head procedures

Ap axial townes patient position

pt is supine, flex pt neck until IOML is perpendicular to the plane of the IR

-top of IR should be level with the vertex/top of skull/head

ap axial townes tube distance

40 inches

ap axial townes tube angle

-if using IOML - angle 37 degrees caudad

-if using OML- angle 30 degrees caudad

ap axial townes centering

2 inches superior to the glabella

-this places CR going through the foramen magnum

AP Axial "Townes" breathing

hold breath

ap axial townes diagnostic image requirements

-entire cranium demonstrated

-shows the occipital bone, which is closest to the ir

-dorsum sellae and posterior clinoid processes are visible through the foramen magnum

-no rotation of the skull

lateral skull pt positioning

pt is seated and placed in an anteriorly obliqued position against the wall bucky, with their affected side of interest closest to the bucky, can also be done prone

-IOML perpendicular to the front edge of the IR

-Interpupillary line perpendicular to the IR

lateral skull fov

needs to include base of skull, vertex of skull, and frontal bones, does NOT need to include mandible

Lateral Skull distance

40 inches

lateral skull tube angle

perpendicular

lateral skull centering

2 inches superior to the EAM

lateral skull breathing instructions

hold breath

lateral skull diagnostic imaging requirements

-entire cranium

-superimposed TMJs

-shows the sella turcica in profile

-this helps show no rotation

pa axial (caldwell method) skull pt position

-pt is standing or facing the wall bucky (pa position)

-if done at table, pt is prone

-tuck /tilt pt head until their forehead and nose are against the wall or table bucky

-flex pt neck until OML is perpendicular to the IR

-make sure MSP is in midline with the bucky

PA (Caldwell Method) skull : What kind of breathing instructions?

hold breath

PA axial (caldwell method) skull tube distance

40 inches

PA axial (Caldwell Method) skull tube angle

15-30 degrees caudad

PA axial (Caldwell Method) skull: centering

at a point exiting the nasion

PA axial (Caldwell Method) skull diagnostic image requirements

-petrous ridges will be in the lower 1/3 of the orbit

skull PA pt position

-rest pt nose and forehead on the table (prone position)

-OML perpendicular to the IR

Skull PA tube angle and centering

-perpendicular

-centered to exit at the glabella

Skull- SMV (full basal)- (schuller method) pt position

-supine position

-hyperextend the neck until IOML parallel to the IR

-pt's vertex of the head should be resting on the IR

Skull- SMV (full basal)- (schuller method) tube angle

CR is perpendicular to the IOML

Skull- SMV (full basal)- (schuller method) centering

1/2 inch below the mandibular symphysis (chin)

skull- trauma cross table- horizontal beam- lateral distance

40 inches

skull- trauma cross table- horizontal beam- lateral pt position

-MSP parallel to the IR

-IOML is perpendicular to the table top and IR

-IP is perpendicular to IR

skull- trauma cross table- horizontal beam- lateral tube angle

horizontal beam/perpendicular

skull- trauma cross table- horizontal beam- lateral centering

2 inches above EAM

skull- trauma ap axial (reverse caldwell) pt position

head and neck are not moved

only the angle of the tube for trauma views

skull- trauma ap axial (reverse caldwell) tube angle

15 degrees cephalic

-in relation to patients OML, in C- collar it may be perpendicular, if OML perpendicular then angle CR 10-15 degrees

skull- trauma ap axial (reverse caldwell) centering

at the nasion

skull trauma AP tube angle

perpendicular , parallel to OML

-if a pt un a c-collar then the CR may need adjusted to some angle of 10-15 degrees caudad

skull trauma AP centering

to glabella

skull trauma AP axial townes tube angle

if using OML- 30 degrees caudad

if using IOML- 37 degrees caudad

skull trauma AP axial townes centering

midway through the EAM's

-exits the foramen magnum

lateral facial bones pt position

affected side closest to the IR

LAO/RAO

true lateral

IP line is perpendicular to the plane of the IR

IOML is perpendicular to the front edge of the IR

lateral facial bones tube distance

40

lateral facial bones tube angle

perpendicular/horizontal

lateral facial bones centering

at a point that enters halfway between the outer canthus and the EAM on the lateral surface of the zygomatic arch

lateral facial bones breathing

hold breath

lateral facial bones diagnostic image requirements

-facial bones in lateral profile

-zygomatic bone is in the center of the IR

-sella turcica in profile

parietoacanthial "waters" facial bones pt position

- pt is seated and facing wall bucky

- or can be done prone

-pt's chin is resting on the bucky

- hyperextend the patients neck until their OML forms a 37 degree angle with the plane of the IR

