Skull is divided into what 2 parts? Show
How many cranium bones are there? How many facial bones are there? What are the names of the 8 cranial bones? -Frontal -Both Parietal -Occipital -Both Temporals -Sphenoid -Ethmoid What cranial bones make up the Calvarium? -Frontal -Both Parietal -Occipital What cranial bones make up the floor of the cranium? -Both Temporals -Sphenoid -Ethmoid  A- Frontal B- R Parietal C- R Temporal D- Ethmoid E- Sphenoid A- Frontal B- Ethmoid C- Sphenoid D- Temporal E- Occipital F- Parietal Which 4 bones articulate with the Frontal bone? -R and L Parietal -Sphenoid - Ethmoid A- Glabella B- Supercilliary Ridge (arch) C- Supraorbital Margin (SOM) D- Supraorbital Notch (foramen) E- Supraorbital Groove F- Frontal Tuberosity (eminence) A- Frontal Tuberosity (eminence) B- Supraorbital Groove C- Glabella D- Supercilliary Ridge (arch) E- Supraorbital Margin (SOM) How many bones does the Parietal bones articulate with? How many bones does the Occipital bones articulate with? What bones do the Parietal bones articulate with? -Frontal -Occipital -Temporal - Sphenoid - Opposite Parietal What bones do the Occipital bones articulate with? -L and R Parietal -L and R Temporal -Sphenoid -Atlas The Temporal bone is divided into how many parts? What are the names of the three parts of the Temporal bone? What bone is purple and what are the parts labeled? Temporal Bone A- Squamous Portion B- Mastoid Portion C- Mastoid Process D- Styloid Process E- Petrous Portion F- Petrous Ridge What 3 bones do the Temporal bones articulate with? Parietal Occipital Sphenoid Each Temporal bone also articulates with 2 facial bones What bones does the Sphenoid bone articulate with? All 7 cranial bones 5 Facial Bones: -R and L Palantine Bones -R and L Zygomatic Bones -Vomer What bone is colored purple and what are the other labeled parts? Temporal Bone A- Frontal Bone B- L Temporal Bone C- Petrous Ridge D- Occipital Bone E- Jugular Foramen F- EAM (External Acoustic Meatus) G- Internal Acoustic Meatus H- Petrous Pyramid I- R Temporal Bone J- Sphenoid Bone What bone is colored in and what are the other labeled parts? Sphenoid A- Anterior Clinoid Process B- Foramen Rotundum C- Foramen Ovale D- Foramen Spinosum E- Clivus F- Dorsum Sellae G- Sella Turcica H- Greater Wing I- Lesser Wing The Ethmoid bone articulates with how many cranial bones and how many facial bones? 2 Cranial -Frontal -Sphenoid 11 facial bones Label the parts A- Frontal Bone B- Parietal Bone C- Temporal Bone D- Occipital Bone E- Body of Sphenoid (sinus) F- Pterygoid Process G- Pterygoid Hamulus H- Vomer I- Perpendicular Plate J- Cribriform Plate K- Crista Galli L- Frontal SInus Name the 4 Cranial Sutures •Coronal •Lambdoidal •Squamosal •Sagittal What projection is this and what are its parts? AP Axial A- Dorsum Sellae of Sphenoid B- Posterior Clinoid Processes C- Petrous Ridge D- Parietal Bone E- Occipital Bone F- Foramen Magnum What projection is this and what are its parts? Lateral A- EAM B- Mastoid portion of Temporal Bone C- Occipital Bone D- Lambdoidal Suture E- Clivus F- Dorsum Sellae G- Posterior Clinoid Processes H- Anterior Clinoid Processed I- Vertex of Cranium J- Coronal Suture K- Frontal Bone L- Orbital Plates M- Cribriform Plate N- Sella Turcica O- Body of Sphenoid What projection is this and what are its parts? PA Caldwell A- Supraorbital Margin of R Orbit B- Crista Galli of Ethmoid C- Sagittal Suture D- Lambdoidal Suture E- Petrous Ridge What are the 3 divisions of the ear? External Ear Middle Ear Internal Ear The Middle Ear communicates with the _________ and the __________ -nasopharynx(Eustachian tube) -mastoids (aditus) The EustachianTube equalizes _________ and is a pathway for _________ pressure disease organisms Name the 3 auditory ossicles 1) Malleus(hammer) 2) Incus(tooth or anvil) 3) Stapes(stirrup) What kind of skull is this? Mesocephalicskull -Skullof average shape -Width75%-80% of length Name the labeled planes and landmarks A- Glabella B- Nasion C- Acanthion D- Mental Point E- Midsagittal Plane (MSP) F- Gonion G- Interpupillary Line (IPL) H- Supercilliary Ridge (arch) I- Supraorbital Groove (SOG) Name the labeled surface landmarks A- Top of Ear Attachment (TEA) B- Auricle (pinna) C- Tragus D- Gonion E- Mental Point F- Acanthion G- Nasion H- Glabella Label the landmarks of orbit A- SOM B- Midlateral Orbital Margin C- IOM D- Inner Canthus E- Outer Canthus From outer eye canthus to EAM Infraorbitomeatalline(IOML) From infraorbital margin to EAM Perpendicular line between pupils of eyes From mental point (center of chin) to EAM What are the 5 common positioning errors when positioning a skull? 