151 terms

Skull

TEA

Corresponds to the level of the Petrous Ridge

Supraorbital Groove

Corresponds to the highest level of the facial bones

Interpupillary Line

A line used in positioning to ensure that the skull is in a true lateral position

Gonion

Posterior angle of the jaw

Tragus

The small cartilaginous flap covering the EAM

Outer Canthus

Lateral junction of the eye

Orbitomeatal Line

Line between the mid-lateral orbital margin and the EAM

Glabelloaveolar Line

Line between the glabella and aveolar process of the mandible

Infraorbitomeatal Line

Line between the inferior orbital rim and the EAM

Mentomeatal Line

Line between the mental point and EAM

Glabella

Smooth, slightly raised area between the eyebrows

Inion

The most prominent point of the external occipital protuberance

Nasion

A depression at the bridge of the nose

Parietal Eminence

Distance between these two points would indicate the widest dimension of the skull

Mastoid Tip

This point can also be used in positioning fr he open-mouth C-spine

Erosion is best demonstrated on which projection?

Lateral Projection

Anatomical Landmarks used to evaluate the Lateral Projection

Orbital Lines or Roof
Rami Mandible
Body of Mandible
Anterior/Posterior Clinoids
Petrous Pyramids
Greater/Lesser Wing of Sphenoid
EAM
Mastoid Tip

Base of Skull, Mastoid Tip, Occlusal Plane

Perpendicular to the film for the AP Open Mouth C-Spine Projection

CR for routine Caldwell Projection

15 degrees Caudal

Why the sinus x-ray is erect

Air and Fluid Levels

Brachycephalic

Skull angle of 54 degrees between the midsagital plane and long axis of the petrous bone

Mesocephalic

Skull angle of 47 degrees between the midsagital plane and long axis of the pertrous bone

Mesocephalic

Average size Skull

Reids Baseline is also called

IOML or Anthropalogic Baseline

Lateral Skull Potioning, Which baseline is perpendicular to the imaginary line along the front edge ofthe IR

IOML is Perpendicular to Imaginary Line

What Projection and CR angle to demonstrate the Superior Orbital Fissure?

Caldwell, 30 degrees Caudal

Which Baseline is parallel to IR for the Submentovertex Projection (SMV)

IOML is Parallel to IR, Perpendicular to CR

CR and Angle for the Haas Method

25 degrees Cephalad

Petrous Pyramid

Densest bone of the 3 aspects of the temporal bone

Properly positioned AP Axial (Towne) projection should place the dorsum sellae in the middle of?

Foramen Magnum

Lack of symmetry of the Petrous Ridges indcates what problem with a Radiograph of an AP Axia Projection?

Rotation

What Positioning errr is present if te Mandibular Rami are not superimposed on a Lateral Skull Radiograph?

Rotation

With a traum patient, what must b determined before performing the SMV Projection?

C-Spine Injury

Where should the Petrous Ridges be located on well positioned 15 Degree Caldwell?

Lower 1/3 of the Orbit

Where should the Petrous Ridges be located on well positioned 30 Degree Caldwell?

Lower than the lower 1/3 of the Orbit

What Skull projection results in th highest Thyroid Dose

SMV (264 mR)

CR and Patient Position for the Towne Projection ofthe Skull

2 1/2" superior to the Glabella, 30 degrees Caudal to the OML

CR and Patient Position for the Lateral Skull Projection

2" Superior to the EAM, Perpendicular to the IR

CR and Patient Position for the Caldwell Projection of the Skull

PA, OML& MSP Perpendicular to the IR, 15 degrees Caudal exiting the Naison

Routine Skull Series

Towne
Lateral
Caldwell

Structures best demonstrated on the Towne Projection

Dorsum Sellae within the Foramen Magnum

Structures best demonstrated on the Lateral Projection

Sellae Turcica in Profile, Cranial halves, Orbital Plates, Clinoids ad Rami Superimposed

Structures best demonstrated on the Caldwell Projection

Petrous Pyramids in the lower 1/3 of the Orbit

Special Skull Projections

PA or AP Skull
SMV
Caldwell
Haas (Reverse Towne)

Haas (Reverse Town) Special Projection Patient Position and CR

PA, OML Perpendicular to the IR, 25 Degree Cephalad, Occipital Bone is Magnified

Caldwell Special Projection Patient Position and CR

PA, OML & MSP perpendicular to IR, 30 degrees Caudal,
Superior Orbital Fissure, Foramen Rotundum, Inferior Orbital Rim

SMV Special Projection Patient position and CR

Vertex of head on IR, IOML Parallel to IR, CR 3/4" Anterior to EAM & Perpendicular to IOML
Petrous Pyramids posterior to mandibular condyles, Sphenoid & Ethmoid Sinuses, Foramen Ovali & Foramen Spinosum

Difference in Degrees between the infraorbitomeatal & orbitomeatal lines

7-8 degrees

Small Irregular Bones occassionally found in the Sutures

Wormain

Bone that contains the Cribiform Plate

Ethmoid

Bone that contains the Foramen Ovale

Sphenoid

Bone assciated with and protects the Hypophysis Gland

Sphenoid

Cranial Bone that Articulates with all other Cranial Bones

Sphenoid

Widest portion of the cranium is formed at a level of?

