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Facial Bones, Mandible, & Paranasal Sinus Positioning Terms in this set (100)True/False: Facial bone studies should always be performed recumbent whenever possible False. (Best to perform erect) True/False: The common basic PA axial projection for facial bones requires a 15-degree caudad angle of the central ray, which projects the dense petrous ridges into the lower one-third of the orbits. True. True/False: An increase in kV of 25% to 30% (using manual techniques) is often required for the geriatric patient with advanced osteoporosis. False. True/False: CT is ideal for facial bone studies because it allows visualization of bony structures as well as related soft tissues of the facial bones. True. True/False: Nuclear medicine is not helpful in diagnosing occult facial bone fractures. False. (Nuclear medicine IS used for this) True/False: MRI is an excellent imaging modality for the detection of small metal foreign bodies in the eye. False. (Strong magnets in MRI prohibit this) What is the name of the fracture that results from a direct blow to the orbit leading to a disruption of the inferior orbital margin? Blow-out fracture A "free floating" zygomatic bone is the result of a ___________ fracture. Tripod fracture What is the major disadvantage of performing a straight PA projection for facial bones, with no CR angulation or neck extension, as compared with other PA facial bone projections? Dense petrous pyramids superimpose the orbits, obscuring facial bone structures. Where is the CR centered for a lateral
projection of the facial bones? C. Zygoma What is the proper method name for the parietoacanthial projection of the facial bones? Waters method What facial bones are best seen with the parietoacanthial projection? Orbits, including infraorbital rims, bony nasal septum, maxillae, zygomatic bones, and arches. What CR angle must be used to project the petrous ridges just below the orbital floor with the PA axial (Caldwell method) projection? B. 30 degrees Which structures specifically are better visualized on the modified parietoacanthial (Waters) projection as compared with the basic Waters projection? Orbital rims and orbital floors Give two reasons why projections of the facial bones are performed PA rather than AP when possible? 1. Reduces OID of the facial bones. What are two differences between the lateral projection of the cranium and the lateral projection for the facial bones? 1. IR is placed portrait for facial bones but landscape for cranium. The parietoacanthial (Waters) projection for the facial bones has the ______ line perpendicular to the image receptor, which places the orbitomeatal line (OML) at a _______ -degree angle to the tabletop and image receptor. Mentomeatal (MML); 37 Where does the CR exit for a parietoacanthial (Waters) projection of the facial bones? Acanthion Where does the CR exit for a 15-degree PA axial (Caldwell) projection for the facial bones? Nasion The modified parietoacanthial (modified Waters) projection requires that the __________ line is perpendicular to the image receptor, which places the OML at a ____ -degree angle to the tabletop and image receptor. Lips-meatal (LML); 55 True/False: Lateral projections for nasal bones generally are taken bilaterally for comparison? True True/False: The oblique inferosuperior (tangential) projection for a unilateral zygomatic arch requires that the skull be rotated and tilted 15 degrees AWAY FROM the affected side. False. (Rotated TOWARD the affected side) True/False. Both oblique inferosuperior (tangential) projections for the zygomatic arch are generally taken for comparison. True. For a parietoacanthial (PA Waters), the petrous ridges should be projected directly below the _________ and projected into the lower half of the maxillary sinuses or below the ___________ for a modified Waters projection. Maxillary sinuses; inferior orbital rims For the superoinferior projection of the nasal bones, the IR is placed perpendicular to the ______ line. Glabelloalveolar line (GAL) Which specific facial bone structures (other than the mandible) are best demonstrated with the submentovertical (SMV) projection if the correct exposure factors are used (soft tissue technique) Zygomatic arches Where is the CR centered for an AP axial projection for the zygomatic arches? 1 inch superior to glabella to pass through mid-arches (at level of gonion) List the proper method name AND the common descriptive name for the parieto-orbital oblique projection for the optic foramen. 1. Rhese projection Three aspects of the face that should be in contact with the head unit or tabletop when beginning positioning for the parieto-orbital oblique projection are the (A)_________, ________, &. ________. The final angle between the midsagittal plane and the IR should be (B)__________, with the (C) _________ line perpendicular to the IR. This places the optic foramen in the (D)_________ quadrant of the orbit. A. Cheek, nose, & chin Which facial bone projection best demonstrates the floor of the orbits? Modified Waters method Which facial bone projection best demonstrates the optic foramen? Parieto-orbital oblique projection (Rhese method) Which facial bone projection best demonstrates a view of a single zygomatic arch? Oblique inferosuperior projection Which facial bone projection best demonstrates a profile image of the nasal bones and nasal septum? Lateral (nasal bones) Which facial bone projection best demonstrates bilateral zygomatic arches? Submentovertical (SMV) projection Which facial bone projection best demonstrates the inferior orbital rim, maxillae, nasal septum, nasal spine, zygomatic bone, and arches? Parietoacanthial projection (Waters method) True/False: The PA axial projection of the mandible produces an elongated view of the condyloid processes? True Which projection of the mandible projects the opposite half of the mandible away from the side of interest? Axiolateral oblique What must be done to prevent the ramus of the mandible from being superimposed over the cervical spine with an axiolateral oblique projection of the mandible? Extend the chin How
