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Oral Radiology > Panoramic Imaging Principles > Flashcards

Panoramic Imaging Principles Flashcards

1
Q

What are the indications for panoramic radiography? (7)

A

(Evaluation of)
1. overall dentition
2. interosseous pathology (cysts, tumors, etc.)
3. TMJ
4. position of 3rd molars
5. dental development & eruption
6. denomaxillofacial trauma
7. developmental disturbances or syndromes

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2
Q

List the advantages of panoramic radiography: (6)

A
  1. Relatively low radiation dose (compared to FMX)
  2. Broad coverage of facial bones and teeth
  3. Easier technique
  4. Can be used in patients with truisms or in patients who cannot tolerate intraoral radiographs (more comfortable & faster)
  5. Quick and convenient radiograph technique
  6. Useful visual aid in patient education
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3
Q

List the disadvantages of panoramic radiography: (6)

A
  1. Lower resolution areas (not able to detect small carious lesions or early periodontal disease)
  2. Overlap in premolar area
  3. Magnification across image is unequal making linear measurements unreliable
  4. Image superimposition of real, double, and ghost images
  5. Requires accurate patient positioning (technique sensitive)
  6. Difficult to image both jaws when patient has severe maxillomandibular discrepancy (class III malocclusion specifically, patient cannot move mandible back to be in line with the maxilla on the bite block)
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4
Q

Because panoramic radiographs have low resolution areas, this does not allow for:

A

detections of small carious lesions or early periodontal disease

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5
Q

Where do we see overlap in panoramic radiographs?

A

premolar area

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6
Q

Describe the magnification of panoramic images:

A

magnification is unequal across the image so making linear measurements is unreliable

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7
Q

Describe when a panoramic may not be indicated due to patient occlusion:

A

Class III malocclusion (patient cannot move mandible back to be in line with maxillary on bite block)

(would need to do a separate pano of maxilla and mandible)

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8
Q

Label the parts of the panoramic machine:

A

Blue: Light/Laser localizer (sagittal plane-center)

Orange: Light/Laser localizer (horizontal planevfrankfort)

Yellow: Bite block and handles for patient

Red: X-ray source and tube inside of it

Green: Head supports/guides

Purple: Receptor/sensor of pano machine

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9
Q

What type of panoramic machine does UMKC use?

A

Orthophos XG Sirona

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10
Q

Label the following parts of the panoramic machine:

A

B: Light/laser localizer- horizontal plane- frankfurt
C: Light/laser localizer- sagittal plane- center
F: Head supports/guides
I: Receptor/sensor
J: X-ray source & tube inside of it
K: Bite block
M: Bite block handles

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11
Q

When the x-ray source is on the right, the ____ side is being image

A

left

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12
Q

When x-ray source is on the left side, the ___ side is being imaged

A

right

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13
Q

Describe the imaging technique of a panoramic machine:

A

continuous movement imaging

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14
Q

Discuss the collimator location on a panoramic machine:

A

there is a collimator at both the exit of the source and the entrance of the receptor

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15
Q

In a panoramic machine, there are multiple ____ that are constantly moving:

A

continuous centers of rotation

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16
Q

Where does the x-ray source start in a panoramic radiograph? Where does it end?

A

starts on the right and ends on the left

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17
Q

Where does the x-ray source never go in a panoramic radiograph?

A

NEVER goes in front of the patient

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18
Q

When the source is in the back of the patient, where is the receptor?

A

In the front of the patient

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19
Q

Where does the head of the patient located at the start of the panoramic radiograph?

A

between receptor and source

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20
Q

The first image that is created is the patients ____ because the x-ray source starts on the ____

A

left; right

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21
Q

What is closer to the receptor will be:

A

imaged

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22
Q

In this image, the x-ray source is on the ____ and the receptor is on the ____.

At what point in time does this occur?

What is being imaged?

A

right; left

beginning of panoramic

imaging left

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23
Q

In this image, the x-ray source is:

At what point in time does this occur?

Where is the receptor located?

