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MSP

Midsagittal plane

IPL

Interpupillary line

SOG

supraorbital groove

TEA

top of ear attachment

EAM

external auditory meatus

IAM

internal auditory meatus

SOM

supraorbital margin

IOM

infraorbital margin

GAL

glabelloaveolar line

GML

glabellomeatal line

OML

orbiomeatal line

IOML

infraorbitalmeatal line

AML

acanthiomeatal line

LML

lipsmeatal line

MML

mentomeatal line

A radiograph of an AP axial proj of the crania reveals that the dorsum sellae is projected below the foramen magnum, but the anterior arch of C1 is visible w/i the foramen. WHich of the following positioning errors led to this radiographic outcome?
a. excessive CR angle
b. insufficient CR angle
c. insufficient flexion of the head and neck
d. tilt of the skull

a

A radiograph of a PA axial proj (Caldwell) of the cranium reveals that the petrous ridges are located at the level of the lower one third of the orbits. The tech performed this proj with the CR angled 15 degree caudal to the OML. How must positioning be altered if a repeat exposure is performed?
a. increase the extension of the skull
b. increase the flexion of the skull
c. increase the CR angle
d. none; position correct

d

A radiograph of a smv proj of the cranium reveals that the mandibular condyles are proj into petrous pyramids. What must be altered during teh repeat exposure to produce a more diagnostic radiograph?
a. increase extension of skull
b. increase flexion of skull
c. decrease CR angle
d. none acceptable image

a

A radiograph of a lateral proj of the cranium reveals that the orbital plate are not superimposed, one is slightly superior to the other. WHich of the following position error led to this outcome?
a. rotation
b. tilt
c. excessive flexion
d. excessive extension

b

A radiograph of a lateral cranium reveal that the mentum was cut off from the bottom of the radiograph. A 10x12 was used and it was placed crosswise. What must be altered if a repeat exposure is performed?
a. center CR at EAM
b. use 14x17
c. place cassett lengthwise
d. none; center and ir correct

d

A patient comes to radiology for a routine study of the cranium. He is unable to flex his head and neck sufficiently to place OML perpendicular to the IR for AP axial proj. What should the tech do to compensate for this problem w/o creating excess magnification of the occipital bone?
a. use IOML w/ CR angle of 37 degree
b. perform Haas
c. Perform smv proj
d. use AML and increase CR angle by 10 degree

a

Pt enters ER w possible basilar skull fracture. Which of the following skull proj would best demonstrate any blood present in the sphenoid sinus?
a. AP w/15 degree cephalic angle
b. Haas method
c. SMV
d. Horizontal beam lateral proj

d

Pt comes to radiology with a history of a possible erosion of the superior orbital fissures. Which of following prom would best demonstrate this structure?
a. PA axial w/ a 15 degree caudal angle to OML
b. SMV
c. PA axial w/ 25 to 30 degree caudal angle to OML
d. AP axial w/ 37 degree caudal angle to OML

c

Pt comes to radiology w/ possible bone cyst w/i the squamous portion of frontal bone. Which of the following proj would best demonstrate this region w/ a minimal amt of distortion of the frontal bone?
a. AP axial w/ 30 degree caudal angle to OML
b. PA axial w/ 30 degree caudal angle to OML
c. PA axial w/ 15 degree caudal angle to OML
d. PA w/ no angle to OML

d

Pt comes to radiology for study of the sella turcica. Which of the following routines would best demonstrate this structure?
a. PA axial w/ 15 caudal angle and lateral proj
b. AP axial and lateral proj
c. SMV and lateral proj
d. Haas and SMV

b

Pt comes to radiology w/ clinical history of an acoustic neuroma. Which of hte following imaging modalities will provide the best assessment for this tumor?
a. Radiography
b. Ultrasound
c. Nuclear Medicine
d. MRI

d

Pt comes to radiology w/ severe mastoiditis. WHich of the following imaging modalities will best demonstrate possible bony destruction w/i the mastoid region?
a. CT
b. Nuclear Medicine
c. Ultrasound
d. MRI

a

Pt comes in w clinical history of a possible pituitary adenoma. Because this is a rural hospital, CT and MRI are not available. Which radiographic proj or position would best demonstrate signs of erosion of sella turcica because of tumor?
a. AP axial Towne
b. PA Caldwell
c. Lateral
d. SMV

c

Small flap of cartilage covering the opening to the ear (EAM)

tragus

This method requires a 25 degree cephalad angle

Haas

The CR is centered 2" superior to EAM for this proj

lateral

AP axial proj w/ 30 degree caudal CR to IOML for sella turcica best visualizes what?

anterior clinoid processes

The eustachian tube attaches to this part of ear

middle

The widest portion of the cranium is found at the level of _______.

parietal tubercles

The joint found btwn lateral condylar portions of the skull and the superior articular process of C1

atlantooccipital joint

This cranial bone makes up the majority of the calvarium

parietal

Name the suture that separates the parietal from the occipital bone

lambdoidal

This division of the temporal bone contains the organs of hearing and equilibrium

petrous

The classification of an average shape skull with a 47 degree angle btwn petrous pyramids and midsagittal plane

mesocephalic

This central portion of bony labyrinth contains the oval window

vestibular

The degree of angluation for Caldwell

fifteen

The cranial bone that possesses the zygomatic process

temporal

For PA proj of skull, which positioning line is perpendicular to IR?

