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Positioning SUMMER 2015 > SKULL positioning > Flashcards

SKULL positioning Flashcards

1
Q

3 divisions of ear

A
  1. external
  2. middle
  3. internal
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2
Q

external ear consists of

A 
auricle (pinna) 
tragus 
EAM
mastoid process 
mastoid tip styloid process
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3
Q

where does the external ear end

A

at the tympanic membrane

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4
Q

where are the location of organs of hearing and equilibrium

A

located in the petrous pyramids

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5
Q

3 parts of middle ear

A
  1. tympanic membrane
  2. tympanic cavity
  3. auditory ossicles
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6
Q
  1. tympanic membrane
A

partition between external and middle ear

transmits sound vibrations

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7
Q
  1. tympanic cavity
A

communicates with nasopharynx by eustachian tube
separated from external ear by tympanic membrane
separated from internal ear by bony labryinth

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8
Q

the tympanic cavity is further divided into 2 parts

A
  1. tympanic cavity proper

2. epitympanic recess (attic)

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9
Q

drum crest (spur)

A

bony projection to which tympanic membrane is attatched

separates EAM from epitympanic recess

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10
Q

middle ear

A

communicates with nasopharynx and mastoids

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11
Q

eustachian tube

A

passageway between middle ear and nasopharynx

equalizes pressure

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12
Q

internal acoustic meatus

A

smaller than the EAM

best demonstrated with CT and MRI

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13
Q

aditus

A

opening between epitympanic recess and mastoid air cells

allows infection in middle ear which may pass to mastoids

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14
Q

3 auditory ossicles

A
  1. malleus
  2. incus
  3. stapes
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15
Q

auditory ossicles

A

transmit sound vibrations

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16
Q

inner ear

A

contains sensory apparatus of hearing and equilibrium

in densest portion of petrous pyramids

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17
Q

2 parts of the inner ear

A
  1. osseous bony labyrinth

2. membranous labyrinth

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18
Q

osseous bony labyrinth

A

bony chamber that houses membranous labyrinth

divided into 3 parts

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19
Q

3 parts of osseous bony labyrinth

A
  1. cochlea
  2. vestibule
  3. semi circular canals
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20
Q
  1. cochlea
A

snail shell
relates to sense of hearing
communicates with middle ear through round window

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21
Q
  1. vestibule
A

communicates with middle ear by way of oval window

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22
Q
  1. semi circular canals
A

anterior
posterior
lateral
relate to direction or equilibrium

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23
Q

what nerves pass through the IAM from membranous labyrinth to the brain

A

cochlear and vestibular nerve

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24
Q

membranous labyrinth

A

intercommunicating system of ducts and sacs housed in the osseous bony labyrinth

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25
Q

2 windows of internal ear

A
  1. oval window (vestibular)

2. round window (cochlear)

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26
Q

oval window

A

receives vibrations from external ear through stapes of middle ear
moves inward with vibration

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27
Q

round window

A

allows movement of fluid within the closed duct system of membranous labyrinth
moves outward

28
Q

clinical indications of cranium (11)

A 
skull fractures 
gunshot wounds 
neoplasms 
multiple myeloma 
pituitary adenoma 
paget's disease 
temporal bone pathology
acoustic neuroma 
cholesteatoma 
polyp 
otosclerosis
29
Q
  1. skull fractures
A

a. linear fractures
b. depressed fractures
c. basal skull fractures

30
Q

a. linear fractures

A

appear as jagged or irregular lucent lines that lie at right angles to the axis of the bone

31
Q

b. depressed fractures AKA ping pong

A

a fragment of bone is separated and depressed into cranial cavity
ex: crushing a ping pong ball dent in it

