Podcast
Questions and Answers
What is the primary positioning method for the patient when using a horizontal beam for sinus imaging?
What is the primary positioning method for the patient when using a horizontal beam for sinus imaging?
- Standing with back against the Bucky
- Seated upright with arms crossed
- Sitting with legs hanging off the edge
- Lying supine with arms extended at sides (correct)
How can it be determined if the skull is not rotated during imaging?
How can it be determined if the skull is not rotated during imaging?
- Ensuring the patient's eyes are closed
- Checking for symmetry in the facial features
- Measuring the distance from a midline point to lateral orbital margins (correct)
- Assessing the alignment of the patient's spine
Where should the center of the receptor be positioned during the supine method of imaging?
Where should the center of the receptor be positioned during the supine method of imaging?
- On the forehead of the patient
- 2.5 cm inferior to the outer canthus of the eye (correct)
- At the level of the outer canthus of the eye
- 3 cm above the outer canthus of the eye
What anatomical structures does the occipito-mental (OM) projection primarily show?
What anatomical structures does the occipito-mental (OM) projection primarily show?
What angle should the interorbital line be in relation to the Bucky/receptor?
What angle should the interorbital line be in relation to the Bucky/receptor?
Which feature should be included in the image to confirm it contains all relevant sinuses?
Which feature should be included in the image to confirm it contains all relevant sinuses?
How is the patient's head positioned for the occipito-mental projection?
How is the patient's head positioned for the occipito-mental projection?
What ensures that there is no rotation in an X-ray image for the occipito-mental projection?
What ensures that there is no rotation in an X-ray image for the occipito-mental projection?
What specific characteristic defines a true lateral position in sinus imaging?
What specific characteristic defines a true lateral position in sinus imaging?
What factor should be ensured regarding the height of the Bucky/receptor during imaging?
What factor should be ensured regarding the height of the Bucky/receptor during imaging?
In the frontal and ethmoid sinus projection, how is the head positioned relative to the horizontal line?
In the frontal and ethmoid sinus projection, how is the head positioned relative to the horizontal line?
During imaging, what should be avoided to ensure an accurate representation of the skull?
During imaging, what should be avoided to ensure an accurate representation of the skull?
Where should the central ray be directed for the frontal and ethmoid sinus projection?
Where should the central ray be directed for the frontal and ethmoid sinus projection?
What is the best position for the patient when performing the occipito-mental projection?
What is the best position for the patient when performing the occipito-mental projection?
What should be the collimated horizontal beam's positioning relative to the patient's anatomy for the OM projection?
What should be the collimated horizontal beam's positioning relative to the patient's anatomy for the OM projection?
What is a key essential image characteristic for an occipito-mental projection?
What is a key essential image characteristic for an occipito-mental projection?
Flashcards
Occipito-mental (OM) projection
Occipito-mental (OM) projection
A radiographic technique used to visualize the floor of the orbits, nasal region, maxillae, and portions of the frontal and zygomatic bones, while positioning the temporal bone below the maxilla.
Patient positioning (OM)
Patient positioning (OM)
Erect or seated, facing the image receptor. Nose and chin touch the receptor's midline. Adjust head to 45-degree orbito-meatal baseline with the Bucky/receptor.
Central ray (OM)
Central ray (OM)
Horizontal, collimated, centered on the receptor's midline at the level of lower orbital margins, with the anterior nasal spine as a centering point.
Image Characteristics (OM)
Image Characteristics (OM)
Petrous ridges should be inferior to maxillary sinuses; no rotation (lateral orbital wall to outer skull margins should be equidistant).
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Frontal and Ethmoid Sinus Projection
Frontal and Ethmoid Sinus Projection
Radiographic technique to view frontal and ethmoid sinuses.
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Patient Positioning (Sinuses)
Patient Positioning (Sinuses)
Seated, facing a vertical image receptor; the median sagittal plane should align with the receptor's midline and be perpendicular to it; the head should be positioned with the orbito-meatal baseline tilted 15° to the horizontal with the nasion in the center of the Bucky.
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Central Ray (Sinuses)
Central Ray (Sinuses)
Perpendicular to the vertical receptor, along the median sagittal plane, exiting at the nasion.
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Collimation Field for Frontal Sinuses
Collimation Field for Frontal Sinuses
The area of the X-ray beam that should include both the ethmoidal and frontal sinuses.
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Frontal Sinus Size Variation
Frontal Sinus Size Variation
The size of the frontal sinuses can differ between individuals.
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Skull Rotation Assessment
Skull Rotation Assessment
Assess skull rotation by measuring the distance from the midline to the lateral orbital margins on both sides; equal distances indicate no rotation.
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Lateral Facial X-ray Positioning (Erect)
Lateral Facial X-ray Positioning (Erect)
Patient sits facing the X-ray machine, the side to be X-rayed is against the receptor, arm on the same side is extended, and receptor is 2.5 cm below the outer eye corner.
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Lateral Facial X-ray Positioning (Supine)
Lateral Facial X-ray Positioning (Supine)
Patient lies on the table, arms extended, and the median plane parallel to the receiver. The receiver is placed to be 2.5cm below the eye corner.
