SKULL VIEWS

Question 1

Skull landmarks

Answer 1

Question 2

Skull Planes and Lines

Answer 2

Question 3

Skull LATERAL/RECUMBANT LATERAL Planes and Lines

Answer 3

• MSP is II to IR
• IPL is ⟂ to IR
• IOML is II to long axis of IR and ⟂ to front edge of IR

Question 4

Skull LATERAL Positioning

Answer 4

-CR: ⟂ entering 2” superior to EAM
-Collimation: 10x12”
-1” beyond skin line
-Mark side closest to IR
-SID: 40”
-Breathing Instructions: Suspend

Question 5

Skull LATERAL Sella turcica and surrounding structures

Answer 5

Question 6

Skull LATERAL Evaluation Criteria

Answer 6

-Proper collimation
-Entire cranium without rotation or tilt
• SI orbital roofs
• SI mastoid regions and EAM
• SI TMJs
• Sella turcica in profile
-No overlap of cervical spine by mandible
-Bony detail of cranium closest to the IR

Question 7

PA/PA AXIAL CALDWELL Planes and Lines

Answer 7

• OML is ⟂ to IR
• MSP is ⟂ to IR

Question 8

PA/PA AXIAL CALDWELL Positioning

Answer 8

-CR: Exiting the Nasion
• PA: ⟂
• PA Axial: 15º caudal
-Collimation: 1” beyond skin line
-SID: 40”
-Breathing Instructions: Suspend

Question 9

PA/PA AXIAL CALDWELL Evaluation Criteria

Answer 9

-Proper collimation
-Entire cranium without rotation or tilt
• Equal distances from lateral borders of skull to lateral borders of orbits
• Symmetric petrous ridges
• MSP of cranium aligned with long axis of field
-PA: orbits filled by petrous ridges
-PA Axial: petrous pyramids in lower 1/3 of orbits
-Bony detail of frontal bone and surrounding structures

Question 10

PA vs PA AXIAL CALDWELL

Answer 10

-PA: orbits filled by petrous ridges
-PA Axial: petrous pyramids in lower 1/3 of orbits

Question 11

AP/AP AXIAL(REVERSE CALDWELL) Positioning

Answer 11

-Position the patient supine with the
MSP of the body centered to the grid
*MSP and OML are perpendicular to the IR
-CR: Perpendicular or directed to the nasion at an angle 15 degrees cephalad
-Breathing: suspend

Question 12

AP/AP AXIAL(REVERSE CALDWELL) Evaluation Criteria

Answer 12

• Entire cranium without rotation or tilt
  demonstrated by:
  
  • Equal distances from lateral borders of skull to lateral borders of orbits on both sides
  • Symmetric petrous ridges
  • MSP of cranium aligned with long axis of collimated field
  • Petrous pyramids lying in lower third orbit with a cephalad central ray angulation of 15 degrees and filling orbits with a 0-degree central ray angulation
• Entire cranial perimeter showing three distinct areas of squamous bone

Question 13

Skull AP AXIAL TOWNE Planes and Lines

Answer 13

• MSP is ⟂ to IR
• OML is ⟂ to IR
(Alternative: IOML ⟂ to IR)

Question 14

Skull AP AXIAL TOWNE Positioning

Answer 14

-CR: Enters 2.5” above Glabella, Exits the Foramen Magnum
• OML: 30º caudal
• IOML: 37º caudal
-Collimation: 1” beyond skin line
-SID: 40”
-Marker in the light field
-Breathing Instructions: Suspend

Question 15

Skull AP AXIAL TOWNE Evaluation Criteria

Answer 15

-Proper collimation
-Entire cranium without rotation or tilt
• Equal distances from lateral borders of skull to lateral borders of foramen magnum
• Symmetric petrous ridges
• MSP of cranium aligned with long axis of field
-Dorsum sella and posterior clinoid processes visible within foramen magnum
-Bony detail of occipital bone

Question 16

Skull AP AXIAL TOWNE TRAUMA

Answer 16

To show the entire foramen magnum, the caudal angulation of the central ray is increased from 40 to 60 degrees to the OML

Question 17

Skull SUBMENTOVERTICAL (SMV) (SCHULLER) Planes and Lines

Answer 17

• IOML is II to IR
• MSP is ⟂ to IR

Question 18

Skull SUBMENTOVERTICAL (SMV) (SCHULLER) Positioning

Answer 18

-CR: Enters the MSP of the throat between the gonions
• ⟂ to IOML
• ⟂ to sella turcica
• 3/4” anterior to the EAM
-Collimation: 1” beyond skin line
-SID: 40”
-Marker in the light field
-Breathing Instructions: Suspend

Question 19

Skull SUBMENTOVERTICAL (SMV) (SCHULLER) Evaluation Criteria

Answer 19

-Proper collimation
-Entire cranium without rotation or tilt
• Equal distances from lateral borders of skull to mandibular condyles
• Symmetric petrous ridges
-IOML is parallel to IR
• Mental protuberance SI over anterior frontal bone
• Mandibular condyles anterior to petrosa
-Bony detail of the cranial base

Question 20

To show the entire foramen magnum in the AP Axial TOWNE position, the caudal angulation of the CR should be increase from 40 to…

Answer 20

60 degrees to the OML

Question 21

For pathological conditions, trauma, or deformity such as a strongly accentuated dorsal kyphosis and the patient cannot stand upright for the AP axial TOWNE position, the patient can be in a…

Answer 21

Lateral decubitus position

Question 22

If patient can’t do AP AXIAL TOWNE projection what other method could be used?

Answer 22

HAAS method (PA Axial projection)

Question 23

Which view has the CR perpendicular to the sella turcica?

Answer 23

SMV(schuller)