much skull rotation (from the lateral skull position) toward the image receptor is required with an axiolateral oblique projectiong for demonstrating each of the following: A. 30 degrees What specific positioning error has been committed if both sides of the mandible are superimposed with an axiolateral oblique projection? Insufficient cephalic CR angle or skull tilt Where should the CR exit for a PA axial projection of the mandible? PA Axial - Acanthion
Which cranial positioning line is placed perpendicular to the image receptor for a PA or PA axial projection of the mandible? Orbitomeatal line (OML) True/False: For a true PA projection of the mandibular body (if this is the area of interest), the AML should be perpendicular to the image receptor. True True/False: The CR should be angled 20 to 25 degrees caudad for the PA axial projection of the mandible. False. (Cephalad) Which aspect of the mandible is best visualized with an AP axial projection? Condyloid processes What CR angle is required for the AP axial projection of the mandible if the OML is placed perpendicular to the image
receptor? OML - 35 degrees caudad Where is the CR centered for an AP axial projection of the mandible? Glabella Which projection of the mandible demonstrates the entire mandible, including the coronoid and condyloid processes? SMV projection Which imaging system provides a single, frontal perspective of the entire mandible? Orthopantomography (panoramic tomography) What device provides inherent collimation during an orthopantomographic procedure? Narrow, vertical slit diaphragm Which cranial line is placed parallel to the floor for orthopantomography of the mandible? Infraorbitomeatal line (IOML) What type of image receptor must be used with analog orthopantomography? Curved, non grid cassette True/False: The modified Law method provides a bilateral and functional study of the TMJ. True True/False: The mandibular condyles move anteriorly as the mouth is open. True Which projection/method of the TMJ requires that the skull be kept in a true lateral position? B. Schuller The axiolateral oblique projection of the TMJ is commonly referred to as the (A) _______ method, which requires a (B) ________ -degree head rotation from lateral and a (C) _______ - degree caudad CR angle. A. Modified Law method If the area of interest is the tempomandibular fossae, angle the CR _____________ to the OML for the AP axial (modified Towne) projection to reduce superimposition of the TM fossae and mastiod portions of the temporal bone. 40-degrees caudad Aligning the ___________ plane perpendicular to the IR prevents rotation of either a PA or AP axial mandible. Midsagittal What analog kV range should be used for sinus radiography? Digital range? Analog: 70-85 kV *This is different than notes from class To demonstrate any possible air or fluid levels within the sinuses, it is important to do what 2 things? 1. Perform positions erect when possible True/False: Ultrasound exams of the maxillary sinuses to rule out sinusitis are possible. True True/False: MRI is the preferred modality to study soft tissue changes and masses within the sinuses. True True/False: Secondary osteomyelitis is often caused by tumor invasion. False List the four most commonly performed routines projections for paranasal sinuses. 1. Lateral Which single projection for a paranasal sinus routine provides an image of all four sinus groups? Lateral If the patient cannot stand for the lateral projection of the paranasal sinuses, the projection should be taken with: A horizontal x-ray beam Which paranasal sinuses are best demonstrated with a PA (Caldwell) projection? Frontal and Ethmoid To avoid angling the CR for the erect PA (axial) Caldwell sinus projection, the head should be adjusted so that the OML is _____ degrees from horizontal. 15-degrees Which group of paranasal sinuses is best demonstrated with a parietoacanthial Waters projection? Maxillary sinuses Which positioning line is placed perpendicular to the image receptor for a parietoacanthial projection? Mentomeatal line (MML) Where are the petrous ridges located on a well-positioned parietoacanthial projection? Just below the maxillary sinuses Which paranasal sinuses are demonstrated with an SMV projection of the paranasal sinuses? Sphenoid, Ethmoid, & Maxillary (All EXCEPT Frontal) Where should the CR exit for both the PA parietoacanthial (Waters) and the PA transoral (open-mouth Waters) projections? Acanthion What is the one major difference in positioning between the parietoacanthial and PA axial transoral projections? The mouth is open with the PA transoral projection Which sinuses are projected through the oral cavity with the PA axial transoral projection? Sphenoid sinuses Which sinus projection best demonstrates the sphenoid sinus in the oral cavity? PA transoral (Open mouth Waters) Which sinus projection best demonstrates the inferosuperior view of the sphenoid and ethmoid sinus? SMV for sinuses Which sinus projection best demonstrates all four paranasal sinuses? Lateral Which sinus projection best demonstrates the best view of the maxillary sinuses? Parietoacanthial (Waters)
