Skull, nasal, sinus Flashcards
1
Q
Soft tissue landmark which is found at the base of the anterior nasal spine
A
acanthion
2
Q
Exit point for the CR during the 15 degrees PA axial (caldwell) projection
A
nasion
3
Q
which line is perpendicular to the IR during the modified pareitoacanthail (modified waters) projection
A
LML
4
Q
Line which is at a 37 degree angle to the IR and table top during the parietoacanthial (waters) projection
A
OML
5
Q
Angle of the OML from horizontal for the erect PA Caldwell sinus projection which will remove the need to angel the CR
A
15º from horizontal
6
Q
Paranasal sinuses which are best demonstrated with a PA (Caldwell) projection
A
Frontal and anterior ethmoid sinuses
7
Q
Modality that can be performed to rule out sinusitis of the sphenoid sinus
A
U/S
8
Q
Structure that lies directly superior to the sphenoid sinus
A
sella turcica
9
Q
Aspect of the ethmoid bone that contains the ethmoid air cells
A
lat masses/labrynth
10
Q
The largest of the paranasal sinuses
A
maxillary sinuses
11
Q
Sinuses which develop during puberty
A
ethmodal air cells
12
Q
Age at which only the frontal and sphenoidal sinuses become distinguishable
A
6-7
13
Q
Structure which is the exit point for the CR on a properly positioned Waters.
A
acanthion
14
Q
Positioning line which is perpendicular to the IR for the parietoacanthial (Waters) projection
A
MML
15
Q
Proper anatomy and location shown for the parietoacanthial (waters) projection
A
Dense petrous pyramids are projected below the maxillary sinuses
16
Q
A radiograph of a lateral skull demonstrates that the oribital plates (roof) of the frontal bone are not superimposed. What is the positioning error present on this radiograph?
A
tilt
17
Q
A radiograph of a SMV projection of the cranium demonstrates that mandibular condyles are projected into the petrous portion (pyramids) of the temporal bone. How must the position be altered during the repeat exposure to correct his error?
A
Extend the skull further to place the IOML parallel to the IR.
18
Q
The majority of the hard plate is formed by
A
maxilla
19
Q
The sphenoid sinus lies directly inferor to the
A
sella turcica
20
Q
What is the angle between the OML and plane of image receptor with a parietoacanthial (waters method) projection? This places the _______ positioning line perpendicular to the IR.
A
37º; MML
21
Q
The CR is centered to exit at the level of the _________ for a well positioned parietoacanthial projection.
A
acanthion
22
Q
Condition that begins with bony destruction followed by bony repair.
A
Paget’s Disease
23
Q
Tangential view may be helpful to determine extent or degree of this fracture.
A
Depressed Fracture
24
Q
Destructive lesion with irregular margin.
A
Osteolytic neoplasm
25
Bone tumor originiating in the bone marrow.
Multiple myeloma
26
Fracture evident by sphenoid sinus effusion
Basal fracture
27
How much central ray angle is required for the AP axial projection (towne method) for skull with the IOML perpendicular to the image receptor?
37º caudad
28
what lies just ant. and med. to the frontal process of the maxilla?
nasal bones
29
Which two projections of the cranium project the dorsum sellae within the foramen magnum?
AP Towne, PA Haas
30
Which auditory ossicle attaches to the oval window?
stapes
31
How much central ray angle is required for the AP axial projection (towne method) for skull with the OML perpendicular to the image receptor?
30º caudad
32
Where is the central ray centered for a lateral projection of the cranium?
2” sup. to EAM
33
Where should the petrous ridges be located (on the image) for a well positioned, 25 degree cephalic PA axial (haas method) projection?
Superior to the mastoid processes and symmetrical
34
Which middle ear structures is considered to be most lateral?
malleus
35
A radiograph of a lateral projection of the cranium reveals that the greater wings of sphenoid are not superimposed. What type of positioning error is present on this radiograph?
Tilt
36
A radiograph of an AP axial projection for the cranium reveals that the dorsum sellae is projected superior to the foramen magnum. What must be modified during the repeat exposure to correct this problem?
Increase CR angle approximate 7 degrees caudad
37
A radiographh of a 15 degree caudad PA axial projection of the cranium reveals that the petrous ridges are at the level of the supraorbital margin. Without changing the central ray angle, how must the head position be modified during the repeat exposure to produce a more acceptable image?
