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Advanced positioning 2015 > Skull > Flashcards

Skull Flashcards

1
Q

Anatomy of the cranium

A

A: Parietal

B: glabella

C: sphenoid

D: superior orbital fissure

E: Temporal bone

F: Supraorbital foramen

G: optic foramen

H: Sphenoid bone

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2
Q

Anatomy

A

A: glabella

B: Pterion

C: Bregma

D: Coronal suture

E: Lambda

F: Lambdoidal suture

G: occipital bone

H: Ext. occipital protuberance (inion)

I: Asterion

J: EAM

K: Styloid process

L: frontal bone

M: Parietal bone

N: Squamosal suture

O: Sphenoid

P: Temporal

Q: Mastoid process

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3
Q

Cranial floor anatomy

A

A: Crista galli B: Cribreform plate C: Optic canal and foramen D: tuberculum sellae E: Ant. clinoid process F: Sella turcica G: Post. clinoid process H: Foramen lacerum I: Dorsum sellae J: Jugular foramen K: Hypoglossal canal L: Foramen magnum M: Occipital N: Clivus O: Petrous portion P: Diploe Q: Temporal bone R: Foramen spinosum S: Foramen ovale T: Optic groove U: Greater wing V: Lesser wing W: Orbital plate X: Anterior Y: Middle Z: Posterior

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4
Q

Slice of lateral skull anatomy

A

A: Maxilla B: Vomer C: Ethmoid D: Nasal E: Crista galli F: frontal sinus G: Frontal H: diploe I: Parietal J: Sphenoidal sinus K: Squamous portion of temporal L: Internal acoustic meatus M: Occipital bone N: Petrous portion of temporal bone O: Clivus P: Pterigoid hamulus Q: Palatine bone

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5
Q

Fontanels

A

A: Anterior fontanel

B: Posterior (lambda) fontanel

C: Mastoidal fontanel

D: Sphenoidal fontanel

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6
Q

Frontal surface anatomy

A

A: Frontal squama

B: Supraorbital margin

C: Glabella

D: Nasal spine

E: Superciliary arch

F: Frontal eminence

G: Superorbital foramen

H: Nasion

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7
Q

Ethmoid anatomy

A

A: Superior nasal conche

B: middle nasal conche

C: perpendicular plate

D: Crista galli

E: ethmoidal sinus

F: Medial orbital wall

G: Air cells in Labyrinth

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8
Q

Ethmoid anatomy

A

A: sphenoid

B: vomer

C: Cribriform plate

D: Crista galli

E: frontal

F: nasal

G: cartilage of nasal septum

H: perpendicular plate

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9
Q

What bone and its articulations?

A

Parietal (ext) bone

A: Parietal

B: occipital

C: temporal

D: frontal

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10
Q

Name the angles

A

A: Occipital

B: Mastoid

C: Frontal

D: sphenoid

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11
Q

Sphenoid anatomy

A

A: Lesser wing B: Optic groove C: Greater wing

D: Optic canal E: Foramen ovale F: Foramen spinosum

G: carotid sulcus H: Dorsum sellae I: Sella turcica

J: Posterior clinoid process K: Tuburculum sellae

L: Foramen rotundum M: Anterior clinoid process

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12
Q

Occipital

A

A: Squama

B: External occipital protuberance (inion)

C: Foramen magnum

D: occipital condyle

E: Basilar portion

F: Condylar canal

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13
Q

internal occipital

A

A: Fossa for cerebrum

B: Internal occipital protuberance

C: Fossa for cerebellum

D: Hypoglossal canal

E: Foramen magnum

F: Jugular process

G: Condyle for articulation with atlas

H; Basalar portion

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14
Q

What bone is this and its parts?

A

Temporal bone

A: Mastoid portion

B: EAM

C: Mastoid process

D: Tympanic portion

E: Styloid process

F: Mandibular fossa

G: Articular tubercle

H: zygomatic process

I: Squamous portion

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15
Q

What is this bone and its parts?

