Imaging Procedures-Test #6(sinuses, TMJ, mandible)

4

how many sinuses are there

sphenoid, ethmoid, frontal, maxillary

what are the 4 sinuses

purpose of sinuses

help voice resonate, reduce weight of skull by containing air, warm and moisten inhaled air, shock absorbers in trauma, control immune system, mucous production, interconnected with nasal cavity

maxillary sinus

largest sinus

maxillary sinus

develops in fetus and fully developed and aerated at birth

maxillary sinus

approximately pyramidal, usually symmetric but can vary in size and shape, sinus floor corresponds to roots of teeth

maxillary sinus

communicates with middle nasal meatus at superior aspect

frontal sinus

2nd largest sinus, can be absent

frontal sinus

fully develop by 6-7, normally paired and rarely symmetrical,

located between vertical plates of frontal bone

where is the frontal sinus located

frontal sinus and anterior/middle ethmoid sinus

communicates with middle nasal meatus

ethmoid sinus

within the lateral masses of the labyrinths of the ethmoid, divided into anterior, middle, and posterior

ethmoid sinus

what sinus is the last to develop

posterior ethmoid sinus

communicates with superior nasal meatus

sphenoid sinus

occupy body of sphenoid, lies below Sella turcica and extend between dorsum sellae and posterior ethmoid air cells

sphenoid sinus

can be singular or paired, asymmetric, communicates with sphenoethmoidal recess of nasal cavity

sphenoid sinus

fully developed by 6-7

7

how many cranial/facial bones make up the orbit

37 degrees lateral, 30 degrees inferior

the optic canal is __________ from the MSP and ___________ as it passes through the sphenoid

frontal, sphenoid, ethmoid

what cranial bones make up the orbit

maxilla, zygoma, lacrimal, palatine

what facial bones make up the orbit

mandible

largest and densest of facial bones

mandible

only movable facial bone

temporal mandibular join

TMJ

hinge/gliding joint

what kind of joint is the TMJ

hyoid bone

u shaped structure at the base of the tongue, attachment of many muscles, easily palpated and seen on image

upright

what position do all paranasal sinus need to be in to demonstrate air-fluid levels

MSP and IOML

what plane is parallel to the IR for the Paranasal Sinuses Lateral Projection

IP

what line is perpendicular to the IR for the Paranasal Sinuses Lateral Projection

½ to 1 inch posterior to outer canthus

where does the CR enter for the Paranasal Sinuses Lateral Projection

collimation for the Paranasal Sinuses Lateral Projection

include all sinuses and mandible can be clipped

evaluation criteria for the Paranasal Sinuses Lateral Projection

all 4 sinuses included, sphenoid best demonstrated, air fluid levels, sella turcica in profile, superimposed orbital roofs and mandibular rami

15

what angle is the OML at with the vertical IR for the Frontal and Anterior Ethmoid Sinuses PA Axial Projection Caldwell Method

nose

What body part should be touching the IR for the Frontal and Anterior Ethmoid Sinuses PA Axial Projection Caldwell Method

nasion

where does the CR exit for the Frontal and Anterior Ethmoid Sinuses PA Axial Projection Caldwell Method

sinus area only

collimation Frontal and Anterior Ethmoid Sinuses PA Axial Projection Caldwell Method

evaluation criteria for Frontal and Anterior Ethmoid Sinuses PA Axial Projection Caldwell Method

Frontal sinuses lying about the frontonasal suture, Anterior Ethmoidal air cells lying above petrous ridges on either side of nasion, Sphenoid sinuses seen through nasal fossa below ethmoids, Air fluid level (if present)

lower 1/3 of orbit

where are the petrous ridges for the Frontal and Anterior Ethmoid Sinuses PA Axial Projection Caldwell Method

frontal and anterior ethmoid

what sinuses are best seen for the PA axial projection caldwell method

maxillary sinuses

what sinus is seen in the parietoacanthial projection waters method

chin

what body part is touching the IR for the parietoacanthial projection waters method

37

what is the angle from the OML and the IR in the parietoacanthial projection waters method

MML

what line is perpendicular to the IR for the parietoacanthial projection waters method

acanthion

where does the CR exit for the parietoacanthial projection waters method

evaluation criteria for the parietoacanthial projection waters method

maxillary sinuses seen, distorted ethmoid and sphenoid sinuses, petrous ridges inferior to the maxillary sinuses

ethmoid and sphenoidal sinuses

what sinuses are seen in the SMV projection of the sinuses

IOML

what plane is parallel to the IR for the SMV projection of the sinuses

3/4’’ anterior to the EAm

where does the CR enter for the parietoacanthial projection waters method SMV projection of the sinuses

evaluation criteria for the SMV projection of the sinuses

sphenoid sinus and ethmoid air cells, mandible condyles anterior to the petrous ridges, superimposition of anterior frontal bone by mental protuberance

Parietoacanthial projection open-mouth waters method

what view is done if SMV sinuses can not be achieved

37

what degree is the OML to the IR for the Parietoacanthial projection open-mouth waters method

ancanthion

where does the CR exit for the Parietoacanthial projection open-mouth waters method

