Exam (Facial Bones, Zyg arches, mandible, TMJ)

How many facial bones are there?

14

What is the largest immovable bone of the face?

Maxillary bones (2)

What facial bones articulates with the orbit and sphenoid?

Palatine bones (2)

What bones make up the lower, outer orbit?

Zygomatic bones (2)

What are the smallest and most medial facial bone?

lacrimal bones (2)

What bones form the bridge of the nose and articulates with the frontal bone?

Nasal Bones (2)

What structures provide rapid warming and humidification of air as it passes to the lungs?

Superior, middle, & Inferior Turbinates

Where is the maxillary sinus to the nasal tubrinates?

Lateral

What is the inferior portion of the bony nasal septum?

Vomer

What is the largest/densest bone of the face?

Mandible

What are the three portions of the mandible?

Ramus, Body, & Mentum

What part of the mandible forms the TMJ?

Mandibular condyle

What is the small U-shaped bone situated at the base of the tongue and is the ONLY bone in the body that does not articulate with another bone?

Hyoid

What are the routine projections for Facial Bones?

-Lateral

-PA Axial (Caldwell)

-Waters

-Modified Waters

-Reverse waters (Trauma)

What is the CR of Lateral Facial bones?*

midway between outer canthus and EAM (zygoma)

What is the only projection that shows all facial bones in their entirety?

Lateral Facial Bones

What line is parallel to the IR but perpendicular to the outer edge of the IR in a Lateral?

IOML

What line is perpendicular in a Lateral?

IPL

What is the CR of PA Axial (Caldwell) Facial Bones?

15 degrees caudal exiting nasion

What lines are perpendicular in a PA Axial (Caldwell) Method?

MSP and OML

When OML is perpendicular, what parts of the face are in contact with the IR?

Nose and forehead

Where are the petrous ridges in a PA Axial (Caldwell)?

Projected into the lower 1/3 of the orbits

What is the CR for a Parietoacanthial (Waters)?

Perpendicular exiting acanthion

What is in contact with the IR in a Waters?

Chin

Where is OML in a Waters?

37 degrees with IR

What lines are perpendicular in a Waters?

MSP and MML

What projection best demonstrates the full length of bony nasal septum and the zygoma?

Parietoacanthial (Waters)

Where should the petrous ridges be demonstrated in a Waters? (sinus)

Below the floor of the maxillary sinuses

Where is OML in a Modified Waters (Facial Bones)?

55 degrees to IR

Where are the petrous ridges in a Modified Waters?

Below inferior border of orbits

What is best demonstrated in a Modified Waters (Facial Bones)?

Bony nasal septum and zygoma

What is the positioning of a Trauma Acanthioparietal (Reverse Waters)?

Supine with MSP centered to midline of grid

What is the preferred projection for trauma facial bones?

Acanthioparietal (Reverse Waters)

Where is OML in Reverse Waters?

37 degrees from IR

In Reverse Waters, What line will be parallel to the central ray?

MML

What is the CR for Trauma Acanthioparietal (Reverse Waters) Facial bones?

Perpendicular to enter acanthion

Which projections demonstrate petrous ridges below floor of maxillary sinus?

Waters & Reverse Waters

Which projections best demonstrate the full length of the bony nasal septum?

Waters & Reverse Waters

What are the routine projections of Nasal Bones?

-PA Axial Caldwell

-Waters

-Both Laterals

What is the articulation between the nasal and frontal bone?

Nasofrontal suture

If an AP Axial (Caldwell) is done in a trauma situation, what is the CR?

15 degrees cephalic entering nasion

What is the CR for Lateral Nasal Bones?

Perpendicular 1/2" distal from nasion (inner canthus)

What is the best projection for evaluating the nasal bones?

Parietoacanthial Waters

What are the routine projections for Zygomatic Arches?

-SMV

-Waters

-Oblique Inferosuperior (Tangential)

-AP Axial (Modified Towne)

Which projection is a unilateral evaluation of the zygomatic arches?

Oblique Inferosuperior (Tangential)

Which projection is the best for a bilateral evaluation of the zygomatic arches?

Submentovertical (SMV)

What is the CR for SMV Zygomatic Arches?

Perpendicular to IOML entering 1" posterior to outer canthus

What is the positioning for SMV?

Hyperextend neck until vertex is in contact with IR

Where is the IOML in an SMV?

// with IR & Perpendicular to Central Ray

When is the only time in an SMV the ray will be perpendicular to the IR?

When the IOML is truly // to the IR

Where are the arches in an SMV?