1.Rotation 2.Tilt 3.Excessiveflexion 4.Excessiveextension 5.IncorrectCR angle For the PA Projection of the skull the OML is _________ to the CR and _________ to the IR. And the Petrous Ridges __________. parallel perpendicular fill orbits (0 degree PA) For the Parietoacanthial (Water's) Projection of the skull, the MML is __________ to the CR and __________ to the IR. And the Petrous Ridges are __________. paralell perpedicular below maxillary sinuses Why is an Erect position preferred to a Recumbent position when it comes to x-raying the skull? Air-fluid levels shown Easier for hypertension patients Which cranial bone houses the organs for hearing and equilibrium? The positioning point at the junction of the upper lip and the nasal septum is: What is the routine for a Cranium (skull) series? -AP Axial (Towne) -Lateral -PA 15 degree (Caldwell), PA 25-30 degree, or PA 0 degree ** PA 25-30 not likely** What are the special projections for a Cranium? -PA axial (Haas) -SMV (submentovertex) For an AP Axial (Towne Method) what is the CR angle and where is the CR? - CR 30° caudad to OML or 37° to IOML - CR 2½ in (6.5 cm) above glabella ** At 30, top of IR usually even with top of head** For an AP Axial (Towne Method), where is the Dorsum Sellae and how are the Petrous Ridges? •Dorsum sellae projected within foramen magnum •Petrous ridges symmetric Is this an acceptable AP Axial projection? Yes this is an acceptable exposure because: -Dorsum sellae projected within foramen magnum -Entire skull visualized -No rotation or tilt -Petrous ridges are symmetric -Optimal exposure factors **The chin is down a little too much** For a Lateral Skull, what is parallel and perpendicular to the CR? Where is the CR? MSP Parallel Interpupillary Perpendicular CR 2 in (5 cm) superior to EAM What are the evaluation criteria for a Lateral Skull? -Entire skull visualized -Cranium seen without rotation or tilt -Correct flexion and extension of skull -Optimal exposure factors Is this an acceptable Lateral Skull? Yes this is acceptable because: -Entire skull visualized -Cranium seen without rotation or tilt -Correct flexion and extension of skull -Optimal exposure factors For a 15 degree PA Cranium, where does the CR exit? For a 0 degree PA Cranium, where does the CR exit? For the PA 15° (Caldwell), where are the Petrous Ridges? -Petrous ridges over lower ⅓ of orbits Is this an acceptable PA 15 degree (Caldwell) projection? Yes this is acceptable because: -Entire skull visualized -No rotation -Petrous ridges over lower ⅓ of orbits -Optimal exposure factors ** Cropped a little too tightly** What is the main difference in criteria between a 0 degree PA cranium projection and a 15 degree (Caldwell) projection? 0 degree: Petrous ridges over supraorbital margin 15 degree: Petrous ridges over lower 1/3 of orbits What projection is this and how do you know? 0° PA projection Because the Petrous ridges are over supraorbital margin What projection is this and how do you know? 15° Caldwell Because the Petrous ridges are over the lower ⅓ of orbits For an SMV projection, what is the CR perpendicular to and where is the CR placed? -perpendicular to IOML and IR -CR1½ in (4 cm) inferior to mandibular symphysis For the SMV projection of the skull, where are the Mandibular Condyles? -Mandibular condyles anterior to petrous pyramids Is this an acceptable SMV for the skull? Yes this is an acceptable image because: -Mandibularcondyles anterior to petrous pyramids An AP Axial is better known as a: A PA Axial (Haas) is better known as a: For a Trauma Lateral Skull, what will be performed? A cross table lateral skull to evaluate fluid/air levels For a PA Axial (Haas) or Reverse Townes Projection, what is perpendicular? What is the CR angle? Where is the CR? -OML Perpendicular -CR 25 cephalad -CRexit 1½ in (4 cm) superior to nasion What are the evaluation criteria for a PA Axial (Haas) or Reverse Townes Projection? Similar to AP axial except: •Dorsum sellae appears larger within foramen magnum •Magnification of occipital bone evident What are 2 repeatable errors that are present on this radiograph? 