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Positioning > Facial Bones > Flashcards

Facial Bones Flashcards

1
Q

SID for facial bones

A

40”

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2
Q

Position for PA Caldwell Facial Bones

A 
Prone or PA Erect
MSP perpendicular to midline of table
Adjust head so that the OML is perpendicular to the IR
Nose and forehead against the IR.
Nasion is at the center of IR
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3
Q

Textbook CR for PA Caldwell Facial Bones

A

Angle 15 degrees caudal

Exits nasion

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4
Q

SFMC CR for PA Caldwell Facial Bones

A

Angle 27 degrees caudal

Exits nasion

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5
Q

Film for PACaldwell

A

10 x 12 LW Bucky

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6
Q

Structures shown PA Caldwell Facial Bones

A 
Orbital rim
Maxillae
Nasal septum
Zygoma
Anterior nasal spine
Looking at floor of orbit
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7
Q

The textbook angle for PA Caldwell shows

A

Petrous pyramids in lower 1/3 of orbits

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8
Q

SFMC angle for PA Caldwell shows

A

Petrous pyramids within the maxillary sinuses; below orbits

This angle will show the orbital floor better.

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9
Q

Rotation for PA Caldwell shows

A

MLOM
Sides of skull are equal distance to lateral borders of orbits
MSP of head aligned with long axis of collimating field.

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10
Q

Routine for facial bones

A

PA Caldwell
Waters
Lateral on affected side
Base view for zygoma

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11
Q

Waters is aka

A

Parietoacanthial Projection

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12
Q

Position for Waters for Facial Bones

A

Prone or PA Erect seated.
MSP to midline of IR.
Adjust head until the OML forms a 37 degree angle with IR.
Place the tip of the Chin up and against IR.
Mentomeatal line is adjusted so it is perpendicular to the IR.
Center the IR at the level of the acanthion.

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13
Q

CR Waters Facial Bones

A

Perpendicular to IR exiting the acanthion.

Acanthion is at center of IR.

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14
Q

Film Waters

A

10 x 12 LW Bucky

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15
Q

Structures Waters Facial Bones

A

Entire rim of orbits
Entire Facial bones
Petrous ridges projected immediately below maxillary sinuses.

Maxillae
Bony nasal septum
Zygoma
Maxillary sinuses

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16
Q

Rotation for Waters

A

MLOM

Sides of skull

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17
Q

Position for Lateral Facial Bones

A

Semi-prone or erect with body in an anterior oblique position.
Place head in a true lateral position.
MSP is parallel to the IR
Interpupillary is perpendicular to the IR.

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18
Q

CR for Lateral Facial Bones

A

CR centered and perpendicular to the zygoma.

Entering lateral surface of zygoma halfway between outer canthus and EAM.

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19
Q

Film for Lateral

A

10 x 12 LW Bucky

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20
Q

Structures for Lateral Facial Bones

A 
Superimposed facial bones and orbital plates.
Sella tursica
Zygoma
Mandible
Maxillae
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21
Q

Rotation for Lateral

A

Look at mandible

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22
Q

How do we tell if there’a any Tilt for Lateral facial bones

A

Look at orbital plates

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23
Q

Base view of Zygoma is aka

A

Submental view or Submentovertical Projection

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24
Q

Base view of Zygoma position

A

Raise chin and hyperextend neck until the IOML is parallel to the IR.
Patient supine and angle sponge to angle neck back.

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25
Q

CR for Base view of Zygoma

A

CR perpendicular to IOML at level of zygomatic arches

CR entering the MSP of the throat at the level approximately 1” posterior to the outer canthi.

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26
Q

Film for Base view of Zygoma

A

10 x 12 LW out of Bucky

Prop up a cassette so it is touching top of head.

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27
Q

Structures seen for Base view of Zygoma

A

Zygomatic arches and symmetrical.

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28
Q

How do we adjust technique for Base view of Zygoma

A

Since it they are thin bones, decrease technical factors.

5 mAs at 70 kVp

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29
Q

If we can only see one of the zygomatic arches well during, base view of Zygoma then what do we do?

A

Oblique Inferosuperior (tangential).

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30
Q

Describe Oblique Inferosuperior (tangential) for zygomatic arch

A

SMV position
Rotate MSP patient head toward affected side 15 degrees.
Tilt top of head 15 degrees away from side being examined.
Skim CR through zygomatic arch on affected side.

