Facial and Nasal Bones Flashcards
How many facial bones are there?
What are they?
How many facial bones are there? 14
What are they? Maxillary (2), lacrimals (2), zygomatic (2), palatine (2), nasal bones (2), nasal conchae (2), vomer (1), mandible (1)
The lacrimals are the ___ bones and have ___ which are where ___ ___ go through.
The lacrimals are the smallest bones and have lacrimal foraminas which are where tear ducts go through.
The zygomatic bones have a ___ process which articulate with the ___ process of the ___ bone which creates the ___ arch.
The zygomatic bones have a temporal process which articulate with the zygomatic process of the temporal bone which creates the zygomatic arch.
Anatomy of the facial bones
Anatomy of the facial bones
What are the routine projections, SID and kVp of the facial bones?
Routine projections = Parietoacanthial (Waters), PA, PA Axial Caldwell, Lateral of affected side
SID = 40”
kVp = 80 grid
Facial Bones - PARIETOACANTHIAL PROJECTION - WATERS METHOD
- The patient is ___ with the ___ plane ___ to the plane of the IR.
- Extend the chin so the ___ is just off the table top and the ___ forms an angle of ___° to the plane of the IR.
- Direct the CR ___ to exit the ___. Center the IR to the CR
- This method will clearly demonstrate all of the facial bones, with the ___ ___ projected just ___ the ___ sinuses.
PARIETOACANTHIAL PROJECTION - WATERS METHOD
- The patient is prone with the midsagittal plane perpendicular to the plane of the IR.
- Extend the chin so the nose is just off the table top and the OML forms an angle of 37° to the plane of the IR.
- Direct the CR perpendicularly to exit the acanthion. Center the IR to the CR
- This method will clearly demonstrate all of the facial bones, with the petrous ridges projected just below the maxillary sinuses.
Facial Bones - PA
- Place the patient in the ___ position.
- Instruct the patient to rest the ___ and ___ on the table and ad just the patient’s head so the ___ and ___ plane is ___ to the plane of the IR.
- Direct the CR ___ to exit the ___.
- Must include entire ___! The ___ ___ should fill the ___. The distance from lateral border of ___ to lateral border of ___ should be ___ on both sides.
Facial Bones - PA
- Place the patient in the prone position.
- Instruct the patient to rest the nose and forehead on the table and ad just the patient’s head so the OML and midsagittal plane is perpendicular to the plane of the IR.
- Direct the CR perpendicular to exit the nasion.
- Must include entire mandible! The petrous ridges should fill the orbits. The distance from lateral border of skull to lateral border of orbit should be equal on both sides.
Facial Bones - PA Axial - Caldwell Method
- Positioning is the same as a routine ___ ___ with the ___ and ___ resting on table.
- Direct the CR with a ___° ___ angle to exit the ___.
- The ___ ___ should be positioned in the ___ ___ of the orbits
Facial Bones - PA Axial - Caldwell Method
- Positioning is the same as a routine PA skull with the nose and forehead resting on table.
- Direct the CR with a 15° caudal angle to exit the nasion.
- The petrous ridges should be positioned in the lower third of the orbits
Facial Bones - Lateral of affected side
- Position the patient as for a lateral skull, affected side ___, placing the ___ line ___ to the IR and the ___ plane ___ to the plane of the IR.
- Direct the CR through the ___ bone, about halfway between the ___ ___ and the ___.
- Only a lateral view of the ___ side must be taken.
- This projection must include ___ facial bones, with the ___ bone in the center. The ___ angles should be ___ on a properly positioned lateral.
Facial Bones - Lateral of affected side
- Position the patient as for a lateral skull, affected side down, placing the interpupillary line perpendicular to the IR and the midsagittal plane parallel to the plane of the IR.
- Direct the CR through the zygomatic bone, about halfway between the outer canthus and the EAM.
- Only a lateral view of the affected side must be taken.
- This projection must include all facial bones, with the zygomatic bone in the center. The mandibular angles should be superimposed on a properly positioned lateral.
What are the routine projections, SID, and kVp of nasal bones?
Routine Projections = Parietoacanthial Projections (Waters Method), Lateral
SID = 40”
kVp = 80 grid
Nasal Bones - Parietoacanthial Projection - Waters Method
- The patient is ___ with the ___ plane ___ to the plane of the IR.
- Extend the chin so the ___ is just off the table top and the ___ forms an angle of ___°to the plane of the IR.
- Direct the CR ___ to exit the ____. Center the IR to the CR.
- This method will clearly demonstrate ___ of the facial bones, and the ___ ___ projected just ___ the ___ sinuses.
Nasal Bones - Parietoacanthial Projection - Waters Method
- The patient is prone with the midsagittal plane perpendicular to the plane of the IR.
- Extend the chin so the nose is just off the table top and the OML forms an angle of 37°, to the plane of the IR.
- Direct the CR perpendicularly to exit the acanthion. Center the IR to the CR.
- This method will clearly demonstrate all of the facial bones, and the petrous ridges projected just below the maxillary sinuses.