1) Rotation- maxillary sinuses in front, mandible not superimposed 2) Clipped in back- must include soft tissue How are tilt and rotation determined on this lateral projection? Tilt: orbital plates not superimposed Rotation: mandibles are in front of the other There is a ___ difference between the orbitomeatal and infraorbitomeatal lines. T or F: Metastaticosteoblastic lesions of the cranium are proliferative bony lesions of increaseddensity. Which projection of the skull will best demonstrate signs of a pituitary adenoma? Lateral **because pituitary is within the Sella Turcica** How much CR angle is required for the AP axial projection of the skull if the IOML is perpendicular to the IR? Which positioning error is present if the orbital plates are not superimposed on a lateral skull radiograph? Tilt **tilt is most correct, but could be a combo of both tilt and rotation** Which variation of the PA (axial) projection of the skull has been performed if the petrous ridges are at the level of the supraorbital margin? What type of CR angle is required for a PA axial (Haas method) projection of the skull? What is a Linear Fracture? jagged/irregular lucent lines that lie at right angles to axis of bone What is a depressed fracture? "ping-pong" fracture fragment of bone that's separated and depressed into cranial cavity What is a basal fracture? fractures through dense inner structures of Temporal Bone Name the numbered parts 1- Glabelloalveolar 2- Mentomeatal Line (MML) 3- Lips-Meatal Line (LML) 4- Acanthiomeatal Line (AML) 5- Infraorbitomeatal Line (IOML) 6- Orbitomeatal Line (OML) 7- Glabellomeatal Line (GML) 8- External Acoustic Meatus 9- Inion R and L Nasal R and L Lacrimal R and L Maxillary R and L Zygomatic R and L Palantine R and L Inferior Nasal Conchae Vomer Mandible Name the labeled facial bones A- Lacrimal B- Nasal C- Zygoma D- Maxilla E- Mandible Name the labeled facial bones A- L Nasal B- L Lacrimal C- L Zygoma D- L Inferior Nasal Conchae E- L Maxilla F- Mandible What 2 cranial bones does the Maxilla articulate with? What 7 facial bones does the Maxilla articulate with? Zygoma Lacrimal Nasal Palantine Inferior Nasal Concha Vomer Adjacent Maxilla A- Frontal Process B- Zygomatic Process C- Body D- Alveolar Process E- Acanthion F- Anterior Nasal Spine A- Frontal Process B- Zygomatic Process C- Alveolar Process D- Maxillary Sinuses What cranial bones do the zygomatic bones articulate with? A- Coronoid Process B- Mandibular Notch C- Condyloid Process D- Condyle E- Neck F- Ramus Synovial Diarthrodial Bicondylar A- Frontal (orbital plate) B- Zygoma C- Maxilla A- Frontal B- Lacrimal C- Ethmoid D- Sphenoid E- Palantine F- Zygoma G- Maxilla H- Orbital surface of maxilla A- Frontal Bone (Orbital Plate) B- Sphenoid Bone C- Small portion of Palantine Bone D- Zygomatic Bone E- Maxillary Bone F- Ethmoid Bone G- Lacrimal Bone A- Zygomatic Prominence B- Body of Maxilla C- Bony Nasal Septum D- Anterior Nasal Spine E- Zygomatic Arch F- Coronoid Process G- Condyle H- Mastoid Process of Temporal Bone I- Angle of Mandible J- Foramen Magnum What is the routine for facial bones? Lateral Parietocanthial (Waters) PA Axial (Caldwell) Why are erect facial projections preferred to recumbent ones? Air-fluid levels shown Easier for hypersthenic patients Easier to move and visualize face When do you use recumbent facial projections? For Lateral Facial Bones projection, the CR is _________ and centered to the _________. What must be included? Perpendicular Zygoma Above orbits, entire mandible, all the way back to EAM, entire nose What are the evaluation criteria for Lateral Facial Bones? •Zygomatic bones in center of radiograph For a Parietocanthial (Waters) projection, the _____ is perpendicular to the IR and the CR is __________ to the IR and exits at the _________. MML Perpendicular Acanthion For an Erect Parietocanthial (Waters) Projection, the CR is __________ with 37 degree _____ and IR and the _____ perpendicular to IR. What are the evaluation criteria for a Parietocanthial (Waters) Projection? •Petrous ridges below maxillary sinuses For a Modified Parietocanthial (Modified Waters) Projection, the CR is perpendicular and exits at the __________. The _____ is perpendicular to the IR and the _____ is 55 degree angle to the IR. Which projection is ideal to demonstrate possible orbital fractures and foreign bodies in the eye? Modified Parietocanthial (Modified Waters) What are the evaluation for a Modified Parietocanthial (Modified Waters) projection? •Petrous ridges projected in lower ⅓ of maxillary sinuses •Orbital floors not distorted For a PA Axial (Caldwell) Projection, the _____ is perpendicular to the IR with a 15 degree _________ angle that exits at the _________. What are the evaluation criteria for a PA Axial (Caldwell) Projection? •Petrous ridges projected into lower ⅓ of orbits What is the routine for Nasal Bones? Lateral Parietocanthial (Waters) What are the special projections for the Nasal Bones? PA Axial (Caldwell) Superoinferior Tangential (axial) For the Lateral Nasal Bones Projection, what line is perpendicular to the