Parital Tubercles

Lateral Juntion of eyelid

Outer Canthus

Posterior Angle of Jaw

Gonion

Corresponds to the highest (Nuchal) Line ofthe Occipital Bone

Inion

Located at junction of the 2 Nasal Bones & the Frontal Bone

Nasion

Line between the Midlateral Orbital Margin & the EAM

OML

Center Point of the EAM

Auricular Point

Positioning line that is primarily used for the modified Waters Projection

Lips-Meatal Line

Line used in positioning to ensure that the skull is in a true lateral position

Interpupillary line

Average KV for the Skull

Film 65-80 Kv
Digital 70-80 Kv

AP Axial (Towne) Skull results in about 10x's more dose to __________ than in a PA Axial (Haas) Projection.

Thyroid

# of Cranium Bones

# of Facial Bones

4 Cranial Bones that form the Calvaria (Skull) Cap

Frontal
Right & Left Parietal
Occipital

4 Cranial Bones that form the Floor of the Cranium

Right & Left Temporal
Sphenoid
Ethmoid

Small Horizontal Plate of the Ethmoid

Cribiform Plate

Vertical Plate of the Ethmoid Bone forming the Upper Portion of the Bony Nasal Septum

Perpendicular Plate

Structure found in the middle of the Sphenoid Bone that surrounds the Pituitary Gland

Sella Turcica

Posterior Aspect of the Sella Turcica

Dorsum Sellae

Which structure of the Sphenoid allows for the passage of the Optic Nerve & is the actual opening into th orbit

Optic Foramen

Which Structure of te Sphenoid Bone help form part of the Lateral Walls of the Nasal Cavities

Medial & Lateral Pterygoid Processes

Radiograph best demonstrates the Sella Turcica

Lateral

Aspect of Frontal Bone forms the Superior aspect of the Orbit

Orbital or Horizontal Portion

Cranial Surtures are________joints

Fiborous or Synarthrodial

Small irregular bones that sometimes develop in adult skull sutures are_________&__________bones & are most frequently found in the________suture.

Sutural & Wormian Bones, Lambdoidal Suture

Superior Rim of Orbit

SOM (Supraorbital Margin)

Notch that separates the Orbital Plates from eachother

Ethmoid Notch

Cranial Bones form the Upper Lateral Walls of the Calvarium

R & L Parietals

Cranial Bone Contains the Foramen Magnum

Occipital

Small Prominence located on Squamous Portion of the Occipital Bone

External Occipital Protuberance or Inion

3 Aspects of Temporal Bones

Squamous Portion
Mastoid Portion
Petrous Portion

Opening of Temporal Bone serves as a Passageway for nerves of Hearing & Equilibrium

Internal Acoustic Meatus

Width between 75% & 80% of Length

Mesocephalic

Width 80% or more Length

Brachycephalic

Width less than 75% of length

Dolichocephalic

CR Angles & Degree of Rotation stated for basic skull positions are based on the ___________Skull & has a angle of _________degrees between the Midsagital Plane & long axis of the Petrous Bone.

Mesocephalic, 47 degrees

Long, Narrow Skull has an angle of appx ______degrees between the midsagital plane & the long axis of the Petrous Bone

+/- 40 Degrees

Thyroid Dose for SMV projection of skull

200-300 mRad

5 Most Common Errors made during a Skull Radiograph

Rotation
Tilt
Excessive Flexion
Excessive Extension
Incorrect CR Angle

What patients require a 25% - 30% reduction in mAs during skull projections

Adults w/ Osteoporosis

Most common neuroimaging procedure performed for the cranium is done w/ what imaging modality

Imaging modality used on neonates w/ a possible intracranial hemorrhage

Ultrasound

Imaging Modality performed to evaluate patients for Alzheimer disease

NuclearMedicine

Basal Skull Fracture

May produce air-fluid level in Sphenoid Sinus

Osteolytic Neoplasm

Destructive Lesion w/ irregular margins

Depressed Skull Fracture

Ping Pong Fracture

Osteoblastic Neoplasm

Proliferative bony lesion of increased density

Pituitary Adenoma

Tumor that may produce erosion of the Sella Turcica

Multiple Myeloma

Bone tumor that originates in bone marrow

Pagents Disease

Osteitis Deformans
May require increase in manual exposure factors

Which Cranial Bone is best demonstrated w/ an AP Axial (Towne Method) projection of the skull

Occipital Bone

When using a 30 degre caudad angle for AP Axial (Towne) projection of skull, what positioning line should be perpendicular to the IR

OML

Lack of Symmetry of the Petrous Ridges indicates what problem?