A

behind the patient

mid-panoramic radiographic

receptor in front

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24
Q

In this image, the x-ray source is:

At what point in time does this occur?

Where is the receptor located?

What is being imaged?

A

on left side of patient

end of panoramic radiograph

receptor on the right

right side

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25
Q

Instead of ____ receptors, we now use ____ receptors

A

PSP/Film; CCD

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26
Q

What differs between the CCD receptors we currently use, versus the PSP/Film receptors previously used?

A

CCD: sensors will be sent to computer and then repeated, exposed on same spot of receptor

PSP/Film: continuously exposed different areas on one receptor

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27
Q

What type of receptor is being described?

Exposure of the same area over and over again and do not need a “new” portion of the receptor

A

CCD receptor

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28
Q

What type of receptor is being described?

Receptors continuously expose different areas on one receptor

A

PSP/Film

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29
Q

Area of focus:

A

focal trough

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30
Q

Describe the focal trough:

A

an area of focus; a 3D curbed zone in which structures are reasonably and well defined.

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31
Q

Where is the focal trough narrower?

A

anterior

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32
Q

Is where both dental arches must be positioned to achieve the sharpest images:

A

Focal trough

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33
Q

Structures positioned in the ___ will result in the clearest images:

A

center of focal trough

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34
Q

What may occur if objects are placed further from the focal through?

A

progressively less clear:
- blurred
- magnified
- reduced in size
- distored

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35
Q

How can you ensure sharpness in a panoramic radiograph?

A

By having both mandibular and maxillary anteriors placed in bite block groove

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36
Q

What does having both mandibular and maxillary anteriors placed in bite block groove ensure in panoramic radiograph?

A

Ensures sharpness of image

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37
Q

Beams are angulated approximately 4 degrees to avoid projection of:

A

thick occipital bone

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38
Q

To avoid the occipital bone, beams are angulated approximately:

A

4 degrees

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39
Q

_____ between the objects in a panoramic radiograph may not be accurate

A

spacial relationships

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40
Q

Give an example of a spacial relationship that may not be accurate and therefore can be misrepresented on panoramic radiographs

A

distance between root apex and mandibular canal

41
Q

Objects closer to the receptor will appear:

A

narrowed and projected lower on the image

42
Q

Objects closer to the source will appear:

A

widened and projected higher up on the image

43
Q

Objects closer to the ____ will appear narrowed and projected lower on the image

Objects closer to the ____ will appear widened and higher up on the image

A

receptor; source

44
Q

Buccal objects will be projected:

A

lower

45
Q

Lingual objects will be projected:

A

higher

46
Q

_____ objects will be projected lower, while ____ objects will be projected higher

A

buccal; lingual

47
Q

Horizontal magnification is determined by:

A

the position of the object within the focal trough

48
Q

_____ magnification is determined by the position of the object within the focal trough

A

horizontal

49
Q

Magnitude of distortion depends on:

A

distance of the object from the center of the focal trough

50
Q

Lingual to the focal trough = closer to the ____ = appears ____

A

source; wider

51
Q

_____ to the focal trough = closer to the source = objects appear wider

A

lingual

52
Q

Why do objects lingual to the focal trough/closer to the source appear wider?

A

the beam passes more slowly through it than the speed at which the receptor moved

53
Q

Buccal to the focal trough = closer to the ____ = appears ____

A

receptor; narrower

54
Q

_____ to the focal trough = closer to the receptor = objects appear narrower

A

buccal

55
Q

Why do objects buccal to the focal trough/ closer to the receptor appear narrower?

A

the beam passes at a rate faster than the receptor movement

56
Q

The green dot would appear ____ while the red dot would appear ____.

Explain

A

narrower; wider

Green dot is buccal to the focal trough (closer to receptor) and the red dot is lingual to the focal trough (closer to the source)

57
Q

Image distortions are only in:

A

the horizontal plane

58
Q

The image distortions are only in the horizontal plane but varies between:

A

anterior and posterior regions of the mandible

59
Q

_____ region = horizontal magnification increases as object moves away from center of focal trough

A

anterior

60
Q

What type of horizontal distortions are more severe?