A

Temporal bone

A: Mastoid process

B: Mastoid air cells

C: Squamous portion

D: Mastoid antrum

E: Arcuate eminence

F: Semicircular canal

G: Petrous ridge

H: petrous apex

I: Carotid canal

J: Promontory (formed by cochlear base)

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16
Q

Name the 9 anterior landmarks pg 286

A

1: angle of mandible or gonion
2: infraorbital margin
3: outer canthus
4: glabella
5: interpupillary line
6: inner canthus
7: nasion
8: acanthion
9: mental point

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17
Q

Name the 9 lateral landmarks

A

1: Gonion
2: EAM
3: Auricle
4: Top of ear attachment
5: Glabellomeatal line
6: orbitomeatal line
7: infraorbitomeatal line
8: Acanthiomeatal line
9: Mentomeatal line

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18
Q

Name the 3 different skull shapes

A

1: mesocephalic skull
2: brachycephalic skull
3: Dolichocephalic skull

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19
Q

Which is the typical skull size/shape?

A

mesocephalic

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20
Q

What skull is short from front to back and wide from side to side?

A

Brachycephalic

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21
Q

What skull is long from front to back and narrow from side to side?

A

dolichocephalic

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22
Q

When imaging the skull in an adult what is the best radiation protection?

A

Collimation but always shield the groin for patient reassurance.

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23
Q

Pt position for Lateral cranium?

A

seated upright or semiprone on table

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24
Q

for the lateral skull how is the MSP to the plane of the IR?

A

parallel

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25
Q

for the lateral skull, what is the position of the IOML to the front edge of the IR? And for the long axis of the IR?

A

perpendicular

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26
Q

for the lateral skull the interpupillary line should be _______

A

perpendicular

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27
Q

For lateral skull, where should the central ray enter the anatomy?

A

2” superior to the EAM

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28
Q

What is the colilmation for a lateral skull?

A

10x12

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29
Q

What are some important landmarks to look for when evaluating a lateral skull radiograph?

A

everything is superimposed and the sella turcica is in profile

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30
Q

How would you do a trauma lateral skull?

A

Cross table with a horizontal beam

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31
Q

What is another name for the PA or PA axial skull?

A

Caldwell

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32
Q

What is the patient position for the Caldwell?

A

either prone or seated with forehead and nose resting on table or bucky. If prone, flex elbows

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33
Q

With a Caldwell skull what landmark should be perpendicular to the plane of the IR?

A

OML

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34
Q

For the Caldwell skull how should the MSP be positioned with the IR?

A

perpendicular

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35
Q

For the caldwell skull where should you center the IR?

A

To the nasion

36
Q

For the PA projection when the frontal bone is primary interest, where should you direct the CR?

A

Perpendicular to exit the nasion

37
Q

for the caldwell, how should the CR be directed?

A

to exit the nasion at a 15 degree angle caudad

38
Q

For the Caldwell skull how should the MSP be positioned with the IR?

A

perpendicular

39
Q

For the caldwell skull where should you center the IR?

A

to the nasion

40
Q

For the PA projection when the frontal bone is primary interest, where should you direct the CR?

A

Perpendicular to exit the nasion

41
Q

To visualize the superior orbital fissures for the PA skull, where should the CR be directed?

A

through the mid orbits at a 20-25 degree angle caudad

42
Q

To visualize the rotundum foramina in a PA skull, where should the CR be directed?

A

to the nasion at a 25-30 degree angle caudad

43
Q

What is the collimation for the PA & Caldwell skull?

A

10x12

44
Q

For a PA skull with a straight beam, how are the petrous pyramids situated in the image?

A

they fill the orbits

45
Q

When doing a 15 degree caudad angle for the Caldwell PA skull, where are the petrous pyramids situated in the image?

A

into the lower 1/3 of the orbits

46
Q

When doing a 30 degree Caldwell PA skull, where are the petrous pyramids situated in the image?

A

Well below the orbits

47
Q

When would it be ok to move the patients head into a true lateral position for a PA skull?

A

During a trauma after the spinal injury has been ruled out.

48
Q

What is the main criteria to look for in a PA skull image?

A

Petrous pyramid relationship with orbits, equal distance from lateral border of orbit to both sides…and nothing is cut off!

49
Q

What is the pt position for the AP skull?

A

Supine or seated upright

50
Q

Where is the CR to be directed for the AP skull?

A

oward the nasion straight or if doing a AP axial (not recommended) at 15 degrees cephalad

51
Q

When is a AP or AP axial skull usually done?

A

When the pt cannot position for the PA or PA axial.

52
Q

What is the collimation for the AP skull?

A

10 x 12

53
Q

What is shown in an AP image?

A

The same criteria as the PA only the orbits are magnified do to OID

54
Q

The more common AP axial projection is also called…

A

Towne method

(think DOWNTOWN)

55
Q

what is the pt position for the Town (AP axial) method?

A

supine or seated

56
Q

What is the position of the MSP for the Towne projection?