Rotation

If patient can't flex head for AP Axial (Towne), what should Tech do?

IOML perpendicular to IR 37 degrees Caudal

What evidence on AP Axial (Towne) indicates correct CR Angle & Correct Head Flexion

Dorsum Sellae & Posterior Clinoids visualized in Foramen Magnum

What positioning error if the Mandibular Rami are not superimposed on a Lateral Skull

Rotation

Projection where Frontal Bone has little or no distortion

PA 0 degree CR

CR for Lateral of Sella Turcica

3/4" Anterior & 3/4" Superior to EAM

Which Imaging Modality is Best to Differentiate between an Epidural & Subdural Hemorrhage

Projection Best Demonstrates Sella Turcica in Profile

Lateral

Projection Best Demonstrates Foramen Rotundum in profile

25-30 degree PA Axial

Projection Best Demonstrates Clivus in profile

Lateral

Where does the CR exit for a PA Axial (Haas) of Skull

1 1/2" Superior to the Naison

CR Angle for the AP Axial (Sella Turcica) if Dorsum Sellae & Posterior Clinoid Processes are Primary Interest

37 degree Caudad

Conchae

Turbinate

Cranial Suture formed by inferior junction of the parietals to the temporal bone

Squamosal Surture

Shallow depression Posterior to Base of Dorsum Sellae & Anterior to Foramen Magnum

Clivus

Pituitary Gland

Hypophysis Cerebri
Master Gland

Suture Separates Frontal Bone from 2 Parietals

Coronal Surture

CR for AP Axial (Towne) w/ IOML Perpendicular to IR

37 Degrees Caudad to IOML
30 Degrees Caudad to OML

2 Projections show Dorsum Sellae within Foramen Magnum

AP Axial (Towne) 30 Degrees Cephalic OML
PA Axial (Haas) 25 Degrees Cephalic OML

Large Cartilanginous aspect of External Ear

Auricle or Pinna

Region where surtures join in the infant skull, soft spots

Anterior/Posterior Fontanels

Articulation @ Anterior end of Sagittal Surture

Bregma

OML

located between outer canthus & EAM

IOML

Connects infraorbital Margin to EAM

GAL

Connects Glabella to point Anterior Aspect of Alveolar process of Maxilla

GML

Line between Glabella & Eam

AML

Under Nose to EAM

LML

Lips to EAM

MML

Mental Point (Chin) to EAM

IPL

Connects Pupils or Outer Canthi of Eye

EAM

Opening of external ear canal

TEA

Superior attachment of the auricle where frames of eye glasses rest

Rotation for Lateral Skull Positioning

Rami
Clinoids
EAM
Greater Wing of Sphenoid
Petrous Pyramid
Mastoid Tip
(Left or Right Turn)

Tilt for Lateral Skull Positioning

Orbital Roof (Plate, Fontal Lines)
Body of Mandible
EAM
Lesser Wing of Sphenoid
Mastoid Tip
(Chin up or don)

Flexion/Extension

IOML Perpendicular to Imaginary Plane at Front Edge of IR
(Chin up or down)

RHESE Method Shows

Optic Foramen

3 Major Foramen Opening

ROS
Rotandum
Ovale
Spinosum

What is the best modalities used today to see the Erosion of the Sella Turcica

MRI & CT

Crista Galli

Holds Coverings of the Brain together

Junction Points

Asterion - Side
Bregma - Front
Lambda - Back
Pterion - Side

Surtures

Coronal - Front
Lambdoidal - Back
Squamosal - Side
Sagittal - Middle

Planes

MSP (Mid sagittal Plane)
Coronal

Facial Landmarks

Glabella
Naison
IPL
Acanthion
Gonion
Mental Point
Supercilliary Arch
SOG
MSP

Lateral Landmarks

TEA
Auricle (Pinna)
Tragus
Gonion (Angle)
Acanthion
Nasion
Glabella

Exam Cranial Bleed

Exam to determine Brain Tissue an Brainstem

MRI

Skull

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