Nasal Bones - Lateral (Both at TriHealth)
- Place the patient in a ___ ___ position with the affected side ___.
- Position the head to place the ___ line ___ to the IR, and the ___ plane ___ with the plane of the film. The ___ should be centered on the IR.
- Direct the ___ CR to the ___ of the ___, about ½ ___ to the ___.
- Cone down to the ___
- Use markers to show which side is ___. Side ___ is side demonstrated.
Note: Some hospital systems may have a protocol requiring both laterals while other systems may only require one lateral projection.
Nasal Bones - Lateral (Both at TriHealth)
- Place the patient in a modified swimmer’s position with the affected side down.
- Position the head to place the interpupillary line perpendicular to the IR, and the midsagittal plane parallel with the plane of the film. The nose should be centered on the IR.
- Direct the perpendicular CR to the bridge of the nose, about ½ distal to the nasion.
- Cone down to the nose
- Use markers to show which side is down. Side down is side demonstrated.
Note: Some hospital systems may have a protocol requiring both laterals while other systems may only require one lateral projection.
Sinuses
The ___-containing cavities situated in the ___, ___, and ___ bones of the cranium
and the ___ bones of the face are called the ___ sinuses. One function of these
cavities is to ___ the ___ of the skull (about ___ lbs) by containing ___. The ___
sinuses (antra of ___) are usually sufficiently well developed and aerated at birth to be
demonstrated radiographically. The other sinuses develop more ___ and are not completely
developed until age ___-___. All of the sinuses are ___ but may be ___ in size. Radiographs
of the ___ sinuses are always performed ___ to demonstrate ___/___ levels.
Sinuses
The air-containing cavities situated in the frontal, ethmoid, and sphenoid bones of the cranium
and the maxillary bones of the face are called the paranasal sinuses. One function of these
cavities is to decrease the weight of the skull (about 8 lbs) by containing air. The maxillary
sinuses (antra of Highmore) are usually sufficiently well developed and aerated at birth to be
demonstrated radiographically. The other sinuses develop more slowly and are not completely
developed until age 17-18. All of the sinuses are paired but may be unequal in size. Radiographs
of the paranasal sinuses are always performed upright to demonstrate air/fluid levels.
What are the routine projections, SID, and kVp of sinuses?
Routine Projections = PA Axial Caldwell Method, Parietoacanthial Open Mouth Waters Method, Lateral of affected side
SID = 40”
kVp = 80 grid
Sinuses - PA Axial Caldwell Method
- The patient is ___ at the bucky, in the same position as for PA skull with the ___ and the ___ plane ___ to the IR.
- Direct the CR with a ___° ____ angle to exit the ___
- This projection demonstrates the ___ and ___ sinuses. There should be ___ distance between the lateral border of the ___ and the lateral border of the ___. The ___ ___ should be positioned in the ___ ___ of the orbits.
Sinuses - PA Axial Caldwell Method
- The patient is upright at the bucky, in the same position as for PA skull with the OML and the midsagittal plane perpendicular to the IR.
- Direct the CR with a 15° caudal angle to exit the nasion
- This projection demonstrates the frontal and ethmoid sinuses. There should be equal distance between the lateral border of the skull and the lateral border of the orbits. The petrous ridges should be positioned in the lower third of the orbits.
Sinuses - Parietoacanthial Open Mouth Waters Method
- Positioning is the same as for facial bones, with the ___ extended and ___ resting on the vertical grid so that the ___ forms an angle of ___° with the plane of the film.
- Have the patient open the mouth ___ while holding this position.
- Direct the CR to exit the ___.
- This projection demonstrates ___/___ levels in the ___ sinuses and the ___ sinuses shown through the open mouth.
- There should be ___ distance between the lateral border of the ___ and the lateral border of the ___. The ___ ___ should be just ___ the ___ sinuses.
Sinuses - Parietoacanthial Open Mouth Waters Method
- Positioning is the same as for facial bones, with the neck extended and chin resting on the vertical grid so that the OML forms an angle of 37° with the plane of the film.
- Have the patient open the mouth wide while holding this position.
- Direct the CR to exit the acanthion.
- This projection demonstrates air/fluid levels in the maxillary sinuses and the sphenoid sinuses shown through the open mouth.
- There should be equal distance between the lateral border of the skull and the lateral border of the orbits. The petrous ridges should be just below the maxillary sinuses.
Sinuses - Lateral of affected side
- The positioning is the same as for lateral skull, with the ___ side closest to the IR and the ___ line ___ to the IR.
- Direct the CR ___ inch ___ to the ___ ___.
- This projection will demonstrate all ___ sinus groups, but the ___ sinus is of primary importance.
Sinuses - Lateral of affected side
- The positioning is the same as for lateral skull, with the affected side closest to the IR and the interpupillary line perpendicular to the IR.
- Direct the CR one inch posterior to the outer canthus.
- This projection will demonstrate all four sinus groups, but the sphenoidal sinus is of primary importance.