Which sinus projection best demonstrates the best view of the frontal and ethmoid sinuses? PA (axial) Caldwell Situation: A radiograph of a parietoacanthial (Waters) projection shows that the petrous ridges are projected within the maxillary sinuses. Is this an acceptable image? If not, what must be done to improve the image during the repeat exposure? No. Petrous ridges should be projected just below the maxillary sinuses. The patient's head needs to be more extended. Situation: A radiograph of a lateral projection of the facial bones shows that the mandibular rami are not superimposed. What positioning error led to this radiographic outcome? Rotation of the skull Situation: A radiograph of a parietoacanthial (Waters) projection shows that the distance between the lateral margins of the orbits and the lateral aspect of the cranial cortex is not equal. What type of positioning error led to this radiographic outcome? Rotation of the skull Situation: A radiograph of a 30-degree PA axial projection of the facial bones shows that the petrous ridges are projected at the level of the inferior orbital margins. Is this an acceptable image for this projection? If not, what must be done to improve the quality of the image during the repeat exposure? Yes, this image meets the evaluation criteria for a 30-degree PA axial projection Situation: A radiograph of a superoinferior projection of the nasal bones shows that the glabella are superimposed over the nasal bones. What positioning error led to this radiographic outcome, and how can it be corrected during the repeat exposure? Excessive flexion of the head or neck, or incorrect CR angle. The CR must be parallel to the GAL. Situation: A lateral radiograph of the facial bones demonstrates that the bodies of the mandible are not superimposed; one is about 1 cm superior to the other. How would this be corrected on a repeat exposure? The head was tilted. Ensure that the MSP is parallel to the IR. Situation: A radiograph of a parieto-orbital oblique (Rhese) projection shows that the optic foramen is located in the upper outer quadrant of the orbit. Is this an acceptable image for this projection? If not, what must be done to correct this problem during the repeat exposure? No. Increase extension of the head and neck. The AML should be placed perpendicular to the IR to ensure that the optic foramen is open and is projected into the LOWER outer quadrant of the orbit (Skull rotation was correct) Situation: A radiograph of an axiolateral oblique projection of the mandible shows that the body of the mandible is severely foreshortened. The body of the mandible is the area of interest. What positioning error led to this radiographic outcome? Insufficient rotation of the skull towards the IR. The skull should be rotated 30-degrees (from lateral) toward the IR to prevent foreshortening of the body. Situation: A patient with a possible fracture of the nasal bones enters the ER. The physician is concerned about deviation of the bony nasal septum along with possible fracture of the nasal bones. What radiographic routine would be best for this situation? Parietoacanthial and R & L Lateral projections. The parietoacanthial (Waters method) or the optional PA axial projections would demonstrate any possible septal deviation. The lateral projections would demonstrate any possible fracture of the nasal bones or anterior nasal spine. (The superoinferior tangential projection would provide an axial perspective but is considered an optional projection in most departments and not part of the routine unless specifically requested.) Situation: A patient with a possible blowout fracture of the right orbit enters the ER. In addition to the basic facial bone routine, what single projection would best demonstrate this type of injury? Modified parietoacanthial (modified Waters method) projection Situation: A patient with a possible fracture of the left zygomatic arch enters the emergency room. Neither the AP axial nor the SMV projection demonstrates the left side well. The radiologist is indecisive as to whether this zygomatic arch is fractured. What other projections can the technologist provide to better define this area? Perform the oblique inferosuperior (tangential) projections. These projections are ideal to demonstrate a depressed fracture of the zygomatic arch. (Bilateral projections are generally taken for comparison) Situation: As part of a study of the zygomatic arches, the technologist attempts to perform the SMV position. Because of the size of the patient's shoulders, he is unable to flex his neck adequately to place the IOML parallel to the image receptor. What other options does the technologist have to produce an acceptable SMV projection? Angle the CR to place it perpendicular to the IOML. Angle the IR to maintain a perpendicular relationship between the CR and the IR. This will prevent distortion of the anatomy. Situation: A radiograph of a PA (Caldwell) projection for sinuses shows that the petrous ridges are projected into the lower half of the orbits and are obscuring the ethmoid sinuses. The technologist used a horizontal x-ray beam for the projection. The skull was positioned to place the OML at a 15-degree angle from the horizontal plane. What positioning modification is needed to correct this problem during the repeat exposure? The head and neck need to be extended more to project the petrous ridges below the ethmoid sinuses. **This doesn't match our notes. Situation: A radiograph of a parietoacanthial projection shows that the distance between the MSP and the outer orbital margin is not equal. What positioning error is present on this radiograph? Rotation of the skull Situation: A radiograph of an SMV projection for sinuses shows that the distance between the mandibular condyles and lateral border of the skull is not equal. What specific positioning error is present on this radiograph? Tilt of the skull Situation: A radiograph of a PA transoral projection shows that the sphenoid sinus is superimposed over the upper teeth and the nasal cavity. How must the position be modified to avoid this problem during the repeat exposure? Increase extension of the head and neck to project the entire sphenoid sinus through the oral cavity. Situation: A radiograph of a parietoacanthial projection (Waters method) shows that the petrous ridges are projected just below the maxillary sinuses. What positioning error (if any) is present?