IR? Is the CR perpendicular or parallel? Where is the CR centered? Interpupillary Perpendicular 1/2 inch inferior to Nasion What are the evaluation criteria for a Lateral Nasal Bones Projection? •Nasal bones centered •Closecollimation For the Superoinferior Tangential Axial projection of the Nasal bones, the IR is perpendicular to what line? The CR is parallel to what line? This projection demonstrates possible what? GAL GAL Medial-lateral displacement What are the evaluation criteria for the Superoinferior Tangential Axial projection of the Nasal bones? •Nasal bones free of superimposition What projections are included in the Basic Zygomatic Arch Routine? Submentovertex (SMV) Oblique Inferosuperior (Tangential) AP Axial (modified Townes) For an SMV projection of the Zygomatic Arches, the CR is perpendicular to the _____ and the _____ is parallel to the IR What are the evaluation criteria for an SMV projection of the Zygomatic Arches? •Zygomatic arches well demonstrated in profile •Zygomatic arches symmetric For an Oblique Inferosuperior Tangential Projection of the Zygomatic Arches, the _____ is parallel to the IR, you rotate and tilt the skull _____ toward the affected side, the CR is __________ to the IR and the IOML, and the CR is to the __________. IOML 15 degrees perpendicular arch of interest What are the evaluation for an Oblique Inferosuperior Tangential Projection of the Zygomatic Arches? •Zygomatic arches well demonstrated •No superimposition For an AP Axial Modified Townes projection of the Zygomatic Arches, the CR is _____ to the _____ or _____ to the _____. The CR is _____ superior to the __________ to pass through __________. 30 degrees OML 37 degrees IOML 1 inch Glabella Mid arches What are the evaluation criteria for an AP AxialModified Townes projection of the Zygomatic Arches? •Zygomatic arches centered What is the routine for a Mandible? Axiolateral Oblique PA (or PA Axial) What are the special projections for a Mandible? In regards to an Axiolateral Oblique Mandible, when the head is in a true lateral, the __________ is best demonstrated. In regards to an Axiolateral Oblique Mandible, when there is a 30 degree rotation toward the IR, the __________ is best demonstrated. In regards to an Axiolateral Oblique Mandible, when there is a 45 degree rotation toward the IR, the __________ is best demonstrated. In regards to an Axiolateral Oblique Mandible, when there is a 10-15 degree rotation toward the IR, a __________ is best demonstrated. General survey of the mandible List the methods to minimize superimposition of opposite mandibular body 1) Employ combo of tilt on head and CR angle not to exceed 25 degrees or 2) Employ 25 degree cephalad angle toward IR with no head tilt What are the evaluation criteria for an Axiolateral Oblique of the Mandible? •Area of interest demonstrated •Mandible not foreshortened A radiograph of a PA Caldwell projection for sinuses reveals that the petrous ridges are projected into the lower one third of the maxillary sinuses. Which of the following modifications should be made during the repeat exposure to produce a more diagnostic image? A.Increase the extension of the head and neck B.Decrease the extension of the head and neck C.Nothing, accept the initial radiograph D.Angle the CR 10o caudad B. Decrease the extension of the head and neck A radiograph of a Waters projection reveals that the petrous ridges are superimposed over the lower third of the maxillary sinuses. What specific positioning error (if any) led to this radiographic finding? A.Insufficient extension of the chin B.Excessive extension of the chin C.Excessive CR angulation D.No error, accept initial radiograph A. Insufficient extension of the chin A blowout fracture of the orbit may be indicated by an air fluid level in which of the paranasal sinuses? Which facial bones are clearly demonstrated on the parietoacanthial projection (Waters method)? 1.) orbits 2.) maxillae 3.) zygomatic arches For the submentovertical projection of the zygomatic arches, the central ray is directed perpendicular to the: 1.mentomeatal line 2.acanthiomeatal line 3.infraorbitomeatal line 4.orbitomeatal line 3. infraorbitomeatal line To successfully demonstrate the ethmoidal and sphenoidal sinuses on the SMV projection, which of the following must occur? 1.) the patient must be recumbent 2.) the infraorbitomeatal line must be parallel with the IR 3.) the central ray must be perpendicular to the infraorbitomeatal line and horizontal For a lateral projection of the facial bones, the IR is centered to the: Which of the sinuses is developed at birth and visible radiographically? Where is the IR centered for the parietoacanthial (Waters method) projection of the sinuses? Which of the following is true regarding positioning for the Waters method? 