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D2: 621 Radiology > Exam 1.12: Panographic Radiology Viewing and Evaluating > Flashcards

Exam 1.12: Panographic Radiology Viewing and Evaluating Flashcards

1
Q

What should you do to create an environment suitable for reading a pan?

A

Viewbox with strong illumination and reduced ambient light

Hot spot, magnifying glass, and hood are helpful too

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2
Q

What order should you evaluate in?

A

Bone structures
Soft Tissue Shadows
Air spaces

Teeth are last

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3
Q

What is the first bony structure to evaluate

A

Right Coronoid Process

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4
Q

How might the coronoid process appear in relation to the zygomatic arch

A

Inferior, Superimposed, or slightly above

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5
Q

How do you know if the coronoid process is usually tall

A

If it is more than 1 cm above the midpoint of the superior border of the arch

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6
Q

What is the term for a tall coronoid arch?

A

Coronoid hyperplasia

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7
Q

What type of movement is hindered by coronoid hyperplasia?

A

Anteriomedial translatory…..patient has trouble fully opening mouth

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8
Q

What can be suspected if the coronoid hyperplasia is only on one side?

A

Osteochondroma

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9
Q

What patients will you see bilateral coronoid hyperplasia on?

A

Teen males thanks to excess growth hormone receptors on coronoid process

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10
Q

This appears as a semilunar rarefaction just below and medial to the sigmoid notch.

A

Medial sigmoid depression

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11
Q

What do you examine after the coronoid process?

A

The condylar head of the mandible

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12
Q

How might you determine if bone pathology is due to a break or inflammatory disease?

A

A break would include damage to the cancellous bone

Inflammatory disease would be limited to the cortical bone

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13
Q

If you see cortical rim degeneration and the patient’s blood work has elevated RA factor, IgM, and erythrocyte sedimentation rate, what would you suggest is the problem?

A

Rheumatoid arthritis

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14
Q

What fibrous structure covers the articular surfaces of the joint in RA?

A

A pannus

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15
Q

What does the pannus have that physically destroys the joint surfaces and cartilage?

A

The pannus is filled with macrophages, proteases, and collagenases

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16
Q

If too much of the condylar head is resorbed, it leaves a sharp residual shape…what often occurs next

A 
Perforation of the disk
Crepitus
Fibrous adhesions
Bony ankylosis
Open bite
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17
Q

What are two rare causes of the condylar degeneration in patient’s without RA?

A

Regional spread of a parotid gland cancer

Primary osseous or cartilaginous neoplasm

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18
Q

If we are talking about osteoarthritis as opposed to RA, in what direction would we expect to see the remodeling progressing

A

Anteromedially

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19
Q

Once the condylar head has flattened enough, what anatomic feature will be visible?

A

Osteophyte, aka bone spur

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20
Q

How will subchondral cysts show up on the image

A

small ovoid RLs just beneath the cortical rim

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21
Q

Where might sclerosis be found in an osteoarthritic TMJ

A

On the condylar head and/or the temporal bone

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22
Q

What is it called when an osteophyte breaks loose

A

Loose bodies

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23
Q

How do you treat osteoarthritis patients with no pain?

A

You don’t.

With pain you give them a condylar shave procedure

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24
Q

What is the condylar fovea

A

Large ovoid RL on the medial aspect of condyle
Not all patients have this
Just means that the bone is thinner here and attenuated less radiation

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25
Q

What direction is more common for bifid condyles

A

Mediolateral

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26
Q

What section of the mandible do we look at after the condylar head?

A

Cortical border starting by moving down the right ramus around the inferior border, and up to the left condyle looking for fractures

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27
Q

What is the first thing you need to determine if you see a jaw fracture?

A

Its age

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28
Q

For the first 4-6 weeks post-fractures what can you see

A

Only the RL fracture line

29
Q

5-6 weeks post fracture what can you see

A

Fuzzy organic callus RP superimposed over the fracture line

30
Q

How long does it takes for the callus to completely remodel and disappear from the radiograph

A

1 year

31
Q

What happens if the fracture lines in the buccal and lingual corticies do not superimpose?

A

It will look like there are two fractures when there is actually only 1

32
Q

What is a greenstick fracture

A

One corex that is broken and one which is bent

33
Q

What is a communited fracture

A

One in which the bone is shattered

34
Q

What percent of jaw fractures are compound?