None. The petrous ridges should be below the floors of the maxillary sinuses on a well positioned parietoacanthial projection Situation: A patient with a clinical history of sinusitis comes to the radiology department for a sinus study. The patient is quadriplegic and cannot be placed erect. Which single projection demonstrates any possible air-fluid levels in the sinuses? The most diagnostic projection is the horizontal beam lateral projection to demonstrate any air-fluid levels. Situation: A patient comes to the radiology department to rule out a possible polyp within the sphenoid sinus. What routine and/or special projection provides the best overall assessment of the sinuses for this patient? The PA and transoral special projection in addition to the routine four sinuses projection series (Lateral, PA Caldwell, Waters, & SMV) Situation: A patient comes to the radiology department with a clinical history of a deviated bony nasal septum. Which facial bone projections best demonstrate the degree of deviation? (More than one correct answer is possible) PA, PA axial, and parietoacanthial projections will demonstrate a possible deviated bony nasal septum. Sets with similar termsCh. 11 Facial and Sinuses Self Test58 terms Danielle_Scanlan Ch. 11 Facial and Sinuses Self Test58 terms ChristineGardner Procedures III: Mandible, TMJ's and Zygomatic Arch…65 terms kim_chilcuttPLUS Sets found in the same folderCh 11: Part 272 terms Biz530 Chapter 11: Cranium, Facial Bones, Paran…186 terms BLCheatherheinkele A&P4: Ch. 11: Skull & Cranial Bones: Sel…178 terms edwardsalicia Ch 11: Part 191 terms Biz530 Other sets by this creatorShoulder Projections23 terms Biz530 Elbow Projections20 terms Biz530 Hand Projections16 terms Biz530 Abdomen Projections18 terms Biz530 Other Quizlet setsAASM 2.6 Cue Cards #1: Technical and Digital Speci…40 terms alex_rees Nursing process and critical thinking59 terms tamaranichole1 Nutrition Exam 435 terms tylerpaul447 Related questionsQUESTION What does upper GI series look at? 9 answers QUESTION What is the purpose of the aluminium filter? 13 answers QUESTION What is the name of the plane that divides the body into right and left halves? 15 answers QUESTION What two views of the abdomen will visualize air/fluid levels? 9 answers Which projection will allow for visualization of all paranasal sinuses?A radiograph of a PA (caldwell) projection for sinuses reveals that the petrous ridges are projected into the lower hald of the orbits and obscuring the ethmoid sinuses. The tech used a horizontal x-ray beam for the projection. The skull was positioned to place the OML at a 15 degree angle from the horizontal plane.
Which projection is particularly useful for demonstrating depressed fractures of the frontal sinus?Radio graphic Imaging Protocols. Which one of the following cranial projections will best demonstrate a possible basilar fracture?Chapter12 Bontegar. What cranial structures are best demonstrated by the SMV projection?A properly positioned SMV projection demonstrates symmetric petrosae, the foramina ovale, spinosum, mastoid processes, sphenoid sinuses, mandible with maxillary sinuses superimposed, and nasal septum.
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Which single projection which will demonstrate possible air fluid levels in the sinuses of the cranium for a quadriplegic patient who Cannot stand?
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