Positioning of the Sinuses, Mandible, TMJs, and Orbits for FB
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103 Terms
What is the technique for the lateral sinuses?
75 kVp @ 18-22 mAs
What is the technique for the waters method of the sinuses?
75 kVp @ 18-22 mAs
What is the technique for the open-mouth waters of the sinuses?
75 kVp @ 18-22 mAs
What is the IR size/orientation for all sinus views?
10 × 12 LW
What is the SID for all sinus views?
40 inch
What is the collimation for all sinus views?
Collimate down to an 8 × 10
Are there tube angles for the sinuses?
No, always horizontal
Where is the CR for the lateral sinuses?
CR to zygoma (midway between outer canthus and EAM)
Where is the CR for the waters method of the sinuses?
CR exits at acanthion
Where is the CR for the open-mouth waters of the sinuses?
CR exits at acanthion
How would you position for a lateral sinus view?
IPL perpendicular to IR/Bucky
IOML perpendicular to front edge of IR/Bucky, IOML parallel to IR/Bucky
How would you position for a waters method of the sinuses?
Rest chin on Bucky
MML perpendicular to IR
OML forms a 37 degree angle with the IR/Bucky
How would you position for an open-mouth waters of the sinuses?
Line up MML perpendicular to IR/Bucky with mouth closed; once aligned, have patient carefully drop jaw (to open mouth) without moving head
Where is the marker placement for the lateral sinus views?
Anterior
What is the breathing for all sinus views?
Suspend respiration
Do you shield for sinus views?
Yes
If you are doing the lateral sinus and it is a trauma what should you do?
Do x-table lateral for air-fluid levels
Where are the petrous ridges for the waters method of the sinuses?
Projected just below the maxillary sinuses
What sinuses does the open-mouth waters demonstrate?
Sphenoid sinuses
What is the technique for the Caldwell method of the sinuses?
75 kVp @ 18-22 mAs
What is the technique for the SMV of the sinuses?
75 kVp @ 28-32 mAs
Where is the CR for the Caldwell method of the sinuses?
CR to exit at the nasion
Where is the CR for the SMV of the sinuses?
CR midway between gonions approximately 1 ½ inches below mandibular symphysis
How would you position for a Caldwell method for the sinuses?
Place patients nose and forehead with neck extended to elevate OML 15 degrees from perpendicular to IR
Or line up AML then bring it down just a tad
How would you position for an SMV of the sinuses?
Hyperextend neck; rest head on vertex
IOML is parallel to IR/Bucky
CR is perpendicular to IOML
Where is the marker placement for the Caldwell method of the sinuses?
Bottom corner of IR
Where is the marker placement for the SMV of the sinuses?
Top corner of IR
Where are the petrous ridges for the Caldwell method of the sinuses?
Projected in lower 1/3 of orbits
If you cannot get an SMV for the sinuses which view do you do instead?
Open-mouth waters
What is the technique for the PA mandible?
75 kVp @ 18-22 mAs
What is the technique for the PA axial mandible?
75 kVp @ 18-22 mAs
What is the technique for the axiolateral oblique mandible?
65-70 kVp @ 6-8 mAs
What is the IR size/orientation for all mandible views?
10 × 12 LW
Which views for the mandible are done tabletop, non-grid?
Axiolateral oblique, Towne method, panorex
How would you collimate for PA mandible?
Collimate down to 8 × 10 approximately
How would you collimate for a PA axial mandible?
Collimate down to 8 × 10 approximately
How would you collimate for an axiolateral oblique mandible?
Slight collimation is fine, including beyond ear
What is the tube angle for the PA axial mandible?
20-25 degrees cephalad
What is the tube angle for the axiolateral oblique mandible?
25 degrees cephalad from IPL
Where is the CR for the PA mandible?
CR exits at the junction of the lips
Where is the CR for the PA axial mandible?
CR exits at acanthion
Where is the CR for the axiolateral oblique mandible?
CR directed to exit mandibular region of interest (between mandibular bodies- aim for soft spot)
How would you position for a PA mandible?
Rest patients forehead and nose against Bucky
Tuck chin, bringing OML perpendicular to IR
How would you position for a PA axial mandible?
OML perpendicular to IR
How would you position for an axiolateral oblique mandible?
Place head in true lateral; have patient close mouth and bring teeth together
Jut chin straight out like a chicken neck (Extend chin forward) then tilt head 10-15 degrees
What does the PA axial mandible best demonstrate?
Proximal rami and elongated view of condyloid process
For the axiolateral oblique mandible, the degree of obliquity depends on the area of interest so, a true lateral best demonstrates?
Ramus
For the axiolateral oblique mandible, the degree of obliquity depends on the area of interest so, a 30 degree rotation towards the IR best demonstrates?
Body
For the axiolateral oblique mandible, the degree of obliquity depends on the area of interest so, a 45 degree rotation best demonstrates?