32
Q

c. basal skull fractures

A

can be found on a plain radiograph by air fluid level in sphenoid sinus

33
Q

complications of basal skull fractures

A

leakage of CSF
meningitis
damage to facial nerve
damage to auditory apparatus

34
Q
  1. gunshot wounds
A

plain images will localize bullets

35
Q
  1. neoplasms
A

new/abnormal growths

36
Q

osteolytic

A

destructive lesions with irregular margins

37
Q

osteoblastic

A

proliferative bony lesions of increased density

38
Q

combo osteolytic and osteoblastic lesions

A

eaten appearance

39
Q
  1. multiple myeloma
A

one or more bone tumors that originate in bone marrow

40
Q
  1. pituitary adenoma
A

tumor of pituitary gland usually diagnosed with CT/MRI

plain image show enlargement of sella turcica and erosion of dorsum sellae

41
Q
  1. paget’s disease
A

cotton wool appearance

unknown etiology

42
Q
  1. temporal bone pathology
A

mastoiditis - bacterial infection where air cells are replaced with fluid filled abcess

43
Q
  1. acoustic neuroma
A

benign tumor of auditory nerve

originates in IAC

44
Q
  1. cholesteatoma
A

begnign cyst like mass or tumor
most common in middle ear or mastoid region
destroys bone

45
Q
  1. polyp
A

growth that arises from a mucous membrane and projects into cavity
may cause sinusitis

46
Q
  1. otosclerosis
A

abnormal sponge like bone grows in middle ear

47
Q

mesocephalic skull

A

average head
width is 75% to 80% of the length
petrous pyramids project anteriorly and medially at a 47 degree angle

48
Q

brachycephalic skull

A 
short from front to back 
broad from side to side 
shallow from vertex to base 
width is 80% or greater than the length 
petrous pyramids have a 54 degree angle
49
Q

dolichocephalic skull

A 
long from front to back 
narrow from side to side 
deep from vertex to base 
petrous pyramids have a 40 degree angle 
width is less than 75% of the length
50
Q

5 common positioning errors

A
  1. rotation
  2. tilt
  3. excessive flexion
  4. excessive extension
  5. incorrect CR angle
51
Q

positioning considerations for asthenic or hyposthenic pt.

A

build up the body to get cervical vertebra in line with foramen magnum

52
Q

positioning considerations for hypersthenic pt.

A

build up the head to get cervical vertebra in line with foramen magnum

53
Q

alternative modalities

A

CT
MRI
Ultrasound
Nuclear med

54
Q

skull series ROUTINE

A

AP axial (towne method)
Lateral
PA axial 15 degrees (caldwell) or 25 - 30 degree angle
PA 0 degrees

55
Q

Skull series SPECIAL

A 
submentovertex (SMV)
PA axial (Haas method)
56
Q

skull AP axial (towne method) clinical indications

A

skull fractures
medial/lateral displacement
neoplastic processes
paget’s disease

57
Q

Skull AP axial (towne method) technical factors

A

SID = 40
10 x 12 IR lengthwise
80-85 kv

58
Q

skull AP axial (towne method) pt. / part position

A

supine or erect
OML perpendicular to IR
if pt. can’t get OML perpendicular place IOML perpendicular
CR angle 30 degrees to OML
CR angle 37 degrees to IOML
CR enters 2.5 inches above glabella to pass through foramen magnum

59
Q

skull AP axial (towne method) what do you see

A

dorsum sellae and posterior clinoids visualized in the shadow of the foramen magnum

60
Q

skull AP axial (towne method) UNDERANGULATION / INSUFFICIENT FLEXION

A

projects dorsum sellae superior to the foramen magnum

61
Q

skull AP axial (towne method) OVERANGULATION / EXCESSIVE FLEXION

A

superimposes the arch of C1 over the dorsum sellae within the foramen magnum

62
Q

are both right and left laterals done for a skull series?

A

yes

63
Q

lateral skull technical factors

A

SID = 40
10 x 12 crosswise
80-85 kv

64
Q

lateral skull pt./part position

A 
erect or recumbent 
side of interest closest to IR 
IPL perpendicular to IR 
IOML perpendicular to front edge of IR 
GAL parallel to front edge of IR 
CR enters 2 inches above EAM or halfway between glabella and inion
65
Q

lateral skull rotation evident by:

A

anterior and posterior separation of symmetric vertical bilateral structures

66
Q

lateral skull tilt evident by:

A

superior and inferior separation of symmetric horizontal structures

Positioning SUMMER 2015 (5 decks)

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