MSP

what plane is parallel to the IR for the Parietoacanthial projection open-mouth waters method

maxillary and sphenoid

what sinuses are seen in the Parietoacanthial projection open-mouth waters method

evaluation criteria for the Parietoacanthial projection open-mouth waters method

sphenoid sinuses projected through the open mouth, maxillary sinuses, petrous ridges below maxillary sinuses

MSP and IOML

what planes are parallel for the lateral orbit

IP

what plane is perpendicular to the IR for the lateral orbit

through outer canthus

where does the cr enter for the lateral orbit

look straight ahead

patient instructions for a lateral orbit

table top

how are all orbit projections performed

evaluation criteria for a lateral orbit

entire orbit, superimposed orbital roofs, body orbit and soft tissues of the eye

¾ inches distal to nasion

where do you center for a PA axial projection of the orbit

MSP and OML

what planes are perpendicular to the IR for a PA axial projection of the orbit

30 caudal

what is the angle for a PA axial projection of the orbits

Evaluation criteria for the PA axial projection of the orbits

entire orbits, petrous ridges below orbital shadows, close collimation, soft tissues of eye still seen, symmetrical orbits

50

what angle should the OML form to the IR for the parietoacanthial projection modified waters method of the orbits

chin on IR

how should the patient be positioned for the parietoacanthial projection modified waters method of the orbits

through mid orbits

where does the CR go through for the parietoacanthial projection modified waters method of the orbits

MSP

what plane is perpendicular to the IR for the parietoacanthial projection modified waters method of the orbits

evaluation criteria for parietoacanthial projection modified waters method of the orbits

Entire orbits, Petrous pyramids lying well below orbital

shadows, No rotation, Symmetric visualization of the

orbits, Close beam restriction centered to orbital region, Boney details of orbit and soft tissues of the eye for localization of foreign bodies

forehead and nose

what is touching the IR for the PA projection mandibular rami

MSP and OML

what planes are perpendicular to the IR for the PA projection mandibular rami

acanthion

where does the CR exit for the PA projection mandibular rami

evaluation criteria for the PA projection mandibular rami

all of mandible and TM joint, pa projections of mandibular body and rami, shows medial/lateral fracture displacement of rami

20-25 cephalic

what is the angle for the PA axial projection of the mandibular rami

angle added

what is the only difference between the PA projection and the PA axial projection of the mandibular rami

IP line

what line is perpendicular to the IR for the Mandible Axiolateral & Axiolateral Oblique Projections

mandibular body

what is parallel with the transverse axis of the IR to prevent superimposition of C-SP for the Mandible Axiolateral & Axiolateral Oblique Projections

25 cephalic

what is the tube angle for the Mandible Axiolateral & Axiolateral Oblique Projections

true lateral

what is the patient position for the Mandible Axiolateral & Axiolateral Oblique Projection of the ramus

30 degrees to the IR

what is the patient position for the Mandible Axiolateral & Axiolateral Oblique Projections for the body

45 degrees to the IR

what is the patient position for the Mandible Axiolateral & Axiolateral Oblique Projection for the symphysis

MSP and OML

what plane is perpendicular to the IR for the ap axial projection TMJ

35 caudal

tube angle for the ap axial projection of the TMJ

3 inches above nasion

where does the CR enter for the AP Axial projection TMJ

closed mouth and open mouth breathing

what two pictures need to be taken for TMJ projections

evaluation criteria for AP axial projection TMJ

collimation to TMJ mandibular condyles and fossa, minimum superimposition of petrous ridges over condyles

½ anterior to EAM and 2 inches superior to EAM

where do you center for a TMJ Axiolateral Projection Modified Schuller

MSP

what plane is parallel to the IR for the TMJ Axiolateral Projection Modified Schuller

IP

what plane is perpendicular to the IR for the TMJ Axiolateral Projection Modified Schuller

25-30 caudad

what is the angle for the TMJ Axiolateral Projection Modified Schuller

evaluation for the TMJ Axiolateral Projection Modified Schuller

TMJ anterior to EAM, condyle in mandibular fossa in closed mouth and inferior to the articular tubercle in the open mouth

15 degrees toward the IR

how do you rotate the patient for the TMJ

Axiolateral Oblique Projection

Modified Law

AML

what plane is parallel to the IR for the TMJ

Axiolateral Oblique Projection

Modified Law

15 caudal

what is the tube angle for the TMJ

Axiolateral Oblique Projection

Modified Law

1 ½ above EAM

where do you center for the TMJ

Axiolateral Oblique Projection

Modified Law

TMJ closest to IR

where does the cr exit for the TMJ

Axiolateral Oblique Projection

Modified Law

evaluation for TMJ Axiolateral Oblique Projection Modified Law

Tight collimation to TMJ

• Relationship between condyle

and mandibular fossa

• Condyle within fossa on closed

mouth

• Condyle inferior to articular

tubercle on open mouth (if

normal)

panorex

dentist xray

1/2 - 1 inch posterior to outer canthus

where does the cr enter for a lateral sinus