Increase extension of the skull to place OML perpendicular to the IR
38
A patient with a possible basilar skull fracture enters the emergency room. They physician wants a projection to demonstrate a possible sphenoid sinus effusion. Which projection of the cranium is best for this situation?
Horizontal beam lateral skull projection with a 15 degree cephalic angel to the OML
39
A patient comes to the radiology department for a skull series. Because of the size of the patient's shoulders, he is unable to flex his neck sufficiently to place the OML perpendicular to the IR for the AP axial projection. His head cannot be raised because of possible cervical trauma. What other options does the technologist have to obtain an acceptable AP axial projection?
Use the IOML (instead of OML), increase angle and add 7 degrees cuadad for a total of 37 degrees.
40
A radiograph of an AP axial (Town method) projection for cranium reveals that the posterior arch of C1 and dorsum sellae are superimposed. Both are projected into the foramen magnum. What modificaton is needed to correct this error present on the initial radiograph?
decrease CR angle based on the skull line used OML-30 degrees or IOML --37 degrees
41
Where are the petrous ridges projected for a properly positioned modified parietoacanthia projection?
lower 1/2 of the maxillary sinuses
42
The CR should be angled as needed to be parallel to the glabellomeatal line (GML) for the superoinferior tangential projection of the nasal bones. (T/F)
F. GAL should be II to CR
43
Which positioning line is placed perpendicular to the image receptor for a modified parietoacanthial projection?
LML
44
Where is the CR centered for a lateral projection of the nasal bones?
1/2” inf to nasion
45
Where is the CR centered for a lateral projection of the paransal sinuses?
midway between the outer canthius and the EAM
46
Why should a patient remain in an erect position for at least 5 minutes before sinus radiography?
to allow fluid in sinuses to settle
47
Which routine projection is best for demonstrating the maxillary sinuses?
Pareitoananthial (waters) projection
48
Location of the petrous ridges for a properly positioned modified waters (modified parietoacanthial) projection.
Lower half of the maxillary sinuses
49
Positioning line to which the CR should be adjusted parallel for the superinferior projection for the nasal bones
GAL
50
Age at which all paranasal sinuses are fully developed
17
51
Paranasal sinuses which communicate with the nasal cavity
all
52
The only paranasal sinuses which are not contained within cranial bones
maxillary sinuses
53
Best sinus routine for a patient with a possible sphenoid sinus polyp.
Basic-lateral
PA Caldwell,
Parietoacanthial,
SMV Special--PA transoral
54
Positioning error occurring during a parietoacanthial which shows the petrous ridges just below the maxillary sinuses
No Error shown, petrous ridges should be below the floors of the maxillary sinuses during the waters
55
Correction to be made during a PA transoral which shows the sphenoid sinus superimposed over the upper teeth and nasal cavity
Increase extension of the head and neck to project the entire sphenoid sinus through the oral cavity
56
Positioning error shown during an SMV sinus in which the distance between the mandibular condyles and lateral border of the skull is not equal.
HEAD TILT
57
A patient with a clinical history of secondary osteomyelitis comes to the radiology department. Which imaging modalities or procedures can be performed to demonstrate the extend of damage to the sinuses.
Routine sinus series or CT if the sinuses can best demonstrate bony erosion.
58
Positioning line which ensures adequate extension of the head for the SMV projection, when it is placed parallel to the IR
IOML
59
Proper CR centering for a lateral projection of the nasal bones
1/2” inf to nasion
60
Positioning line which is placed perpendicular to the IR for a modified parietoacanthial projection?
LML
61
A superinferior, tangential projection for the nasal bones was taken with the following analog exposure factors: 18x24 cm (8x10), IR crosswise, 85 kv, 13 MAS, 40 inch SID. The resultant radiograph was unsatisfactory because of poor visibility of the nasal bones. Which technical factors should be changed for the repeat exposure?
Reduce kVp to 50 or 60 and increase mAs accordingly
62
A radiograph of lateral position for sinuses reveals that the greater wings of the sphenoid bone are not superimposed. What specific positioning error is present?
tilt
63
Why should the horizontal CR be used for the erect PA (Caldwell) projection for sinuses rather than the usual 15 degrees caudad angle?
To demonstrate any air/fluid levels w/o distortion
64
Where is the central ray centered for an SMV projection of the skull?