1.) the orbitomeatal line forms a 37-degree angle with the plane of the IR 2.) the mentomeatal line is perpendicular to the IR plane 3.) the coronal plane is perpendicular to the IR plane Label the facial bones A- Nasal Bones B- Lacrimal Bones C- Zygoma D- Inferior Nasal Conchae E- Maxilla F- Mandible A- Frontal Sinuses B- Maxillary Sinuses C- Zygoma D- Petrous Ridge E- Mandibular ramus F- Nasal Septum G- Orbital Floor H- Sphenoid Sinuses The maxillary sinuses are best shown with the ______________ projection. You are performing an AP axial (Towne) projection for TMJs. As compared to a standard Towne for a skull, what adjustments must be made in order to properly demonstrate the TMJ's? A.Collimation to a smaller area B.CR centered lower, placing TMJ's in center of field C.Perform images both open mouth and closed mouth D.No changes are needed. A town view is not changed for TMJs E.The OML is angled 15o to the plane of the IR A. Collimation to a smaller area B. CR centered lower, placing TMJ's in center of field C. Perform images both open mouth and closed mouth A properly positioned AP axial (Towne) projection should project the dorsum sellae in to the middle aspect of the: An enlarged or eroded sella turcica seen on a lateral skull image may indicate what pathology? A- Frontal sinuses B- Ethmoid Sinuses C- Sphenoid Sinuses D- Maxillary Sinuses E- Ethmoid Sinuses F- Frontal sinuses G- Maxillary Sinuses H- Sphenoid Sinuses When performing a lateral facial bones image, which of the following does NOT need to be included on the image? A. Entire mandible B. Entire maxilla C. Entire Zygoma D. Entire frontal bone You have performed a PA Caldwell of the sinuses. The petrous ridges are projected into the lower third of the orbits. What adjustment should be made to improve this image? Nothing. This is an acceptable image. Which sinus projection demonstrates all four sets of sinuses? Which one of the following pathologic indications may require a decrease in manual exposure factors? When performing an SMV for sinuses, what is the correct centering point for the CR? Midway between the angles of the mandible For a lateral projection of the skull or sinuses, the _______________ line must be perpenidcular to the image receptor to insure there is no tilt. The OML is tilted ______________ degrees from perpendicular for a modified PA Caldwell for paranasal sinuses. The ________ position best demonstrates the frontal sinuses without superimposition or excessive distortion A fracture involving the facial bones where a blow to one side causes a fracture to the opposite side is termed a ____ fracture. A patient comes to radiology for a sinus series on a cart. She is unable to stand or sit erect for any of the projections. Which of the following projections will best detect any air/fluid levels present in the maxillary sinuses? A radiograph of a lateral cranium reveals that the mentum was cut off from the bottom of the radiograph. A 24 ´ 30-cm (10 ´ 12-inch) IR was used, and it was placed crosswise. What must be altered if a repeat exposure is performed? A. Center the CR at the EAM B. Increase SID to reduce magnification C. Place the 24 ´ 30-cm (10 ´ 12-inch) IR lengthwise D. None of the above; all of the structures were demonstrated. D. None of the above; all of the structures were demonstrated. A radiograph of a submentovertex projection reveals that the mandible is superimposed over the ethmoid and sphenoid sinuses. Which of the following modifications will eliminate this problem? a. Increase the flexion of the head and neck. b. Perform the axiolateral oblique instead of the submentovertex projection. c. Increase the extension of the head and neck. d. Perform the projection with the patient supine. Increase the extension of the head and neck. For a PA and PA Axial Mandible, the ______ is perpendicular to the IR. The CR is perpendicular and exits at the ______. What are the evaluation criteria for a PA Mandible? •Condyloid processes demonstrated and symmetric For an SMV of the Mandible, the ______ is parallel to the IR and the CR is __________ and perpendicular to the ______. IOML midway between mandibular angles IOML What are the evaluation criteria for an SMV of the Mandible? •Entire mandible demonstrated What is the routine for the Optic Foramina? Parietoorbital Oblique (Rhese) Parietoacanthial (Waters) PA (Caldwell) What is the name of this projection? Rhese Method (3 point