exam 4 -- paranasal sinuses

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24 Terms

1
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paranasal sinuses

  • four groups

    • generally, frontal (2), ethmoid (many), sphenoid (1 or 2), and maxillary (2)

  • communicate with nasal cavity

  • generally fully developed by teenage years


<ul><li><p>four groups</p><ul><li><p>generally, frontal (2), ethmoid (many), sphenoid (1 or 2), and maxillary (2)</p></li></ul></li><li><p>communicate with nasal cavity</p></li><li><p>generally fully developed by teenage years</p></li></ul><p></p>
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maxillary sinuses

  • other name: antrum of highmore

  • within maxilla

  • above upper teeth

  • air-fluid levels visible

    • develop in fetus and a cavity is present at birth


<ul><li><p>other name: antrum of highmore</p></li><li><p>within maxilla</p></li><li><p>above upper teeth</p></li><li><p>air-fluid levels visible</p><ul><li><p>develop in fetus and a cavity is present at birth</p></li></ul></li></ul><p></p>
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communication between sinuses and nasal cavity

site of communication: opening into the middle nasal meatus within the nasal cavity (fossae)

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frontal sinuses

  • posterior to glabella

  • rarely symmetrical

  • number varies

    • rarely becomes aerated before age 6

      • generally larger in men


<ul><li><p>posterior to glabella</p></li><li><p>rarely symmetrical</p></li><li><p>number varies</p><ul><li><p>rarely becomes aerated before age 6</p><ul><li><p>generally larger in men</p></li></ul></li></ul></li></ul><p></p>
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ethmoid sinuses

  • within lateral masses of ethmoid bone

  • communicate with sphenoid sinus and nasal cavity

    • last to develop


<ul><li><p>within lateral masses of ethmoid bone</p></li><li><p>communicate with sphenoid sinus and nasal cavity</p><ul><li><p>last to develop</p></li></ul></li></ul><p></p>
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sphenoid sinuses

  • below sella turcica

  • may indicate basal skull fracture (sphenoid effusion)

    • becomes visible at age 6


<ul><li><p>below sella turcica</p></li><li><p>may indicate basal skull fracture (sphenoid effusion)</p><ul><li><p>becomes visible at age 6</p></li></ul></li></ul><p></p>
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osteomeatal complex

pathway of communication between frontal, maxillary, & ethmoid sinuses provide drainage

  • consists of: ethmoid sinuses, ethmoid bulla, uncinate process, middle nasal concha, maxillary sinus, inferior nasal concha, nasal cavities, nasal septum

  • key passageways: infundibulum, middle nasal meatus, inferior nasal meatus


<p>pathway of communication between frontal, maxillary, &amp; ethmoid sinuses provide drainage</p><ul><li><p>consists of: ethmoid sinuses, ethmoid bulla, uncinate process, middle nasal concha, maxillary sinus, inferior nasal concha, nasal cavities, nasal septum</p></li><li><p>key passageways: infundibulum, middle nasal meatus, inferior nasal meatus</p></li></ul><p></p>
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nasal cavities

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ethmoid sinuses in osteomeatal complex

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ethmoid bulla

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uncinate process

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middle nasal concha

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maxillary sinus in osteomeatal complex

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inferior nasal concha

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nasal septum

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infundibulum

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middle nasal meatus

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inferior nasal meatus

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paranasal sinus routine

  • basic

    • lateral

    • PA caldwell

    • parietoacanthial (waters)

    • submentovertex (SMV)

  • special

    • parietoacanthial transoral (open mouth waters)


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technical considerations for sinuses

  • 70 to 80 kV

  • erect

  • horizontal beam

  • AEC not recommended


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positioning for lateral sinuses

CR midway between outer canthus and EAM

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evaluation criteria for lateral sinuses

  • all four sinuses demonstrated

  • cranium not rotated or tilted

  • optimal exposure factors


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positioning for PA Caldwell sinuses

  • OML perpendicular to IR, w/ 15 degree tilt of pt’s head

    • OML 15 degrees from horizontal

  • horizontal CR

  • CR exits at nasion


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evaluation criteria for PA Caldwell sinuses

  • frontal and ethmoid sinuses demonstrated

  • petrous ridges in lower 1/3 of orbits

  • no rotation or tilt

  • optimal exposure factors