1.5" inferior to the mandibular symphysis midway between the gonions.
65
Name of the structure which divides the nasal cavity into compartments and circulates air coming into the nasal cavities
conchae or turbinates
66
two structures that are better visualized on the modified parietoacanthial (waters) as compared with the basic waters method
orbital rims, orbital floors
67
CR angle that must be used to project ridges just below the orbital floor with the PA axial (Caldwell) projection
30º
68
Name of the winus which will be projected through the open mouth with a PA axial transoral projection
sphenoid
69
Name of the passageway between the maxillary sinuses and middle nasal meatus
infundibulum
70
what is between the inner and outer tables of the skull, posterior to the glabella?
frontal sinuses
71
specific aspect of the ethmoid bone which contains the ethmoid sinuses?
lat masses/labrynths
72
age at which the frontal sinuses usually become aerated
6
73
Name of the sinus which can be affected by an infection of the teeth if the infection travels upward
maxillary
74
Preferred modality to study soft tissue changes and masses within the sinuses
MRI
75
Modality which can be used to rule out sinusities
U/S of maxillary sinuses
76
kv range for sinuses
65-80
77
Is secondary osteomyelities caused by a tumor?
no
78
Projection that best demonstrates the profile image of the nasal bones and nasal septum
lat
79
Proper location of the petrous ridges for a PA waters projection
directly below maxillary sinuses
80
Exit point for the CR during the parietoacanthial (waters) projection
acanthion
81
Line which is placed perpendicular to the IR for the parietoacanthial (waters) projecton
MML
82
Positioning error shown during a parietoacanthial (waters) shows that the distance between the MSP and the outer orbital margin is not equal
head rotation
83
Correction to be made durng a PA (Caldwell) sinus x-ray when the petrous ridges are projected into the lower half of the orbits, obscuring the ethmoid sinuses
head and neck must be extended more to project the petrous ridges below the ethmod sinuses
84
Best radiographic routine for an ER patient with possible fracture of the nasal bones with concern of deviation of the bony nasal septum.
PA Waters, and right and left laterals (superinferior only if requsted)
85
Correction to be made during a superinferior projection of the nasal bones which shows the glabella superimposed over the nasal bones
Decrease flexion of the head and neck or fix CR angle so GAL II to CR
86
Anatomy best seen with the PA transoral sinus projection
sphenoid sinus in oral cavity
87
Anatomy best seen with the SMV sinus projection
Inferosuperior view of the sphenoid and ethmoid sinuses
88
Anatomy best seen with the PA Caldwell sinus projection
Best view of the frontal and ethmoid sinuses
89
Anatomt best seen with the parietoacanthial (waters) projection of the sinuses
maxillary sinuses
90
Anatomy best seen with the lateral sinus projection
all four paranasal sinuses
91
The one major difference in positioning between the PA parietoacanthial (waters) and PA axial transoral projections
The mouth (oral cavity) is open with the PA transoral projection
92
Sinuses which are projected through the oral cavity with the PA Axial transoral projection
Sphenoid sinuses
93
Proper CR exit point for both the PA parietoacanthial (waters) and the PA axial transoral (open mouth waters) projection
level of acanthion
94
Three paranasal sinuses which are demonstrated with an SMV projection of the paranasal sinuses
Sphenoid sinus
Ethmoid sinus
Maxillary sinus
95
Location of the petrous ridges on a well positioned parietoacanthial projection
just below the maxillary sinuses
96
Positioning line which is placed perpendicular to the IR for a parietoacanthial (Waters) paranasal sinus projection
MML
97
Amount of angel of the OML to the IR for the parietoacanthial (waters) projection
37º
98
Group of paranasal sinuses which is best demonstrated with a pareitoacanthial (waters) projection
maxillary
99
Alternate lateral paranasal sinus projection to be taken for a patient who cannot stand
horizontal XR beam
100
Four most commonly performed basic or routine projections for paranasal sinuses
Lateral
PA Caldwell
Parietoacanthial (waters)
SMV---submentovertex
101
Location or junction at which a deviated nasal septum is most likely to occur?
between the septal cartilage and the vomer (pushed laterally to one side)
102
term for average shaped head and approx angle of petrous pyramids
mesocephalic, 47º
103
term for short broad shaped head and approx angle of petrous pyramids
brachycephalic, >47º (+/-54º)
104
term for long narrow shaped head and approx angle of petrous pyramids
dolichocephalic, <47º (+/- 40º)
105
skull is made of how many bones
22
106
4 cranial bones that primarily make up floor of calvarium?