landing) for optic foramina When doing an AP Axial Modified Townes projection, the ______ is perpendicular to the IR, the CR is angled _____ caudad, and the CR is at the level of the _____ (2 in anterior to the _____). What are the evaluation criteria for the AP Axial TMJ? •Condyloid processes and TM fossa demonstrated What is this projection? AP Axial (Modified Townes) For TMJ When doing an Axiolateral Oblique (Modified Law Method) for TMJ, rotate the skull ____ toward the IR, place the CR 1 and 1/2 in superior to the upside of the _____, and angle the CR _____ caudad. caused by “head on” injury to the orbit, often in sports •Fractures floor of the orbit •Often causes injury to eye globe and nerves •Maxillary sinuses filed with blood and/or eye contents caused by blow to the cheek •Fractures zygoma in three places and frees zygoma, separating it from other bones •Often seen as fracture to inferior and lateral borders of orbits on Water’s view What projection is this and what needs to be done to fix it? SMV Mandible the head needs to be tilted back What is the positioning error for a parietocanthial (Waters) projection if the petrous ridges are within the maxillary sinuses? Excessive flexion fix it with more extension T or F: The Axiolateral Oblique (modified Law) projection for TMJ requires a CR angle of 15 degrees caudad and 15 degrees downward rotation of the skull from a lateral skull position. A fracture of the floor of the orbit due to a direct strike to the base is termed a: What are the 4 groups of the Paranasal Sinuses? Maxillary Frontal Ethmoid Sphenoid A- Frontal B- Ethmoid C- Sphenoid D- Maxillary E- Frontal F- Ethmoid G- Sphenoid H- Maxillary What are the functions of the paranasal sinuses? •Serve as resonating chamber for the voice •Decrease weight of skull •Aid in warming and moisturizing inhaled air •Act as shock absorbers in trauma •Possibly control the immune system What sinuses are usually the only ones developed enough to be demonstrated radiographically at birth? What sinuses do not fully develop until 17 to 18 years of age? Where do you find the Maxillary Sinuses? The Maxillary Sinuses are the _____ and the most _____. They are _____ and are roughly _____ in shape. Largest, Symmetric paired pyramidal The frontal sinuses are the _____, _____, are loacted __________, vary greatly in __________, and are occasionally _____. 2nd largest paired between vertical plates of frontal bone size and shape absent The Ethmoid sinuses are within the __________, are in __________, and communicate with __________. lateral masses of ethmoid bone three collections sphenoid sinus and nasal cavity The Ethmoid sinuses are best seen on a: The Sphenoid Sinuses are located __________, are __________, and are the most __________. below sella turcica asymmetric posterior A- Nasal Cavities B- Ethmoid Sinus C- Ethmoid Bulla D- Uncinate Process E- Middle Nasal Concha F- Maxillary Sinus G- Inferior Nasal Concha H- Nasal Septum I- Inferior Nasal Meatus J- Middle Nasal Meatus K- Infundibulum What projection is this and label the 4 sinus groups. Lateral A- Frontal What projection is this and label the 4 sinus groups. PA Caldwell A- Frontal What projection is this and label the 4 sinus groups. PA Transoral Projection (Open Mouth Waters) What projection is this and label the sinus groups SMV Projectionfor Sinuses A- Maxillary B- Ethmoid C- Sphenoid What is the Paranasal Sinus Routine? •Lateral •PACaldwell •Parietoacanthial(Waters) •Submentovertex(SMV) What are the Technical Considerations for Sinuses? •kVRange: •Analog:65-75 •Digitalsystems: 75-85 •Erect •Horizontalbeam •AECnot recommended T or F: Upright position for sinuses is necessary to demonstrate fluid levels and the CR should remain horizontal For a Lateral Sinus, the CR should be: midway between outer canthus and EAM For PA Caldwell Sinuses, the _____ is perpendicular to IR, there is a _____ tilt, the OML is 15° from _________, the CR is _________, and the CR exits the ________. OML 15 degree horizontal horizontal nasion For a Parietocanthial (Waters) Projection of the sinuses, the _____ is perpendicular to the IR, the CR is __________, and the CR exits at the _________. For and SMV of the sinuses, the _____ is parallel to the IR, the CR is ________, and the CR is between the ________. IOML Horizontal Angles of the Mandible For a PA Transoral (Waters) the _____ is perpendicular to the IR, the mouth is _____, the CR is _________, and the CR exits at the ________. MML Open Horizontal Acanthion The older term “antrum of Highmore” describes the: Which paranasal sinus is the last one to develop? What