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X-ray Beam Direction (Lateral Facial)
X-ray Beam Direction (Lateral Facial)
The horizontal X-ray beam is directed 2.5cm below the outer canthus (corner) of the eye.
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Facial Bones & Sinuses Inclusion
Facial Bones & Sinuses Inclusion
The X-ray image should ideally include all important facial bones, sinuses, and frontal sinus on the side being examined.
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Anterior Cranial Fossa Superimposition
Anterior Cranial Fossa Superimposition
A true lateral view will have the lateral portions of the anterior cranial fossa in alignment.
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Lateral Facial X-ray Positioning (Patient Facing)
Lateral Facial X-ray Positioning (Patient Facing)
The patient sits facing an X-ray cassette, head is turned so the mid-plane is parallel to the cassette, and the interpupillary line is perpendicular to the cassette.
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Radiographic Techniques: Facial Bones and Sinuses
- Lecture 3, focusing on facial bones and sinuses.
- Includes various radiographic projections, emphasizing different views.
Facial Bones and Sinuses
- Diagrams (Figs. 8.25a, 8.25b) illustrate skull structures, showing frontal sinuses, ethmoid sinuses, floor of the anterior cranial fossa, sphenoid sinuses, maxillary sinuses, zygomatic arch, anterior nasal spine, and other important structures.
- A labeled radiograph (Fig. 8.26a) visually represents key anatomical structures like outer skull margin, zygomatic arch, petrous ridges, and symphysis menti.
- Additional labeled radiographs (Figs. 8.26b and 8.26c) display further details, including soft tissue, inferior orbital margin, frontal sinuses, sphenoid sinuses, and maxillary sinuses.
Occipito-Mental Projection (Fig. 8.28a)
- This projection highlights the floor of the orbits, nasal region, maxillae, inferior portions of the frontal bone, and zygomatic bone.
- The projection aims to position the petrous portions of the temporal bone below the inferior maxilla, preventing interference on the facial bone image.
Occipito-Mental Projection: Patient and Image Receptor Positioning
- Patient should be positioned erect, facing the Bucky/receptor.
- Nose and chin should be in contact with the Bucky/receptor's midline.
- Adjust the head to ensure the orbito-meatal baseline forms a 45-degree angle with the Bucky/receptor.
- The horizontal central line of the Bucky/receptor should align with the lower orbital margins.
- Ensure the median sagittal plane of the patient is perpendicular to the Bucky/receptor.
Occipito-Mental Projection: X-ray Beam Direction and Location
- The collimated horizontal beam is centered on the Bucky/receptor before positioning.
- The beam's crosslines on the Bucky/receptor should align with the patient's anterior nasal spine.
- The petrous ridges should be displayed inferior to the maxillary sinus floors.
- Rotation should be avoided; lateral orbital wall distances from the outer skull margins should be equal on both sides.
Occipito-Frontal Sinuses
- This projection demonstrates frontal and ethmoid sinuses.
- Position the patient facing the vertical Bucky/skull unit, ensuring the median sagittal plane aligns with the Bucky's midline, perpendicular to the unit.
- Raise the orbito-meatal baseline to 15 degrees from the horizontal.
- Ensure the nasion is centered on the Bucky.
Occipito-Frontal Sinuses: X-ray Beam Direction and Location
- The central ray should be perpendicular to the Bucky's vertical axis, running along the median sagittal plane, exiting at the nasion.
- Collimation should encompass the frontal and ethmoidal sinuses, though sinus size varies between individuals.
- All relevant sinuses should be visualized in the image.
- Ensure no rotation of the skull to prevent distortion, which may be evaluated by comparing distances from midline to lateral orbital margins on both sides.
Lateral Projection (Figs. 8.32a, 8.32b)
- Used to specifically evaluate facial bone injuries in cases of trauma, always using horizontal beams.
- Patients can be positioned either erect or supine.
Lateral Projection: Erect Positioning
- Patient sits facing the vertical Bucky/receptor.
- The side under examination must contact the Bucky/receptor.
- Extend the arm on the same side for stability.
- The Bucky/receptor height is adjusted so its center is 2.5 cm below the outer canthus of the eye.
Lateral Projection: Supine Positioning
- The patient lies on the trolley, arms extended, median sagittal plane vertical to the trolley top (supine).
- The CR cassette supports the side under examination; center aligned 2.5cm below the outer canthus.
- Interorbital line should be perpendicular to the Bucky/receptor for a true lateral.
Lateral Projection: Essential Image Characteristics
- All facial bones and sinuses, including the frontal sinus, must be visualized without distortion.
- Anterior cranial fossa's lateral portions must not be superimposed in a true lateral view.
Nasal Bones (Figs. 8.35a, 8.35b)
- Positioning: Patient faces 18x24cm cassette in vertical Bucky unit. Head aligned so the median sagittal plane is parallel and interpupillary line perpendicular to the image receptor. The nose should roughly center the image.
- Direction: Horizontal central ray of x ray through the nasal bone center, collimating the nose.
Nasal Bones: Image Characteristics
- The image should depict nasal bones, soft tissues, frontonasal suture, and anterior nasal spine.
- The image of the nasal bones should be obtained without rotation.
- Exposure should be suitable for clear visualization of nasal bone and soft tissues. Sharp bony details verify no image motion.
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