facial Flashcards
3 sutures in an adult skull
sagittal
coronal
lambdoid
structures in a baby skull
metopic suture
coronal suture
lambdoid suture
anterior fontanelle
posterior fontanelle
parietal bone
occipital bone
frontal bone
what are the structures that can be identified in a lateral skull
coronal suture
lambdoid suture
vessels
petrous ridge
mastoid
sella turcica
orbits
nasal airways
what structures can be identified in an OM skull view
sinuses: frontal, and maxillary sinus
orbits
zygoma
zygomatic arch
mandible
nasal and ethmoid air cells
internal orbital canals
odontoid peg
what structures should be seen in a lateral facial view
sinuses: frontal, sphenoid, ethmoid and maxillary sinus
orbits, mandible, mandible ramus, mandible angles
criteria of an ideal lateral facial view
floor of anterior cranial fossa superimposed
mandibular angle is over the anterior cervical spine
check pituitary fossa, sella turcica for true lateral
check mandible angles for true lateral
how is patient positioned for lateral sinus view
supine, HBL
types of skull fracture
linear fracture (most common)
depressed fracture
diastatic
ping pong fracture
what is dolan line
consist of:
- orbital line
- zygomatic line
- maxillary line
evaluate:
- maxillofacial fractures on OM view
what are the lines on a facial bone xray to identify fractures
- dolan line
- McGrigor-Campbell lines
what are signs of an orbital blowout fracture
teardrop sign
black eyebrow sign
how can foreign bodies be introduced into a body
ingestion
aspiration
penetration
insertion
through medical surgical procedures
common causes for FB introduction
developmental immaturity
psychiatric illness
altered level of consciousness
structural dental anomalies
abnormal deglutition
illicit concealment of drugs
risky food
radiopacity of FB
metal and glass are mostly radiopaque, shown in
- plain x-ray
- US
- CT
wood and plastic are mostly radiolucent, shown in
- US
- CT
what structures can be seen in a lateral neck radiograph
epiglottis
hyoid bone
laryngeal ventricle
calcified cricoid cartilage
trachea
common site of FB
neck
abdomen
chest
body orifices
indication for urgent removal of FB in esophagus
- sharp object
- button battery
- bone fragment
- any corrosive agents
- potential perforation
indications for urgent removal of FB in the stomach
persistent vomiting
progressive abdominal distention
indications for urgent removal of FBs in abdomen
abdominal pain/ peritonitis
gastrointestinal bleeding
failure to move distally for more than 2 weeks
indication of possible perforation of esophagus
air in
- cervical soft tissue
- subcutaneous
- supraclavicular
- mediastinum
pneumothorax
pleural effusion
retropharyngeal swelling
what view to take for aspirated FB
expiratory in patients who can cooperate
if not, consider bilateral decubitus
why is bilateral decubitus done for aspirated FB
assess air-trapping caused by inhaled FB
expectation is that the dependent lung will collapse partially in the normal patient
where there is an obstructive FB, there will be an air-trapping and hyperlucency of the dependent lung
what is the teardrop sign in facial fracture associated with
-herniation of orbital contents through orbital floor
- associated fracture of the maxillary sinus allows air to leak into the orbit
what does black eyebrow sign in an orbital blowout fracture associated with
fracture of the maxillary sinus allows air to leak into the orbit
what structures can be identified by the first Dolan line?
fracture of the superior rim of orbits
black eyebrow sign due to orbital emphysema
opacification/ air-fluid level in the frontal sinuses side
what structures can be identified by the second dolan line
widening of the zygomatico-frontal suture
what structures can be identified by the third dolan line
mouth roof and maxillary sinuses
where does the first dolan line run
orbital line
- traces the inner margins of the lateral, inferior and medial orbital wall and the nasal arch
where does the second dolan line run
zygomatic line
- traces the superior margin of the zygomatic arch and body, extending along the frontal process of the zygoma to the zygomaticofrontal suture
where does the third dolan line run
maxillary line
- traces the inferior margin of the zygomatic arch, body and the lateral wall of the maxillary sinus
how does the first line of McGrigor Campbell line run
passes through the zygomatico-frontal sutures and across the upper edge of the orbits
how does the second line of McGrigor Campbell line run
follows the zygomatic arch, crosses the zygomatic bone and follows the inferior orbital margins to the opposite side
how does the third line of McGrigor Campbell line run
connect the condyle and coronoid process of the mandible and medial wall of maxillary antra on each side
how does the fourth line of McGrigor Campbell line run
passes the mandible ramus and the occlusal plane of teeth
what does the first McGrigor Campbell line see
- widening of zygomatico-frontal suture
- fractures of the superior rim of the orbits
- black eyebrow sign
- opacification/ air-fluid level in the frontal sinuses side
what does the second McGrigor Campbell line see
- fracture of superior aspect of the zygomatic arch
- fracture of inferior rim of orbits
- soft tissue shadow in superior maxillary antrum
- fracture of nasoethmoid bones and medial orbits
what does the third McGrigor Campbell line see
- fractures of the inferior aspect of zygomatic arch
- fractures of the lateral maxillary antrum
- opacification/ air fluid level in the maxillary sinus
- fractures of the alveolar ridge
