facial bone technique Flashcards

1
Q

reasons for requesting a lateral skull x-ray

A

skeletal surveys for NAI or myeloma
shunt series for hydrocephalus
FB demonstration

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2
Q

reasons for requesting a facial bones x-ray

A

zygomatic arch fracture
tripod fracture
orbital bow-out fracture

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3
Q

radiation protection to consider

A

ID
avoid repeats
gonad protection
LMP

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4
Q

what does RBL stand for

A

radiographic baseline

runs from the EAM to the outer canthus of the eye

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5
Q

what does IPL stand for

A

inter-pupillary lines - runs between the pupils

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6
Q

what does EAM stand for

A

external auditory meatus

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7
Q

what does OM stand for

A

occipito-mental

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8
Q

what does SMV stand for

A

sub-mento vertical

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9
Q

what does TMJ stand for

A

tempero-mandibular joint

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10
Q

positioning for a lateral skull

A
  • lateral aspect of head in contact with receptor
    frontal, parietal and occipital bones seen
  • EAM superimposed
  • IPL at 90 degrees to receptor
  • centering point = midway between the external occipital protuberance and the glabella - 5cm superior to the EAM
  • SID is 100cm
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11
Q

correct positioning for a lateral skull

A

floor of anterior cranial fossa, anterior and posterior clinoid processes and sella turcica should be superimposed

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12
Q

radiographic technique for the OM

A
  • face detector
  • anterior nasal spine coincident with the midline of the detector
  • outer canthus of eye and EAM should be equidistant to ensure no rotation
  • IPL should be parallel to receptor
  • raise patients chin to bring RBL 45 degrees to image receptor
  • infra-orbital margin should be aligned to central lines
  • SID = 100cm
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13
Q

area of interest for OM

A

include superior orbital margins superiorly, distal aspect of maxillae inferiorly and parietal and temporal bones laterally

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14
Q

correct positioning for OM

A
  • distance between lateral orbital borders and lateral skull should be equidistant to indicate no rotation
  • petrous ridge to be projected inferior to the maxillary sinus
  • nasal septum should be coincident with the midline of the image
  • inferior orbital margins should be on the same horizontal place and coincident with midline of the image
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15
Q

technique for OM 30 degrees

A

first steps same as OM

  • centring point = upper portion of the symphysis menti due to caudal angle
  • SID = 100cm
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16
Q

AOI for OM 30 degrees

A

include superior orbital margins superiorly, mandible/mastoid air cells inferiorly and parietal/temporal bones laterally

17
Q

correct positioning for OM 30 degrees

A

distance between lateral orbital borders and lateral skull borders should be equidistant, petrous ridge projected below the maxillary sinus and orbital floor seen through maxillary sinus

18
Q

what does ABC’s stand for

A
a= alignment
b= bones
c= cartilage disruption 
s= soft tissue
19
Q

two ‘lines’ used for analysis

A

Dolans
McGregors
used to analyse for discontinuities and abnormalities

20
Q

technique for modified OM view

A
  • on a trolley
  • supine with a vertical central ray
  • centered on anterior aspect
  • positioning of the RBL should be the same
  • often angled cranially
  • the less the chin is raised the greater the angle applied
  • does not demonstrate fluid levels
21
Q

technique for lateral facial bones

A
  • lateral aspect of face in contact with receptor
  • frontal bone, nasal septum, maxillae and mandible all in profile
  • EAM superimposed
  • IPL is at 90 degrees to receptor
  • center is 2.5cm behind outer canthus of the eye along the RBL
  • SID = 100cm
22
Q

AOI for lateral facial bones

A

frontal bone superiorly, mandible inferiorly, posteriorly see the anterior portion of the parietal and temporal bone and c spine

23
Q

correct positioning for lateral facial bones

A

include EAMs superimposed, floor of anterior cranial fossa and sella turcica should be superimposed and superimposition of tables of bone

24
Q

technique for modified SMV jug handles view

A
  • aims to get zygoma parallel to receptor rather than base of skull
  • patient supine or erect, neck extended until long axis of zygoma arches are parallel to image receptor
  • EAM equidistant from receptor
  • centering = midway between EAMs
  • head may be tilted 5-10 degrees away from side under examination
25
Q

AOI for jug handles view

A

superiorly is mandibular symphysis, entirety of zygomatic arches laterally

26
Q

correct projection for jug handles view

A

angles of the mandible should be clear of petrous temporal bones, whole length of zygomatic arches should be seen and midline of patient skull should be coincident with midline of image