OML

The mastoid air cells communicate with this part of the ear

middle

Hereditary disease which involves excessive spongy bone formation of the middle and inner ear

otosclerosis

If pt is unable to depress chin sufficiently to bring OML perpendicular to IR the IOML can be placed perpendicular w/ CR caudad angle of _____ degrees

37

This proj results in the highest thyroid dose of all skull proj

SMV

The sensory apparatus of both equilibrium and hearing are contained in this part of ear

internal

Lesions of decreased density

osteolytic

This is an alternative proj for pt who cant flex their neck sufficiently for AP axial (Towne)

Haas

An opening btwn the epitympanic recess and the mastoid air cells

aditus

This disease is characterized by a "cotton-wool" appearance radiographically

pagets

This structure includes cochlea, vestibule, and semicircular canals

osseous labyrinth

The frontal bone articulates with how many cranial bones

four

This bony landmark represents the highest level of facial bone mass

orbital plates

This fontanel is last to close at about 18 months of age

anterior

The frontal, sphenoid and occipital bone all articulate with which other bone

parietal

This fracture is sometimes called a ping-pong fracture

depressed

This landmark corresponds with the level of petrous ridge

TEA

This proj requires that the IOML is placed parallel to the IR

SMV

The left mastoid fontanel becomes the _____________ in an adult

Left asterion

This cavity is part of the middle ear

tympanic

The PA proj of the skull requires how many degrees of angluation?

zero

This kV range is recommended for all skull proj

medium

The ethmoid notch is part of this bone

frontal

This cranial bone possesses the zygomatic process

temporal

The difference btwn the infraorbiomeatal and orbitomeatal line is about ___ degrees

7

This modality best demonstrates early signs of Paget's disease of the skull

Nuclear medicine

This bone forms a protection for the pituitary gland

sphenoid

The structure of the inner ear responsible for hearing

cochlea

This bone contains the foramen ovale

sphenoid

This cranial bone possesses the superior nasal conchae

ethmoid

This cranial bone articulates with ALL other cranial bones

sphenoid

For a PA axial proj of skull, which positioning line is perpendicular to IR

OML

What is total number of fontanels in an infant?

6

Small irregular bones occasionally found in cranial sutures

wormian

For a lateral proj of the skull the CR is centered 2" ________ to the EAM

superior

This bone contains the cribriform plate

ethmoid

This anatomy should be shielded when possible

thyroid

The anterior fontanel found in the adult skull and what bones does it connect

bregma (f & p)

posterior fontanel found in adult skull and what connects

lambda (p & o)

right sphenoid fontanel found in adult and what connect

rt pterion (p,t,s)

left sphenoid fontanel found in adult and what connect

left pterion (p,t,s)

right mastoid fontanel found in adult and what connect

right asterion (p,t,o)

left mastoid fontanel found in adult and what connect

left asterion (p,t,o)

coronal

frontal and parietal

sagittal

2 parietal

lambdoidal

occipital and parietal

squamosal

parietal and temporal

mesocephalic

47 degrees, width btwn 75-80% length

brachycephalic

>47 degrees, width 80%-more length

dolicocephalic

<47 degrees, width <75% length

AP Axial
(Towne)

80 20
30 degree caudad to OML chin depressed
37 degree caudad to IOML no depression
CR 2 1/2" above glabella

Lateral Skull

80 8
MSP parallel IR, IPL perpendicular IR, IOML perpendicular edge IR
CR 2" superior to EAM

PA Axial
(Caldwell)

80 18
OML perpendicular IR, exit @ nasion
15 degree caudad, petrous ridge low 1/3 orbits
25-30 degree caudad, petrous ridge below orbits

PA 0 degrees

80 18
OML perpendicular IR, exit @ glabella
CR perpendicular IR (parallel to OML)
Petrous ridge fill orbits and superimpose supraorbital region

SMV

80 30
IOML parallel IR perpendicular CR
CR 1 1/2" inferior mandibular symphysis midway btwn gonion

PA Axial
(Haas)

80 20
OML perpendicular IR, 25 degree cephalad to OML
CR to MSP pass through level of EAM exit 1 1/2" sup to nasion
(can't do AP towne, magnifies occipital region but lower thyroid dosages)

Lateral: Sella Turcica

80 10
IPL perpendicular table, MSP parallel table, IOML perpendicular front IR
CR 3/4" ant 3/4" sup EAM, 4" sq collimation

AP Axial: Sella Turcica
(Towne)

80 22
IOML perpendicular IR
37 degree caudad if dorsum sellae and post clinoid process interest w/i foramen magnum
30 degree caudad if ant clinoid process interest above foramen magnum
CR 1 1/2" above superciliary arch exit @ foramen magnum

Linear fracture

jagged or irregular lucent lines

Depressed fractures

ping-pong, fragment of bone separate and depressed into cavity

basal skull fractures

through dense inner structures of temporal bone, see air fluid levels in sphenoid sinus use horizontal lateral, CT

Osteolytic

destructive lesions w/ irreg margins

Osteoblastic

proliferative bony lesion of increase density

Combo blastic and lytic

moth-eaten appearance

multiple myeloma

tumor originate in bone marrow

pituitary adenomas

tumor of pituitary seen by CT or MRI, images show enlargement of sella turcica and erosion of dorsum sellae

paget's disease (osteitis deformans)

bony destruction then bony repair, radiographically area of lucency demonstrate destructive stages, cotton-wool appearance w/ irreg area of increase density.
Seen with nuclear medicine best

mastoiditis

bacterial infection of mastoid process, mastoid air cell fill with fluid abscess, CT

acoustic neuroma

benign tumor of auditory nerve sheath, CT or MRI

Cholesteatoma

benign cystlike mass or tumor in middle lear or mastoid region destroy bone

otosclerosis

hereditary disease w/ excessive spongy bone formation of middle and inner ear, late adolescence or young adult, CT

Bones apart of calvaria (skullcap)

frontal, right and left parietal, occipital

Bones apart of floor

right and left temporal, sphenoid, ethmoid

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