is the positioning error for a parietoacanthial projection if the petrous ridges are within the maxillary sinuses? What projection is this? What is the repeatable error in this image and how would you fix it? Open Mouth Waters there is not enough extension- this is demonstrated by the petrous ridges projected into the Maxillary sinuses - you fix this by bringing the chin up more What projection is this? What are the 2 repeatable errors in this image? Parietocanthial Rotation Chin is not up high enough What projection is this? What are the 3 repeatable errors in this image? SMV Clipped at top Clipped on the R side Not enough extension What projection is this? What are the positioning errors? Lateral Collimation could be better Rotated and tilted- w/more tilt than rotation Frontal sinuses not displayed What projection is this image? Is this an acceptable image? Waters Not acceptable b/c it is underpenetrated/underexposed and you cannot make out the maxillaries What view is the top image? The bottom? Is anything repeatable? Top- Waters: chin needs to be brought up Bottom- Caldwell: the petrous ridges are too low so the chin needs to be brought up What view is the top image? The bottom? Is anything repeatable? Top- OM Waters: mouth needs to open more Bottom- Caldwell: maxilla is cut off What is the angle between the OMLand the plane of the IR for a well positioned Waters (Parietoacanthial)projection? What line is perpendicular to the IR? What projection of the sinuseswill demonstrate all four sets of sinuses? What projection(s) will bestdemonstrate the sphenoid sinuses? What projection? Where is the pathology? Which of the following isessential to demonstrate air fluid levels when performing a sinus series? A.)Correct collimation B.)Horizontal beam C.)Angled bucky D.)upright patient E.)An SMV projection Horizontal Beam Upright Pateint If a patient is unable to sit orstand upright, what projection(s) should be performed to demonstrate thesinuses? T or F: The liver is the largest gland in the body The Falciform ligament divides the liverinto what two major lobes? The two minor lobes evident on the visceralsurface of the liver are the: Caudate lobe Quadrate lobe A- R Lobe B- Galbladder C- Falciform Ligament D- L Lobe A- L Lobe B- Falciform Ligament C- Quadrate Lobe D- Galbladder E- Caudate lobe F- Inf Vena Cava G- R Lobe The Hepatic artery supplies ________ blood from the _________ to the liver and the Portal vein ________ blood from ________ to be filtered by liver. Oxygenated Abdominal Aorta Carries Digestive System What are the 2 blood supplies to the liver? Hepatic Artery Portal Vein From an imaging standpoint, what is the primary function of the liver? Biliary System/Bile Route 1) Right and left hepatic ducts jointo form Common Hepatic duct 2) Common Hepatic duct unites with Cystic duct to form Common Bile duct 3) Common Bile duct unites with Pancreatic Duct and empties into Duodenum Label the parts of the Bile route A- R Hepatic dict B- Cystic duct C- Galbladder D- Duodenum E- Pancreatic duct F- Common Bile duct G- Common Hepatic Duct H- L Hepatic duct Label the parts of the Gallbladder A- Spiral Valve B- Neck C- Body D- Fundus E- Cystic duct What are the functions of the Gallbladder? 1.Storage of bile -Hydrolysis -Choleliths(gallstones) 3.Contraction when stimulated -Cholecystokinin(CCK) Label the parts of the Distal Common Bile duct A- Common Bile duct B- Pancreatic duct C- Hepatopancreatic Ampulla D- Hepatopancreatic Sphincter E- Region of Duodenal Papilla F- Duodenum Percutaneous Transhepatic Cholangiography "PTC" -performed on patients with jaundice when ductal system has been demonstrated as dilated but cause is unclear -may be used to place drainage catheter to obstructive jaundice -often performed in interventional diagnostic suite Postoperative (T-Tube) Cholangiography "Delayed cholangiography" -Performed post operatively or postinterventional procedure -May be performed in main Radiology -Performed via a T-shaped tube leftin the common hepatic and common bile ducts for postoperative drainage Postoperative (T-Tube) Cholangiography is performed to demonstrate: -Caliberand patency of ducts -Statusof sphincter of the hepatopancreatic ampulla -Thepresence of residual or previously undetected stones Endoscopic/retrograde/cholangio/pancreat/ography -Used todiagnose biliary and pancreatic pathologic conditions -Useful method when ducts are notdilated and ampulla is not obstructed -Performed by passing a fiberopticendoscope through the mouth into the duodenum under fluoroscopy Condition of having gallstones Cholecystitis: acute or chronic