Soft Palate, Pharynx, Larynx Flashcards
Negative Nasopharyngography CM
Air
Negative and Positive Nasopharyngography indication/s
Hypertrophy of the pharyngeal tonsil or adenoids
Negative Nasopharyngography proj/ view
Lateral
Negative Nasopharyngography pt/ strucure posn
Sitted laterally-front VGD; head- true lat posn
Negative Nasopharyngography cxt and crd
8x10/ 10x12- longit- VCH/VGD;
3/4” (1.9cm) anterior to EAM
Negative Nasopharyngography SN
Exposure–during intake deep breath through nose
Positive Nasopharyngography CM
10-15cc iodized oil (dianosil oil) or finely ground barium sulfate
Positive Nasopharyngography procedure
- Orient pt regarding procedure
- Ask pt to refrain from sneezing and inhibit CM swallowing during exam
- Pt to follow instructions carefully
Nasopharyngography projection/s
- Submentovertical (SMV)
- Lateral
- Chittinand, Patheja, and Wisenberg
SMV Nasopharyngography pr posn
Supine: shoulders same transverse plane; OML- 40-45deg to a horizontal plane;
1st: no cm; 2nd: w/cm
keep head in this posn for entire exam
SMV Nasopharyngography cxt and crd
10*12- longit- VCH/VGD;
15-20deg cephalad bn mandibular angles
SMV Nasopharyngography SN
Position pt on RT after local anesthetization
Nasopharyngography Lat Posn: Pt
Supine: shoulders same transverse plane; OML- 40-45deg to a horizontal plane
Nasopharyngography Lat Posn CXT and CRD
10*12 vertical CW at lat L side of pt’s head- supported sandbag;
horizontally to 3/4” (1.9cm) anterior to EAM
Nasopharyngography Lat Posn SN
After this phase, pt- sit up and blow nose to evacuate CM; remainder to be swallowed
Chittinand, Patheja, and Wisenberg Pt Posn (nasopharyngo)
Sitted before VGD
1. prelim lat and SMV
2. Spray water–each nasal cavity
3. Spray micropaque powder- each nostril
4. 2 SMV proj; at rest and during modified valsalva (air blown w cheek puffed out)
5. 1 lat proj
Chittinand, Patheja, and Wisenberg Nasopharyngography SN
- No anesthisia
- Use of standard spray bottle
- Have pt blow nose, rest is swallowed
- Immediate CXR should not reveal ba in lungs
- 24hr follow-up radiography should reveal complete cleaning of nasopharynx
Palatography indications
Bloch and Quantrill: Tumors
Morgan et al: Chewing and swallowing abnormalities in children; Cleft palate
Bloch and Quantrill CM used
Thick, creamy BaSO4 (Ba Sulfate) suspension
Bloch and Quantrill pt posn/ procedure
Sitted lat in front VGD;
1st image: pt- swallow CM
2nd: 0.5ml injected into each nasal cavity
Bloch and Quantrill CXT and CRD
810/ 1012 longit- VCH/VGD centered on the nasopharynx (3/4” or 1.9cm anterio to the EAM)
Chewing and swallowing abnormalities in children CM
Ba-impregnated chocolate fudge
Chewing and swallowing abnormalities in children Pt/ Structure Posn
Sitted lat in front VGD; child- chew- ba-impregnated choco fudge
Chewing and swallowing abnormalities in children SN
w/ cineradiography
Cleft palate studies are performed in
the following manner:
pt- sitted laterally–in front VGD;
IR centered at nasopharynx (3/1” or 1.9cm anterior to the EAM)
** for cleft palate studies: 1” below EAM
** make exposures during phonation (d-a-h, m-m-m, e-e-e)
Why make exposure during phonation? (Palatography)
To deme range of soft Palate movement and tongue position
Pharyngography CM
Thick, creamy mixture of water and barium Sulfate (50%-50%)
Pharyngography SN
- usually carried out using fluoroscopy w/ spot-film images only
- synchronized w a rapid exposure w the shortest exposure time
- may use fluoroscopic equipment w spot radiography/ video tape/ cine film
Pharyngography Procedure
- Scout film- AP/ Lat
- Pt- hold ba Sulfate w bolus in the mouth until signaled, and then swallow the bolus in one movement (full distention- tables spoon)
- Expo during deglutition
- If mucosal study- ask pt- refrain swalling again
- Take mucosal study during modified valsalva maneiver for double-contrast delineation
Pharyngography proj/s
- AP
- Lat
AP Pharyngography pt posn
Conventional sitting/ standing in front VGD/ VCH- MSP of neck coincide MLL of CXT
AP Pharyngography CXT and CRD
8*10- longit- VCH/VGD;
MSP at laryngeal prominence (C3-C4)
Lat Pharyngography pt posn
Conventional sitting/ standing laterally in front of VGD/ VCH- coronal plane just anterior TMJ to coincide w MLL of CXT; neck slightly exteded
Lat Pharyngography CXT and CRD
horizontally 72” TMJ; coronal plane at laryngeal prom (C3-C4)
Pharyngography Added Methods
- Guns on Method
- Templeton and Kredel
Tie a dark-colored shoestring snugly around pt’s throat above thyroid cartilage (displacement coincides w anterior and superior cartilage movement)
Gunson method
Action of CM is so rapid that expo be made as soon as anterior movement is made
Templeton and Kredel