Unless very flat or traumatically depressed, arches are projected beyond parietal eminences

Should exposure factors be high or low for Zygomatic Arches?

Low because the arches are small

What is the positioning for Oblique Inferosuperior (Tangential)?

-Hyperextend neck until vertex is on IR

-Rotate MSP 15 degrees toward side being examined

-Tilt head approx. 15 degrees away from side examined

What is the CR for Oblique Inferosuperior (Tangential) Zygomatic Arches?

Perpendicular to IOML entering 1" posterior to outer canthus

What are the two reasons why an Oblique Inferosuperior Tangential Projection performed?

When we don't see a single arch after an SMV

or

Neither of arches are demonstrated in an SMV due to facial structure

Where is IOML in Oblique Inferosuperior (Tangential)?

parallel in IR

What projection removes the zygomatic arch from superimposition of other facial bones?

Oblique Inferosuperior (Tangential)

Which zygomatic arch projection is a unilateral evaluation?

Oblique Inferosuperior (Tangential)

What is the CR for an AP Axial (Modified Towne) Zygomatic Arches when OML is Perpendicular?

30 degree caudad entering glabella (1" above nasion)

What is the CR for an AP Axial (Modified Towne) Zygomatic Arches when IOML is Perpendicular?

37 degrees caudad entering glabella (1" above nasion)

What are the routine projections for the Mandible?

-PA

-PA Axial or AP Axial (Towne)

-Modified Waters

-Rt and Lt Axiolateral Oblique

-SMV

What is the CR of a PA Mandible of the Ramus

Perpendicular exiting acanthion

What is the CR of a PA Mandible of the Body?

Perpendicular exits through lips

What line should be perpendicular when evaluating the Rami of the mandible?

OML

When the OML is perpendicular in a PA Mandible, what is best demonstrated?

Rami of Mandible

What line should be perpendicular when evaluating the Body of the mandible?

AML

When the AML is perpendicular in PA Mandible, what is best demonstrated?

Body of mandible

What is the CR of an AP Axial (Modified Towne) Mandible

35 degrees caudal 3" above nasion, passing through TMJ's

When the AML is perpendicular, what is in contact with the IR?

Nose and chin

What is the CR of a PA Axial Mandible of the Ramus?

20-25 degrees cephalic exiting acanthion

What is the CR of a PA Axial Mandible of the Body?

30 degrees cephalic exiting midway between TMJ

Which projection best demonstrates the mandibular condyles and ramus?

PA Axial

Where is the OML in a Modified Waters of the Mandible?

55 degrees with the IR

Which projection of the mandible demonstrates the gonion?

Modified Waters

What is the CR of Rt & Lt Axiolateral Obliques of the mandible?

25 degrees cephalic to exit mandibular region of interest (Ramus, Body, or Symphysis)

For Axiolateral obliques of the Mandible, head should be rotated to place the area of interest _____________ to the IR

parallel

How much should the head be rotated in an Axiolateral Oblique to evaluate the Ramus?

0 degrees (true lateral)

How much should the head be rotated in an Axiolateral Oblique to evaluate the Body of the mandible?

30 degrees toward IR

How much should the head be rotated in an Axiolateral Oblique to evaluate the Symphysis?

45 degrees toward IR

What is the CR of SMV Mandible?

Perpendicular to IOML and centered midway between the angles of the mandible

What demonstrates the entire mandible without superimposition?

Panographic Tomography

What is the routine projections of the TMJ?

-Axiolateral Oblique (Modified Law) Open and Closed Mouth

-Axiolateral (Schuller) Open and Closed Mouth

-AP Axial (Towne) Open and Closed Mouth

For the Axiolateral Oblique (Modified Law) TMJ, how should the head be rotated?

Head should rotate toward IR until MSP is 15 degrees

What line should be parallel in Axiolateral Oblique (Modified Law) TMJ?

AML

What is the CR for Axiolateral Oblique (Modified Law) TMJ?

15 degrees caudal 1.5" superior to upside EAM

What line is parallel in Axiolateral (Schuller) TMJ?

IOML

What is the CR for Axiolateral (Schuller) TMJ?

25 degrees caudal exiting EAM closest to IR

What lines are perpendicular in AP Axial (Modified Towne) for TMJ?

MSP and OML

What is the CR for AP Axial (Modified Towne) for TMJ?

35 degrees caudal entering 3" above nasion & passing through TMJ's (EAMs)

What is the only projection that is a bilateral evaluation of the TMJ?

AP Axial (Modified Towne)