Mentum
For the axiolateral oblique mandible, the degree of obliquity depends on the area of interest so, a 10-15 degree rotation best demonstrates?
A general survey
What is the technique for the SMV of the mandible?
75 kVp @ 18-22 mAs
What is the technique for the Towne method of the mandible?
75 kVp @ 24-32 mAs
What is the technique for the panorex of the mandible?
Follow hospitals protocols
What is the collimation for the SMV of the mandible?
Collimate down to at least an 8 × 10
What is the collimation for the Towne method of the mandible?
Collimate on all sides to within 2 inches of nasal bones
What is the collimation for the panorex of the mandible?
Collimate on all sides to nasal bones
What is the tube angle for the Towne method of the mandible?
35 degrees caudad if OML perpendicular to IR
What is the tube angle for the panorex of the mandible?
As needed to ensure CR is parallel to GAL
Where is the CR for the SMV of the mandible?
CR at level 1 ½ inches inferior to mandibular symphysis
Where is the CR for the Towne method of the mandible?
Center to glabella
How would you position for a SMV of the mandible?
Rest head on vertex
IOML parallel to IR
How would you position for a Towne method of the mandible?
Tuck chin, and angle CR 35 degrees caudad if OML perpendicular to IR
Tube angle would be 42 degrees if using IOML
How would you position for a panorex of the mandible?
Adjust height of chin rest until IOML is aligned parallel with floor
Where is your marker placement for the SMV of the mandible?
Top corner of IR
What is the SID for all mandible views?
40 inch
What is the breathing for all mandible views?
Suspend respiration
Do you shield for the mandible?
Yes
What is the technique for the modified Towne method of the TMJs?
75 kVp @ 24-32 mAs
What is the technique for the modified Law method of the TMJs?
75 kVp @ 18-22 mAs
What is the technique for the Schuller method of the TMJs?
75 kVp @ 18-22 mAs
What is the IR size/orientation for all TMJ views?
10 × 12 LW
What is the SID for all TMJ views?
40 inch
What is the collimation for the modified Towne method for the TMJs?
Collimate to 8 × 10
What is the collimation for the modified Law method for the TMJs?
Collimate to 7 × 7
What is the collimation for the Schuller method for the TMJs?
Collimate to 7 × 7
What is the tube angle for the modified Towne method of the TMJs?
CR 35 degrees caudad from OML or 42 degrees caudad if using IOML
What is the tube angle for the modified Law method of the TMJs?
CR 15 degrees caudad
What is the tube angle for the Schuller method of the TMJs?
While in true lateral, andlg CR 25-30 degrees caudad
Where is the CR for the modified Towne method of the TMJs?
CR 3 inches superior to the nasion or CR passes 1 inch anterior to the level of the TMJs
Where is the CR for the modified Law method of the TMJs?
CR to 1 ½ inches superior to upside EAM (looking at the downside)
Where is the CR for the Schuller method of the TMJs?
CR to ½ inch anterior and 2 inches superior to upside EAM
How would you position for a modified Towne method of the TMJs?
Tuck chin
OML perpendicular to IR/Bucky
How would you position for a modified Law method of the TMJs?
Align IOML perpendicular to front edge of IR (IOML parallel to Bucky)
From lateral position: rotate face 15 degrees toward IR/Bucky (separates TMJs so not superimposed)
How would you position for a Schuller method of the TMJs?
IOML perpendicular to front edge of IR (IOML parallel to Bucky)
Head in true lateral; IPL perpendicular to IR
Results in greater elongation of the condyle, as compared to the modified Law
What is the breathing for the TMJ views?
Suspend respiration
How many views do you do for the Schuller method and what are there?
2; open and closed mouth view
Where is your marker for the Schuller method?
Mark side closest to IR/Bucky
What is the technique for the Caldwell method for the orbits for a FB?
75 @ 18-22 mAs
What is the technique for the waters method for the orbits for a FB?
75 kVp @ 18-22 mAs
What is the technique for the lateral position for the orbits for a FB?
75 kVp @ 18-22 mAs
What is the IR size/orientation for all orbits for a FB views?
10 × 12 LW
What is the SID for all orbits for a FB views?
40 inch
What is the tube angle for the Caldwell method for the orbits for a FB?
15 degrees caudal
Where is the CR for the Caldwell method for the orbits for a FB?
CR to exit at the nasion
Where is the CR for the waters method for the orbits for a FB?
CR exits at acanthion
Where is the CR for the lateral position for the orbits for a FB?
CR to zygoma
How would you position for a Caldwell method for the orbits for a FB?
OML perpendicular to IR/Bucky
Ensure patient doesn’t move in between eyes up and eyes down images
How would you position for a waters method for the orbits for a FB?
MML perpendicular to IR
OML forms a 37 degree angle with IR/Bucky
How would you position for a lateral position for the orbits for a FB?
IPL perpendicular to IR/Bucky
IOML perpendicular to front edge of IR
What is the breathing for all orbits for FB views?
Suspend respiration