R/L temporal, sphenoid, ethmoid
107
junction of eyelids near nose aka
inner canthus
108
lat junction of 2 eyelids aka
outer canthus
109
sup. rim of the orbits aka
superior orbital margin (SOM)
110
inf. rim of orbit aka
infraorbital margin (IOM)
111
lat portion of the orbital rim aka
midlateral orbital margin
112
the most ant. part of the calvarium is?
the frontal bone
113
how many bones articulate w the parietal bone?
5
114
what 5 bones articulate w the parietal bone?
frontal, occipital, temporal, sphenoid, and opp. parietal
115
how many bones articulate w the occipital bone?
6
116
what 6 bones articulate w the occipital?
2 parietals, 2 temporals, sphenoid, and atlas
117
how many bones articulate w the temporal bone?
3
118
what 3 bones articulate w the temporal bone?
parietal, occipital and sphenoid
119
how many bones does the sphenoid articulate w?
all other 7 cranial bones
120
how many cranial bones are there?
8
121
what is the calvarium?
skull cap (frontal, R/L parietal, occipital)
122
cranial bones are divided into?
calvarium/skullcap and cranial floor
123
what bones make up the cranial floor?
R/L temporal, sphenoid, ethmoid
124
how many bones does the ethmoid articulate w?
2
125
which 2 bones does the ethmoid articulate w?
frontal and sphenoid
126
which small section of bone is located sup. to cribriform plate?
crista galli
127
shallow depression just post. to the base of the dorsum sellae and ant. to the foramen magnum is the
clivus
128
what is the name of the cranial suture formed by the inf. junction of the parietals to the temporal bones?
squamosal
129
pterygoid hamulus is located on which bone?
sphenoid
130
ant. clinoid process is located on which bone?
sphenoid
131
glabella is located on which bone?
frontal
132
foramen ovale is located on which bone?
sphenoid
133
perpendicular plate is located on which bone?
ethmoid
134
sup. nasal conchae is located on which bone?
ethmoid
135
foramen magnum is located on which bone?
occipital
136
cribriform plate is located on which bone?
ethmoid
137
zygomatic processes are located on which bone?
temporal
138
lat. condylar portions are located on which bone?
occipital
139
superciliary arch is located on which bone?
frontal
140
EAM is located on which bone?
temporal
141
inion is located on which bone?
occipital
142
sella turcica is located on which bone?
sphenoid
143
petrous ridge is located on which bone?
temporal
144
petrous ridge corresponds to the level of which important external landmark
TEA (top of ear attachment)
145
(lat skull) tilt is evident by ____ & ____ separation of symmetric horizontal structures such as _________ & ____________ of sphenoid
sup. & inf.; orbital roofs/plates & greater wings of sphenoid
146
(lat skull) rotation is evident by ____ & ____ separation of symmetrical vertical bilat structures such as ____, mandibular rami, and ______ of sphenoid
ant. & post.; EAM, greater wings of sphenoid
147
(PA Caldwell) no rotation is assessed by equal distance of what?
equal distance from the midlat orbital margins to the lat cortex of cranium
148
(PA Caldwell) if the distance btw the R lat orbit and lat cranial cortex is greater than the L side, what has occurred?
face rotated toward L side
149
supraorbital groove (SOG) important bc it corresponds to the highest level of the facial bone mass, which is also the level of the?
floor of the ant. fossa of the cranial vault
150
the post. extension of the ____ approximates the location of the inion
IOML
151
slanting of MSP laterally is called what?
tilt
152
(AP Towne) dorsum sellae projected sup. to foramen magnum indicates?
underangulation of CR or insufficient neck flexion/extension
153
(AP Towne) superimposition of post. arch of C1 over the dorsum sellae w/in the foramen magnum, foreshortening the dorsum sellae, indicates?
overangulation of CR or excessive flexion
154
(AP Towne) shifting of the ant./post. clinoid processes laterally w/in the foramen magnum indicates?
tilt
155
what position of skull does NOT show tilt w the MSP perpendicular to the IR?
PA Caldwell
156
(SMV) if distance on the L side btw the mandibular ramus and lat cranium is greater on the L than R, then the cranial vertex is what?
tilted to the L
