Skull Projection 2-compressed PDF

# EYE Localize Foreign Bodies ## Lateral Projection - semiprone - outer canthus - affected side on IR - MSP // IR - IPL 1 IR > **Superimposed orbital roofs** > - outer canthus > - R or L position > - non grid > - ↑ resolution > - magnification ## PA Axial Projection - MSP I IR - OML I IR - Re...

# EYE Localize Foreign Bodies ## Lateral Projection - semiprone - outer canthus - affected side on IR - MSP // IR - IPL 1 IR > **Superimposed orbital roofs** > - outer canthus > - R or L position > - non grid > - ↑ resolution > - magnification ## PA Axial Projection - MSP I IR - OML I IR - Rest Forehead & nose IR > **30° caudad** > **Center OF Orbits** > - Petrous portions (temporal) below inferior margin of the orbits ## Parietoacanthial Projection, Modified Waters Method > **(PA Projection) displacing the petrous ridge (by part)** - Chin on IR - MSP L IR - DML 50° IR > **Midorbits** > **Petrous Pyramid below orbital shadows** # Facial Bones ## Lateral Projection - semiprone - MSP // IR - IOMI // IR - IPL I IR > **BEST: Depressed fracture of frontal sinus.** > - R or L position > - zygoma/malar (b/n outer canthus) > - EAM > - Superimpored facial bone: > - superimposed mandibular rami > - orbital roofs > - zygomatic bone > - center > - no rotation > - Sella turcica ## Facial Profile: Relationship Bony & Soft tissue > **w/ the use of 2 films** > - w/ intensifying screen (bone positive) > - nonscreen film (soft tissue negative) # Waters Method (Parieto Acanthial Projection) - prone - MSP I IR - MML I IR - OML 37° IR - nose (3/4) in (1.9cm) away from grid > **CRS MML // exit acanthion** > **demo: Best projection For Facial Bones** > - orbits > - maxillae > - zygomatic arches > - petrous ridge below maxillary sinuses # Modified Waters Method (Modified Parietoacanthial Projection) - prone - MSP I IR - MML I IR - OML 55° IR > **I Acanthion** > - 35° CR > - Petrous ridge below inferior border of orbits > - petrous ridge w/in maxillary sinus > - orbital floor I IR // to CR > - Inferior displacement of orbital floor & opacified maxillary sinus > - Blow out Fx # Reverse Waters Method (Acanthial Parietal Projection) - supine - MSP IIR - MML LIR - chin up - DML 37° IR > **I Acanthion** > - superior facial bones (magnified waters method) > **FOR Trauma Pt adjust the CR instead of the part. CR // to MML** # Caldwell Method (PA axial Projection) - prone - forehead & nose IR caudad - MSP I IR - OML I IR > **15° acanthion** > **demo** > - orbital rims > - maxillae > - nasal sepnum > - zygomatic bone > - anterior nasal septum > - petrous ridge - lower third of bits > - petrous ridge - below inferior orbital margins > - orbital floors > **Radiolucent forehead 30° caudad (exaggerated Caldwell)** # Law Method (PA oblique axial Projection) - Semiprone - zygoma, nose I cephalad - chin IR (posterior gonion) - unaffected side IR - OML I IR > **25-30° Lower antrum** > **(Obsolete)** > - floor & posterior wall of maxillary sinus of side down > - external orbital wall > - zygomatic bone > - anterior wall of maxillary sinus of side up # Nasal Bones (STL nose) - semiprone - MSP // IR - 10MI II IR - IPL LIR > **I (1/2 in) more nasion** > - nasal bones > - soft tissue structures (nearect IR) > - R or L position > - (occlusal film) # Tangential Projection (Superior-Inferior Projection) - Extraoral IR: - prone - fully extended chin - MSP I IR - GAL 1 IR - Intraoral film: insert occlusal 1 in mouth - supine - head elevated - MSP 1 Film - CAL I Film > **// GAL nasal bone portion that extend beyond the CAL** > **For demo: medial or lateral displacement of fragments in fractures ** > **Contraindications** > - children or adults w/ short nasal bones > - concave face > - protruding upper teeth # Waters Method (Parieto-Acanthial Projection) - Prone - MSP I IR - MML IIR - DML 37° IR - nose 1.9 cm away from IR > **I Acanthion** > - displacement of bony nasal septum & depressed fx of nasal wings # Zygomatic Arches ## Submentovertical Projection (SMV) - seated - upright - MSP L IR - 10MI // IR - vertex head IR - neck hyperextended > **I 1in. posterior to outer canthi** > **Best demo: bilateral symmetric zygomatic arches** > - schuller/pfieffer method > - (↓ exposure factor) > - (vsm) verticosub mento ## Modified Titterington Method (PA axial Superoinferior Projection) - Prone - nose & chin IR - MSP LIR > **23-38° vertex midway b/n zygomatic arches** > **well shown zygomatic arches** # Modified Towne Method (AP axial Projection) - supine - MSP I IR - DML I IR - TOML I IR > **6/labella (1 in above nasion)** > - 30° caudad > - 37° caudad > **(Jug Handle view)** > - bilateral symmetric zygomatic arches free of superimposition > **(Unilateral) zygomatic arch - one side only** # Tangential Projection (For PT w/ depressed fx or flat cheek bones: ) - upright - neck hyperextend - Vextex on IR - IOML // IR - MSP 15° toward side of examined - top of head tilt 15° away > **I 10ML** > - skim at zygomatic arch > - 1 in posterior to outer canthus > - zygomatic arch free from superimposition # May Method (Tangential Projection) - prone - neck extended - chin on IR - 10MI // IR - MSP 15° away from side examined - top of head tilt 15° away > **I 1 1/2 in posterior to outer canthus** > - zygomatic arch free of superimposition > **For PT w/ depressed fx or flat cheekbones** # Mandibular Symphysis ## PA Axial Projection (occlusal film) - seated - upright - MSP I film - chin forward > **40° to 45° posteriorly** > - mandibular symphysis > - (b/n lips & tip of chin) > - mandibular symphysis > - mental foramina > - roots (lower lower) # Mandibular Rami ## PA Projection - prone/seated - forehead, nose in IR - OML I IR - MSP I IR > **I Acanthion** > - mandibular body > - rami > - For medial or lateral displacement of fragments in fx of rami ## PA Axial Projection - prone - forehead & nose IR - OML I IR - MSP I IR > **20°-25° cephalad** > **I Acanthion** > - mandibular body & rami > - condylar processes > - for medial or lateral displacement of fragments in fx of rami # Mandibular Body ## PA Projection - prone - nose & chin IR - mandibular symphis // IR - AML I IR - MSP LIR > **I ul of lips** > - mandibular body ## PA Axial Projection - Prone - nose & chin IR - mandibular symphysis // IR - AML I IR - MSP L IR > **30° cephalad** > **midway b/n TMJ** > - mandibular body > - TMJ's - inferior to mastoid process ## Zanelli Recommended > - ↑ contrast > - TMJ > - fill the mouth w/ air ## Towne Method (AP Axial Projectim) - supine - chin - tuck - OML I IR - TOML I IR - MSP I IR > **35° to 42° caudad** > **Glabella** > - condyloid processes of mandible > - tm fossae > **40° - tm fossae & mastoid portion** # Mandible ## Axiolateral Oblique Projection - seated/semiprone/semisupine - head lateral posi - IPL I IR Ramus - rotate head 30° toward IR Body - rotate head 45° toward IR Symphysis - (place the desired portion of mandible // IR) > **25° cephalad** > - mandibular region of interest > - mandibular body & rami > - 1/ to IR > - semisupine - use wedge sponge > - muscular/ hypersthenic pt - MSP 15° 10° cephalad to IR > - Reduce the possibility of projecting shoulder over the mandible # Submentovertical Projection (SMV) - upright/supine - MSP I IR - neck fully extended - vertex on IR - IOML // IR > - 10ML > - 6/n gonion > - midway b/n > - mandibular body > - coronoid > - condyloid processes of rami > - schuller / pfieffer method # Verticosubmental Projection - prone - MSP I IR - chin on IR - IOML // IR > - 10ML > - posterior outer canthi > - coronoid processes visible > - schuller method > - or occlusal plane > - Better Demo: condyle & neck condylar processes # Panoramic Tomography (Orthopantomography) ## Rotational Tomography - Technique employed to produced to mograms of curved surfaces > **For fracture & dislocation suspected** > - panoramic image of the entire mandible, TMJ, dental arches > - distortion- free lateral image of the entire mandible > - Pt who sustained severe mandibular or TMJ trauma > - Useful for general survey studies of dental abnormalities > - Adjuvant for pre-bone marrow transplant # Temporomandibular Articulations ## Modified Towne Method (AP axial Projection) - supine - MSP 1 IR - OML I IR - closed-mouth: posterior teeth in contact ( not incisor) - open-mouth: - open as wide as possible - condyles to be carried out of mandibular fossa - petrosa on condyle > **35° caudad** > - 3 in (7.6cm) above nasion > - Best demo: tm fossae > - 5° > - tmJ > - demo: condyles of mandible > - mandibular fossae (temporal) > - closed-mouth > - open-mouth > - Condyle & temporomandibular articulation below pars petros > **Contraindications** > - Not for trauma pt > - Mouth of open & mandible protruded (jutted forward) # Schuller Method (Axiolateral Projection) - Semiprone - head lateral - affected side IR - MSP // IR - IPL I IR > **25-30° caudad** > - 1/2 in anterior > - 2 in superior to upside EAM > - TMJ open mouth > - TMJ closed anterior to EAM > - closed mouth > - condyle in mandibular fossa > - open - mouth > - condyle inferior to articular tubercle > **R or L position** > **To localize TMJ:** > - 1/2 inch anterior EAM > - 1 in inferior EAM > **2 exposures:** > - closed-mouth > - open-mouth (unless contraindicated) # Modified Law Method (Axiolateral Oblique/Lateral/Transcranial/ Axial Projection) - semiprone - TMJ closed mouth - open mouth - use IR- changing tunnel or Bucky tray - bilateral - MSP 15° IR - IPL I IR - AML // IR - cheek om IR ( 1/2 anterior) > **15° 1 1/2 in caudad (3.8 cm)** > - condyles & neck (mandible) > - relation b/n superior mandibular fossa & condyle > - to EAM > - open - mouth > - mandibular fossa > - inferior & anterior excursion condyle > -closed mouth > - Fractures of neck & condyle of ramus # Inferosuperior Transfacial Position - semiprone - true Lateral - IPL 10 - 15° IR - MSP 15° IR > **30° cephalad** > - uppermost TMJ > - gonion # Albers-Schonberg Method (Lateral Transfacial Position) - semiprone - head in true lateral - IPL I IR - MSP // IR - 10ML // IR > **20° cephalad** > - lower tmJ > - lateral > - in open & close mouth position # 2anelli Method (Lateral Transfacial Position ) - lateral recumbent - head in true lateral - parietal region IR - MSP 30° IR > **I uppermost gonion** > - TMJ