Positioning for Paranasal sinuses Flashcards

1
Q

Essential Projections for Sinuses

A

Lateral

Posteroanterior (PA) axial (Caldwell method)

Parietoacanthial (Waters method)

Parietoacanthial (Waters method) open-mouth modification

Submentovertical (SMV)

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2
Q

why is upright needed for sinuses

A

Need upright for fluid levels

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3
Q

how should the CR be ?

A

CR must be horizontal

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4
Q

What is the view that shows all four sets of sinuses ?

A

Lateral projection
- frontal
- maxillary
-ethmoid
sphenoid

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5
Q

what does the lateral projection of the sinuses demonstrate

A

All four sets of sinuses
Anteroposterior (AP) and superoinferior dimensions of paranasal sinuses
Thickness of frontal bone
Detail of side closer to image receptor (IR)

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6
Q

how is the IOML for the lateral projection of the sinuses

A

Infraorbitomeatal line (IOML) perpendicular to front edge of IR

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6
Q

how is the MSP for the lateral projection of the sinuses

A

Midsagittal plane (MSP) of head parallel with IR plane

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7
Q

CR for the lateral projection of the sinuses

A

Horizontal and perpendicular to IR
Enters ½ to 1 inch (1.3 to 2.5 cm) posterior to outer canthus
Center IR to CR

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7
Q

how is the IPL for the lateral projection of the sinuses

A

Interpupillary line (IPL) perpendicular to IR plane

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8
Q

what does the PA Axial Projection (Caldwell Method) demonstrates

A

Frontal sinuses above frontonasal suture
Anterior ethmoid air cells
Sphenoid sinuses seen through nasal fossa below or between ethmoids
Petrous pyramids in lower third of orbits

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9
Q

What sinuses is best demonstrated for PA axial Projection Caldwell

A

frontal sinuses and anterior ethmoid air cells

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10
Q

how are the petrous ridges in the PA Axial Projection (Caldwell Method)

A

Petrous pyramids in lower third of orbits

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11
Q

what is the sphenoid sinuses seen through in the PA Axial Projection (Caldwell Method)

A

Sphenoid sinuses seen through nasal fossa below or between ethmoids not well demonstrated

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12
Q

part position for the PA axial Caldwe

A

Tilt vertical Bucky down 15 degrees or rest on nose to put head at 15 degrees
Rest patient’s forehead and nose on device

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13
Q

what should be centered to IR in PA Axial (Caldwell Method)

A

Nasion

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14
Q

how is the msp and oml in the PA Axial (Caldwell Method)

A

MSP and orbitomeatal line (OML) perpendicular to IR plane

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15
Q

how should the patients OML be positioned for PA Axial (Caldwell Method)

A

Position patient’s OML at 15-degree angle to horizontal CR

16
Q

CR for PA Axial (Caldwell Method)

A

Horizontal
Exits nasion
Center IR and CR

17
Q

how do you get the PA axial caldwell method

A

either angle bucky or angle the OML 15 degrees

18
Q

what is demonstrated in the Parietoacanthial Projection (Waters Method

A

Maxillary sinuses
Petrous pyramids lying inferior to maxillary floor
Frontal and ethmoid sinuses are distorted

18
Q

what is best demonstrated in the Parietoacanthial Projection (Waters Method

A

maxillary sinuses

19
Q

how is the MSP and MML in the
Parietoacanthial Projection (Waters Method)

A

MSP and mentomeatal line (MML) perpendicular to IR plane

20
Q

what are the four sinuses

A

frontal, ethmoid, maxillary, and sphenoid

21
Q

what degree is the OML in the
Parietoacanthial Projection (Waters Method)

A

OML is 37 degree from cassette

22
Q

how should the head be positioned in the Parietoacanthial Projection (Waters Method)

A

Hyperextend neck to place OML at 37-degree angle from IR plane

23
Q

how is the CR in the Parietoacanthial Projection (Waters Method)

A

CR:
Horizontal
Exits acanthion

24
Q

how is the patient positioned for the Parietoacanthial Projection (Open-Mouth Waters Method)

A

Seated erect facing Bucky
MSP centered to midline

25
Q

how is the head positioned in the Parietoacanthial Projection (Open-Mouth Waters Method)

A

Hyperextend neck to place OML at 37-degree angle from IR plane

26
Q

what is the CR for Parietoacanthial Projection (Open-Mouth Waters Method)

A

Horizontal
Exits acanthion

26
Q

how is the head positioned in the Parietoacanthial Projection (Open-Mouth Waters Method)

A

Hyperextend neck to place OML at 37-degree angle from IR plane

27
Q

what is the degree of the OML in the Parietoacanthial Projection (Open-Mouth Waters Method)

A

37 degrees

28
Q

how is the MSP and MML in the Parietoacanthial Projection (Open-Mouth Waters Method)

A

MSP and MML perpendicular to IR plane

29
Q

what does the Parietoacanthial Projection (Open-Mouth Waters Method) demonstrate

A

Sphenoid sinuses through open mouth

30
Q

how are the petrous ridges in the open mouth waters method

A

they lie inferior to maxillary floor

31
Q

how is the head positioned in the SMV

A

Hyperextend neck and rest vertex of head on vertical grid device

32
Q

how is the MSP in the SMV

A

MSP perpendicular to IR plane

33
Q

how is the IOML in the SMV projectio

A

Neck extended to place IOML parallel to IR plane

34
Q

CR for the SMV projection

A

Horizontal and perpendicular to IOML
Enters MSP ¾ inch (1.9 cm) anterior to level of external acoustic meatus (EAM) level of sella turcica

35
Q

what does the SMV projection demonstrate

A

Sphenoid and ethmoid sinuses
Bony nasal septum

36
Q

Which sinuses are best demonstrated on the parietoacanthial projection (Waters method)?

A

Maxillary

37
Q

Which sinuses are best demonstrated on the PA axial projection (Caldwell method)?

A

Frontal