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31
Q

What view shows orbits better?

A

Modified Waters

With OML 55 degrees to IR

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32
Q

What is an optional Zygomatic Arch view

A

AP Axial

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33
Q

Position for AP Axial Zygomatic arches

A

Position like AP Axial Townes:
Patient seated upright or supine position.
MSP centered to midline of the grid.
OML is perpendicular to IR

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34
Q

CR for AP Axial Zygomatic arches

A

CR to 1” above glabella

Textbook says CR to enter the glabella 1” above the nasion at an angle 30 degrees caudal.
and CR passed directly through Zygomatic Arches
CR 30 degrees to OML
If patient cannot flex neck enough, then CR 37 degrees to IOML.

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35
Q

Orbits Routine

A

PA Caldwell
Modified Waters Erect if possible
Lateral of Affected Side

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36
Q

SID and Film for Orbits

A

40” SID
10 x 12 LW
Bucky

37
Q

Position for Modified Waters Orbits

A

PA erect if possible.
IR centered at level of center of orbits.
Rest chin on IR.
Adjust head until the OML forms a 55 degree angle with the IR.
Lips-meatal line is perpendicular to IR.
lips against IR

38
Q

CR for Modified Waters Orbits

A

CR directed perpendicular through mid-orbits; exits the acanthion.

39
Q

Structures seen Modified Waters Orbits

A

Good for blow-out fx.
Orbital floors are projected less distorted than water’s.
Petrous projected in lower half of maxillary sinuses.
See entire orbits
Close beam restriction to orbital region.

40
Q

Position for Lateral Orbits

A

Semi-prone or erect.
RAO or LAO body with head lateral against IR.
MSP parallel to the IR.
Interpupillary Line is perpendicular to IR.
IPL is centered to IR

41
Q

CR for lateral orbits

A

CR directed perpendicular through the outer canthus

42
Q

Structures seen lateral orbits

A

Superimposed facial bones and orbital plates

43
Q

What optional view is used to see Optic Foramen?

A

Rhese Oblique

44
Q

Position for Rhese Oblique Orbits

A

Prone or PA Oblique
Chin, cheek, and nose on IR
MSP 53 degrees to IR
AML perpendicular to IR

45
Q

CR for Rhese oblique

A

CR perpendicular to downside orbit
CR will go directly through optic foramen
40” SID
Bucky and Grid

46
Q

Structures for Rhese Oblique

A

Optic Foramen in lower outer quadrant

Looking for destruction of sphenoid strut from a tumor.

47
Q

Mandible routine

A 
PA Axial (Caldwell position)
Both obliques
48
Q

PA Axial (Caldwell Position) mandible positioning

A

PA or prone
Forehead and nose against table or vertical Bucky.
OML perpendicular to IR
Open mouth at center of IR

49
Q

CR for PA Axial (PA Caldwell) mandible

A

CR is 10 degree cephalic to exit open mouth.

Textbook: CR directed 20 to 25 degrees cephalic to exit at the acanthion.

50
Q

Structures PA Axial (PA Caldwell) Mandible

A

Mandibular Rami , body, mentum, and condyles
Condyles and coronoids superimposed.
Not including the whole skull.
This image used to show medial or lateral displacement of fragments in fractures of the Rami.

51
Q

Position for right and left Axiolateral Posterior obliques Mandible

A

Place pt in Posterior oblique with head in true lateral position. Tilt top of head 15 degrees to IR.
Angle the tube 25 degrees cephalic.

52
Q

CR for right and left obliques Mandible

A

Angle tube 25 degrees cephalic.
CR perpendicular to submentum between gonion and mentum.
Total degrees of angle is 40.

53
Q

Structures for right and left obliques Mandible

A 
Mandibular Rami
Condylar process
Coronoid process
Body, and mandibular notch
You see the side closest to the IR
54
Q

Optional Mandible

A

AP Axial

Submentalvertex

55
Q

Position for AP axial mandible.

A

OML perpendicular to IR.
Center at glabella
Patient recumbent supine with wedge under head so chin is tucked down.