A

75%

35
Q

Besides the mucosa, what tissue can the fracture involve that would make it compound?

A

PDL

36
Q

What is required in order to properly treat compound fractures?

A

Prophylactic ABX in order to prevent osteomyelitis

37
Q

What is the most common part of the jaw for a fracture?

A

Body

Middle of body is slightly more common than posteror

38
Q

What is the least common part of the mandible to get fractured?

A

Condyle

39
Q

What can masseteric hypertrophy, gum chewing, or parafunctional habits cause in the mandible?

A

Antegonial notch

40
Q

Where is the lingula normally located

A

opposite the occlusal surface of the second molars

but sometimes it is superior to this position, good to know for nerve block administration

41
Q

When would third molar extraction be expected to cause at least temporary parasthesia?

A

If it is causing downward displacement of the mandibular canal

42
Q

Most IAN nerve fibers exit out of the mental foramen, where do the rest exit?

A

They continue anteriorly and exit at the lingual foramen between the genial tubercles

43
Q

What is another name for a lingual submandibular salivary gland depression

A

Staphne defect

44
Q

What does a staphne defect look like on the pan

A 
Well defined
Ovoid
Unilocular Radiolucency
Inferior to mand. canal
Near angle of mandible
45
Q

What thin, fuzzy, trabeculae with affected lamina dura indicate?

A

Osteopenic pattern, refer to physician

46
Q

The RL caused by the external auditory meatus should be just lateral to what bony structure?

A

Condylar head

47
Q

What bony structure that is just medial to the condyle should not be mistaken for a fracture?

A

Zygomatico-temporal suture

48
Q

What does a zygomatic air cell defect look like

A

Uni or multiocular RL in the articular eminence of the distal half of the zygomatic arch

49
Q

Upside down teardrop shaped radiolucency adjacent to the lateral border of the maxillary sinus

A

Pterygomaxillary fissure

50
Q

Erosion of the corticies of the pterygomaxillary fissure indicates what

A

Pharyngeal malignancy

51
Q

Two triangular RPs inferior to the pterygomaxillary fissure and superimposed over the coronoid process of the mandible

A

Pterygoid plates

52
Q

A RP spiny structure just lateral to the maxillary tubersoity, and this is best appreciated radiographically if the area is edentulous

A

Hamular process

53
Q

What do the two RP lines in the inferior orbit represent?

A

Infraorbital canal

54
Q

Vertical band of bone immediately medial to the pterygomaxillary fissure

A

Malar process of the zygoma

55
Q

Why does the lateral 1/3 of the maxillary sinus always appear more opaque than the medial 2/3?

A

Because the malar process of the zygoma is always superimposed over it

56
Q

Which wall of the maxillary sinus is not well visualized on a pan?

A

Posterior

57
Q

What should the antrum of the maxillary sinus be evaluated for?

A

Degree of pneumatization vs. opacification

58
Q

This linear horizontal RP is superimposed over the midportion of the maxillary sinuses and over the nose

A

Hard palate

59
Q

Eagle’s Syndrome or Carotid Artery Syndrome require treatment for….

A

Calcified Stylohyoid ligaments

60
Q

This bone has the soft tissue shadow of the base of the tongue and epiglottis superimposed over it

A

Hyoid

61
Q

Which part of the hyoid rises out of the body at a 45 degree angle

A

Lesser Horns

62
Q

Which is the only cervical vertebra that has a transverse foramina?

A

C2

63
Q

Which is the soft tissue, Conchae or Turbinates?

A

Conchae

64
Q

A soft tissue opacity just beneath the shadow of the tongue and just above the hyoid

A

epiglottis

65
Q

A crescent shaped RL will be superimposed on the roots of the maxillary teeth and floor of sinus

A

Palatoglossal air space

66
Q

how do you prevent the palatoglossal air space?

A

Have patient place tongue against the roof of their mouth

67
Q

If the patient places their tongue correctly this wedge-shaped RL over the ramus which represents air around the tonsils will be present instead

A

Oropharyngeal airspace

68
Q

Two thin oblique slit-shaped RLs superimposed over the soft tissue shadow of the nose represents this

A

Nasal air in the nasal fossa

D2: 621 Radiology (16 decks)

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