A

perpendicular

57
Q

What is the landmark for the Town projection and what is its position?

A

the OML should be perpendicular to the plane of the IR

58
Q

If the pt cannot flex enough for the OML to be perpendicular to the IR, what is the alternative?

A

the IOML can be perpendicular (degree of the CR must also be increased by 7 degrees)

59
Q

Where is the upper margin of the IR when positioning for the Town projection?

A

at the level of the highest point of the cranial vertex

60
Q

Where is the CR directed for the Town (AP axial) projection and how many degrees?

A

through the foramen magnum at a 30 degree caudal angle unless the IOML is perpendicular then the angle changes to 37 degrees caudal

61
Q

Where is the CR to enter when doing the Town (AP axial) projection?

A

2.5” above the glabella and passes through the level of the EAM

62
Q

What is shown in the images for the Towne projection?

A

symmetric petrous pyramids, posterior foramen magnum, the posterior clinoid is within the foramen magnum

63
Q

For the Town (AP axial) projection, what needs to be done to see the entire foramen magnum?

A

increase the caudal angle to 40-60 degrees to the OML

64
Q

What is a main reason to do a PA axial (HAAS method) on a patient?

A

When the pt is to obese or cannot sit correctly for the AP axial (Towne) projection.

65
Q

How is the pt positioned for the PA axial (HAAS) projection?

A

prone or seated upright; if prone flex elbows for support.

66
Q

How is the part positioned for the PA axial skull (HAAS) projection?

A

forehead and nose on the table with the MSP perpendicular to the grid

67
Q

What is the landmark and how is it situated for the PA axial skull (HAAS) method?

A

the OML is perpendicular to the IR

68
Q

How is the CR directed for the PA axial skull (HAAS) projection?

A

25 degrees to the OML cephalad

69
Q

Where does the CR enter for the PA axial skull (HAAS) projection?

A

1.5” below the external occipital protuberance (inion) and exits about 1.5” superior to the nasion

70
Q

What is shown for the PA axial (Haas) skull image?

A

he occipital region, petrous pyramids, dorsum sellae & posterior clinoid process within the foramen magnum

71
Q

What is also known as the reverse town method?

A

the PA axial skull or (HAAS method)

72
Q

What does SMV stand for?

A

Submentovertical

73
Q

What is another name for the SMV projection?

A

the schuller method

74
Q

What is the landmark for the SMV and how should it be positioned?

A

the IOML should be as nearly parallel with the plane of the IR as possible

75
Q

How is the CR in relation to the IOML for the SMV skull method?

A

perpendicular to the IOML

76
Q

For the SMV projection of the skull, what is the ideal position in which to place the pt?

A

Ideal position to place the pt is sitting upright in a chair. If unable for pt to be in this position, images can be obtained with pt supine. Midsagittal plane perpendicular to IR.

77
Q

If the pt has to be supine for the SMV skull what additional steps should be taken?

A

elevate the torso on firm pillows to allow the head to rest on its vertex, hyperextending the neck

78
Q

How should the CR be directed for the SMV projection? (Schuller method)

A

perpendicular to the IOML, entering the throat between the angles of the mandible, passing through a point 3/4” anerior to the level of the EAM

79
Q

The CR should be centered to the ____ and the IR should be parallel to the _____ for the SMV

A

IR

IOML

80
Q

What is seen on the SMV image for the skull?

A

Just about everything! maxillary sinus, ethmoid air cells, sphenoid sinus, mandible, foramen spinosum, mandibular condyle, dens, petrosa, mastoid process, occipital bone

(TEETH ARE SUPERIOR IN THE IMAGE & OCCIPITAL IS INFERIOR)

81
Q

What are the 4 typical set of projections for a skull series?

A

1 & 2. both laterals

  1. PA axial (caldwell)
  2. AP axial (Towne method)
82
Q

What is the degree difference between the OML and IOML?

A

7 degrees

83
Q

What is the degree difference between the OML and the GML?

A

8 degrees

84
Q

What is the degree difference between the GML and the IOML?

A

15 degrees

85
Q

What views show the rotundum foramina?

A

Modified Caldwell with a 25-30 degree angle, exit nasion

&

Waters

86
Q

Anatomy of the cranium

A

A: Parietal

B: glabella

C: sphenoid

D: superior orbital fissure

E: Temporal bone

F: Supraorbital foramen

G: optic foramen

H: Sphenoid bone

Advanced positioning 2015 (15 decks)

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