrated with a pareitoacanthial (waters) projection
Maxillary
Angle of the OML from horizontal for the erect PA Caldwell sinus projection which will remove the need to angel the CR
15 degrees from horizontal
Paranasal sinuses which are best demonstrated with a PA (Caldwell) projection
Frontal and anterior ethmoid sinuses
Alternate lateral paranasal sinus projection to be taken for a patient who cannot stand
Horizontal x ray beam
Four most commonly performed basic or routine projections for paranasal sinuses
Lateral
PA Caldwell
Parietoacanthial (waters)
SMV—submentovertex
Is secondary osteomyelities caused by a tumor
No
Preferred modality to study soft tissue changes and masses within the sinues
MRI
Modality which can be used to rule out sinusities
Ultrasound exams of the maxillary sinuses
Two conditions which must be met for proper demonstration of any possible air/fluid levels within the sinuses
perform positions erect when possible
horizontal beam
kv range for sinuses
65-80
Amount of rotation from the lateral skull position toward the IR that is required with an axiolateral oblique projection for demonstrating the mentum region
45
Projection that best demonstrates the profile image of the nasal bones and nasal septum
Lateral
Line which the IR should be placed perpendicular for the superinferior projection of the nasal bones
Glabelloalveolar line (GAL)
Proper location of the petrous ridges for a PA waters projection
directly below the maxillary sinuses
Projections for nasal bones which are taken bilaterallyerally
Lateral projections of the nasal bones
Line which is at a 55 angle to the IR and table top during the modified parietoacanthial (modified waters projection)
Orbitomeatal line (OML)
Line which is perpendicular to eh IR during he modified pareitoacanthail (modified waters) projection
lips meatal (LML)
Exit point for the CR during the 15 degrees PA axial (caldwell) projection
nasion
Exit point for the CR during the parietoacanthial (waters) projection
Acanthion
Line which is at a 37 degree angle to the IR and table top durng the parietoacanthial (waters) projection
orbitomeatal line (OML)
Line which is placed perpendicular to the IR for the parietoacanthial (waters) projecton
Mentomeatal line (MML)
CR angle that must be used to project ridges just below the orbital floor with the PA axial (Caldwell) projection
30 degres
two structures that are better visualized on the modified parietoacanthial (waters) as compared with the basic waters method
orbital rims
orbital floors
Name of the winus which will be projected through the open mouth with a PA axial transoral projection
sphenoid
Name of the passageway between the maxillary sinuses and middle nasal meatus
infundibulum
specific location of the frontal sinuses
between the inner and outer tables of the skull, posterior to the glabella
specific aspect of the ethmoid bone which contains the ethmoid sinuses
lateral masses or labrynths
age at which the frontal sinuses usually become aerated
6 years
Name of the sinus which can be affected by an infection of the teeth if the infection travels upward
maxillary
Location or junction at which a deviated nasal septum is most likley to occur
between the septal cartilage and the vomer (pushed laterally to one side)
Name of the structure which divides the nasal cavity into compartments and circulates air coming into the nasal cavities
conchae or turbinates
Soft tissue landmark which is found at the base of the anterior nasal spine
Acanthion