- MML perpendicular with the bucky

parietoacanthial "waters" facial bones distance

40

parietoacanthial "waters" facial bones tube angle

perpendicular

parietoacanthial "waters" facial bones centering

at a point exiting the acanthion

parietoacanthial "waters" facial bones diagnostic image requirements

-entire orbit and facial bones are demonstrated

-shows petrous ridges are below the maxillary sinuses

PA axial (caldwell) for facial bones pt position

prone or pt seated facing wall bucky

pt forehead and nose against ir

flex pt neck until OML is perpendicular to the IR

make sure the pt MSP is midline with the bucky

PA axial (caldwell) for facial bones distance

40

PA axial (caldwell) for facial bones tube angle

15-30 degrees caudad

PA axial (caldwell) for facial bones centering

exiting the acanthion

facial bones- modified parietoacanthial (modified waters) pt position

-extend neck, rest chin, and nose on surface,

-adjust head so OML forms a 55 degree angle with the IR

-LML perpendicular

facial bones- modified parietoacanthial (modified waters) tube angle

perpendicular

facial bones- modified parietoacanthial (modified waters) centering

exits the acanthion

what does facial bones- modified parietoacanthial (modified waters) demonstrate?

blow out fracture and the maxillary sinuses

mandible axiolateral oblique pt position

-side of interest closest to the IR

-close mouth and bring teeth together

-extend neck slightly

-rotate head toward the IR to place the mandibular region of interest parallel to the IR

mandible axiolateral oblique tube angle

25 degrees cephalic from IPL/horizontal

what does the head in true lateral for mandible show

ramus of mandible

what does head degree of 30 degrees demonstrate on the mandible

body of mandible

what does head degree rotation of 45 degrees demonstrate on the mandible

mentum of mandible

PA mandible pt position

-prone or PA upright at the wall bucky

-tuck chin until OML is perpendicular to the IR

PA mandible tube angle

perpendicular

PA mandible centering

exits at the junction of the lips

PA mandible demonstrates

rami of the mandible

mandible ap axial townes pt position

-supine or upright at the wall bucky

-tuck chin until OML is perpendicular to the IR

-can use IOML too

mandible ap axial townes tube angle

35 degrees caudad if using OML

42 degrees caudad if using IOML

mandible ap axial townes centering

1 inch superior to the glabella

mandible ap axial townes demonstrates

condyloid processes of the mandible

mandible PA axial pt position

PA/prone

-OML perpendicular to IR

mandible PA axial tube angle for showing the rami of the mandible and condyloid processes

angle CR 20-25 degrees cephalic

mandible PA axial showing the body of the mandible angle tube

30 degrees cephalic

mandible PA axial centering

exit the acanthion

mandible- submentovertex (full basal) pt positioning

-hyperextend the neck

-IOML is parallel to the IR

-resting head on the vertex

mandible- submentovertex (full basal) tube angle

perpendicular to the IR/IOML

mandible- submentovertex (full basal) centering

1 1/2 inches inferior to the mental symphysis

TMJ axiolateral oblique (modified law method) pt position

- head in true lateral

-rotate face toward IR 15 degrees

-perform open mouth and closed mouth series

TMJ axiolateral oblique (modified law method) tube angle

15 degrees caudad

TMJ axiolateral oblique (modified law method) centering

1 1/2 inches superior to upside EAM

TMJ - axiolateral (schuller method) pt position

rest lateral surface of head against the bucky or table with side of interest closest

-IPL perpendicular to the table

-IOML perpendicular to the front edge of IR

TMJ - axiolateral (schuller method) tube angle

25-30 degrees caudad

TMJ - axiolateral (schuller method) centering

1/2 inch anterior and 2 inches superior to upside of EAM

TMJ - axiolateral (schuller method) mouth open demonstrates

condyle moves to the anterior margin of the mandibular fossa

TMJ - axiolateral (schuller method) with mouth closed

condyle within mandibular fossa

TMJ ap axial (modified towne) pt position

tuck chin so OML is perpendicular, can use IOML as well

TMJ ap axial (modified towne) tube angle

35 degrees caudad if using OML

42 degrees caudad if using IOML

TMJ ap axial (modified towne) centering

3 inches above nasion, perform open mouth and closed mouth images

parietoacanthial "waters" for nasal bones pt position

pt is seated and facing wall bucky, or done lying prone

-pt chin is against the wall or table bucky

-hyperextend neck until their OML forms a 37 degree angle with the plane of the IR

-MML perpendicular

parietoacanthial "waters" for nasal bones distance

40

parietoacanthial "waters" for nasal bones tube angle

perpendicular

parietoacanthial "waters" for nasal bones centering

exiting the acanthion

parietoacanthial "waters" for nasal bones breathing

hold breath

parietoacanthial "waters" for nasal bones diagnostic image requirements

helps demonstrate deviated septum

shows petrous ridges below maxillary sinuses

lateral nasal bones pt position

pt seated with the affected side closest to the IR, RAO/LAO

IP line perpendicular to plane of the IR

lateral nasal bones tube angle

perpendicular

lateral nasal bones centering

at a point at the bridge of the nose or a point that is 1/2 inch distal to the nasion

lateral nasal bones demonstrates

lateral nasal bones demonstrates

nasal bones, nasal spine, and frontonasal suture in lateral profile, appears as a beak

PA axial caldwell nasal bones pt position

nose and forehead against the image receptor

pa axial caldwell nasal bones tube angle

15 degrees caudad

pa axial caldwell nasal bones centering

exit the nasion

pa axial caldwell nasal bones demonstrates

that projects the petrous ridges into the lower third of the orbits to visualize the orbital rims, maxillae, nasal septum, and zygomatic bones