A

anterior region

61
Q

____ region = less degree of magnification

A

posterior region

62
Q

What type of horizontal distortions are less severe?

A

posterior region

63
Q

The magnitude of horizontal distortion varies between:

A

anterior & posterior regions of the jaw

64
Q

In the anterior region horizontal magnification increases markedly as the:

A

object moves AWAY from center of the focal trough

65
Q

There is less degree of magnification in the:

A

posterior region

66
Q

Two identical objects located in the anterior and posterior region may have:

A

different horizontal magnifications

67
Q

Horiztonal measurements made on the panoramic radiographs are:

A

unreliable

68
Q

Every anatomical structure positioned between the center of rotation & receptor results in:

A

real images

69
Q

Where do real images occur?

A

every anatomical structure between the center of rotation & receptor

70
Q

This image is describing:

A

real images

71
Q

What is depicted by the arrow & dot in this image?

A

rotation center

72
Q

Created by objects located between the x-ray source and center of rotation:

A

ghost images

73
Q

Describe how ghost images appear:

A
  1. on the opposite side
  2. at a higher level
  3. blurred and magnified
74
Q

Anatomical structures that cast a ghost image include: (7)

A
  1. inferior border of mandible
  2. angle of mandible
  3. ramus of mandible
  4. hyoid bone
  5. cervical spine
  6. jewelry
  7. palate
75
Q

Ghost images are created by objects located:

A

between the x-ray source and center of rotation

76
Q
  1. inferior border of mandible
  2. angle of mandible
  3. ramus of mandible
  4. hyoid bone
  5. cervical spine
  6. jewelry
  7. palate

These all have the potential to result in:

A

ghost images

77
Q

What does the orange circle represent?

A

object that would create a ghost image

78
Q

What does the orange circle represent?

A

object that would create a real image

79
Q

List the characteristics of ghost shadows: (4)

A
  1. appears on the opposite side
  2. positioned higher than real structure
  3. more blurred than real structure
  4. vertical component is highly magnified
80
Q
  1. appears on the opposite side
  2. positioned higher than real structure
  3. more blurred than real structure
  4. vertical component is highly magnified

These are all characteristics of:

A

ghost shadows

81
Q

What type of image would this earring create?

A

ghost image

82
Q

What can be seen in the panoramic image?

A

ghost image of inferior border of the mandible and hard palate

83
Q

What can be seen in this panoramic image?

A

ghost image of inferior border of the mandible

84
Q

What can be seen in this panoramic image?

A

ghost image of nose ring

85
Q

What can be seen in this panoramic image?

A

ghost image of necklace

86
Q

What can be seen in this panoramic image?

A

ghost image of cervical spine

87
Q

Objects that lie posterior to the center of rotation and are intercepted twice by the x-ray beam result in:

A

double images

88
Q

Double images occur due:

A

objects that lie posterior to the center of rotation and are intercepted twice by the x-ray beam

89
Q

What structures may result in double images? (3)

A
  1. hyoid bone
  2. epiglottis
  3. cervical spine
90
Q

The hyoid bone, epiglottis, and cervical spine all result in double images, all of which:

A

cast images on both the right and left side of the image

91
Q

All double images are:

A

real images

92
Q

What is depicted by the orange structure in this image?

A

object causing double image

93
Q

What can be seen in this panoramic image?

A

double image of the hyoid bone

94
Q

What can be seen in this panoramic image?

A

double image of the cervical spine

95
Q

What can be seen in this panoramic image?

A

double image of the epiglottis

96
Q

List the steps of positioning for a panoramic x-ray: (9)

A
  1. remove jewelry, glasses, & dentures
  2. place lead apron
  3. bite in bite block groove
  4. stand patient upright
  5. align the center laser line
  6. align the Frankfurt horizontal plane
  7. close side guides
  8. have the patient close their lips, swallow & keep tongue on palate, & hold still
  9. expose the radiograph
97
Q

Which image shows the correct body position?

A

top image

98
Q
A

Oral Radiology (21 decks)

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