56
Q

CR for AP Axial Mandible

A

35-40 degrees caudally
At glabella
CR passes through mandible

57
Q

Structures for AP Axial Mandible

A

Looking for Fx of Condyloid processes or
Ramus
Elongates Mandible

58
Q

Position for submentovertex of mandible

A

IOML parallel to IR

Positioned the same as other SMV

59
Q

CR for submentovertex of mandible

A

CR perpendicular to IOML and midway between the angles of mandible (submentum)

60
Q

Structures for submentovertex of mandible

A

Entire Mandible

61
Q

Routine for Nasal Bones

A

Modified Waters

Both Laterals

62
Q

CR for nasal bones modified waters

A

CR perpendicular to and exits acanthion.

63
Q

Film for nasal bones modified waters

A

Grid

10 x 12 LW

64
Q

Structures nasal bones modified waters

A

Bony Nasal Septum Petrous pyramid appears in lower half of maxillary sinuses
Orbital floors seen very well
Orbits are more true to size and shape.
Blow-out fx seen BC floor of orbits seen well.

65
Q

Nasal bones Both Laterals position

A

Erect or semi-prone
If on table, have patient in RAO or LAO body position and arm of affected side, at pt side
Head is lateral position
MSP parallel to IR
Inter pupillary Line is perpendicular to IR

66
Q

CR Nasal bones Both Laterals

A

CR perpendicular to 1/2” inferior to nasion

CR perpendicular to IR

67
Q

Film for Nasal bones Both Laterals

A

10 x 12 LW table top
Collimate 3-4” square
No Grid if in Bucky

68
Q

Structures Nasal bones Both Laterals

A

Nasal bone with soft tissue

Anterior nasal spine

69
Q

Technique for nasal bones

A

1.6-2 mAs at 55kVp

70
Q

Optional for nasal bones

A

Superoinferior Axial

71
Q

Position for nasal bone Superioinferior Axial

A

Sitting or prone
With GAL perpendicular to IR
Table top

72
Q

CR for nasal bone Superioinferior Axial

A

CR parallel to GAL

73
Q

Structures for nasal bone Superioinferior Axial

A

To see if there is any shift side to side ( medial or lateral deviation)
Nasal bones not superimposed
See septal cartilage

74
Q

Modified Waters aka

A

Modified Parietoacanthial Projection

75
Q

Limitation to see nasal bone Superioinferior Axial

A

OID
If frontal bone is not flat
Bucky teeth
Prominent chin

76
Q

Panorex

A

It rotates around or head and it is a long exposure so keep finger on button.

77
Q

Using a Panorex for mandible, what line is parallel to floor

78
Q

Structures seen Panorex

A

Entire mandible and all teeth and roots, Condyloid, coronoid, ramus, body
Evaluate teeth fx or disruption
Fx mandible

79
Q

Limitations of mandible

A

Broad shoulders

bun in hair

80
Q

What are modifications if pt can’t tilt head for Axiolateral Posterior Obliques Mandible?

A
  1. Angle tube 40 degrees cephalic

2. Pt recumbent semi-prone or semi-supine; tilt IR 15 degrees with sponge; CR 25degrees cephalic

81
Q

Position for Modified Waters Nasal Bones

A

Patient prone or PA Erect.
Adjust the patient’s head so the OML forms a 55 degree angle with the IR.
Lipsmeatal line in perpendicular to IR

82
Q

Position for PA Caldwell Orbits

A

Patient prone or PA Erect.
MSP is perpendicular to midline of table.
Rest forehead and nose on IR.
Adjust head so that the OML is perpendicular to the IR.

83
Q

CR textbook version for PA Caldwell Orbits

A

Angle CR 15 degrees caudal, exits nasion.

84
Q

CR SFMC for PA Caldwell Orbits

A

Angle CR 27 degrees caudal,

Exits nasion

85
Q

Structures seen PA Caldwell Orbits

A

Orbital rim, maxillae, bony nasal septum, Zygoma
Textbook 15 angle: Petrous pyramid in lower 1/3 of orbits
SFMC 27 angle:
Petrous pyramid within maxillary sinuses

86
Q

Right and Left Lateral Oblique for mandible is AKA

A

Axiolateral Mandible

87
Q

Caldwell Method aka

A

PA Axial projection

88
Q

Evaluation criteria for AP Axial Zygomatic Arches

A

Zygomatic arches project lateral to mandibular rami.

Positioning (7 decks)

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