Inflammation of Gallbladder Surgical removal of Gallbladder Laparoscopic cholecystectomy Removal of Gallbladder with minimally invasive laparoscope Surgical removal of Gallbladder via open incision . Narrowing of biliary duct You have performed a PA Caldwell of the sinuses. The petrous ridges are projected into the lower third of the orbits. What adjustment should be made to improve this image? nothing this is an acceptable image When performing a PA Caldwell projection of the sinuses, the CR should exit at what point? When performing a lateral facial bones image, which of the following does NOT need to be included on the image? To successfully demonstrate the ethmoidal and sphenoidal sinuses on the SMV projection, which of the following must occur? 1. The patient must be recumbent 2. The infraorbitomeatal line must be parallel with the IR 3. The CR must be perpendicular to the infraorbitomeatal line and horizontal. What is the CR angulation for the axiolateral oblique projection of the TMJ? Along with the use of erect positions, what other technical factor is important to demonstrate air/fluid levels in the paranasal sinuses? A patient comes to radiology for a sinus series on a cart. She is unable to stand or sit erect for any of the projections. Which of the following projections will best detect any air/fluid levels in the maxillary sinuses? What is the CR angulation for the axiolateral oblique projection of the TMJ? Functions of the Gallbladder include: 1. Storing bile 2. Concentrating Bile 3. Storing Cholecystokinin Which sinus is projected through the oral cavity with a parietocanthial transoral projection? A blowout fracture is normally best demonstrated on which projection? A specific radiographic examination of the biliary ducts is termed: The liver is divided into _____ major and minor lobes. The two main hepatic ducts join to form the: Which of the following convey(s) blood to the liver? 1. hepatic veins 2. hepatic artery 3. portal vein Which of the following must be projected below the maxillary sinuses for the parietocanthial projection (waters) of the sinuses? What can the technologist do if the patient cannot extend the head and neck adequately for the routine submentovertex projection of the zygomatic arches? Angle the CR to place it perpendicular to the IOML. Where is the CR centered for a lateral projection of the facial bones? Zygoma- midway between the EAM and the outer canthus Which sinuses are best demonstrated with a parietocanthial projection? Which bone is involved with a tripod fracture? Which projections will demonstrate the ethmoidal sinuses? 1. Lateral 2. PA Axial (Caldwell) 3. SMV The common hepatic duct and the cystic duct join together to form the: A radiograph of a parietocanthial (Waters) projection reveals the petrous ridges are superimposed over the lower 30% of the maxillary sinuses. What specific positioning error (if any) led to this radiographic finding? A radiograph of a lateral projection of the cranium reveals that the orbital roofs (plates) are not superimposed-- one is slightly superior to the other. Which of the following positioning errors led to this radiographic outcome? The _________ sinuses develop last and are not fully developed until the teenage years. A fracture involving the facial bones where a blow to one ride causes a fracture to the opposite side is termed a _________ fracture. What is the radiologically important primary function of the liver? What Cr angle is required for the Schuller method projection of the TMJs?Chapter12 Bontegar. What is the position of the skull for an Axiolateral projection Schuller method of the TMJs?The Schuller Method requires the skull to be in a true lateral position. The CR should be 25-30 degrees caudad. 1/2" anterior & 2" superior to the upside of the EAM. Which projection of the TMJ is the Axiolateral oblique projection?
How much skull tilt and rotation are required for the oblique?Rotate the skull 15° away from the affected side.
How much skull tilt and rotation are required for the oblique Inferosuperior tangential projection for zygomatic arches?Which direction and how many degrees is the skull tilted and rotated for the oblique inferosuperior (tangential) projection for the zygomatic arch? The head is rotated 15 degrees from midline towards the side being radiographed and the chin is tilted 15 degrees towards the zygomatic arch being examined.
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The modified law method for tmjs requires a ____ rotation of the skull and a ____ angle of the cr.
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