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list the facial bones and their numbers:
- nasal bones (2)
- lacrimal bones (2)
- maxillae bones (2)
- zygomatic/malar bones (2)
- palatine bones (2)
- inferior nasal conchae (2)
- vomer (1)
- mandible (1)
- = 14 total
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which bone is sometimes referred to as the "anchor bone" of the face?
the maxillae
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ridges of bone that the roots of the teeth fit into:
alveolar processes
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what is the largest immovable bone of the face?
maxillae
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what is the largest and densest bone of the face?
mandible
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where are the maxillary sinuses located?
the body of the maxillae
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name the bone and label it:
- maxillae bones
- A. infraorbital foramen
- B. body of maxillae
- C. alveolar process
- D. frontal process
- E. zygomatic bone
- F. zygomatic process
- G. anterior nasal spine
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what bones make up the hard palate?
- anterior 3/4 is formed by the maxillae
- posterior 1/4 is formed by the palatine bones (horizontal plates)
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how are the palatine bones shaped?
- an "L" shape
- the horizontal portion help to form the hard palate
- the vertical portion extends up the nasal cavity
- the tip of the vertical portion can be seen within the orbit
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what two bones make up the zygotic arch?
- the zygoma
- the zygomatic process of the temporal bone
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a dislocation of the zygoma from all three articulations (with frontal bone, temporal bone, and maxilla):
- tripod fracture
- also called a free-floating malar
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close-up of the nasal cavity...name the blue and the purple structures:
- blue: superior and middle nasal conchae (ethmoid bone)
- purple: inferior nasal concha
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the bone that forms the inferior section of the nasal septum:
vomer
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- mandible
- A. condylar process
- B. alveolar portion
- C. symphysis
- D. coronoid process
- E. mental foramen
- F. mental point
- G. mental protuberance
- H. body of mandible
- I. ramus
- J. mental foramen
- K. mental protuberance
- L. body of mandible
- M. angle of mandible/gonion
- N. ramus
- O. condylar process
- P. neck
- Q. mandibular notch
- R. coronoid process
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- A. hyoid bone
- B. body
- C. lesser cornu
- D. greater cornu
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describe the basic shape and aspects of the orbit:
- conical in shape
- the entire outer rim is the base
- the innermost/most posterior area is the apex
- the superior part of the base is the SOM
- the inferior part of the base is the IOM
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- A. optic canal
- B. ethmoid bone
- C. lacrimal bone
- D. maxilla
- E. frontal bone
- F. sphenoid bone
- G. zygomatic bone
- H. palatine bone
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at what age does the symphysis of the mandible unite?
one year old
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give the two angles the orbits make within the skull?
- angled 37 degrees toward MSP
- angled 30 degrees upward from the OML
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what projection is commonly used to best view the orbits?
- the Rhese Method
- (a parieto-orbital oblique projection)
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for the rhese method of the orbit, what side is best demonstrated?
the down side
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for the reverse rhese method of the orbit, what side is best demonstrated?
the up side
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give the projection criteria for the parieto-orbital oblique projection (Rhese Method):
- CR is perpendicular
- pt prone
- center 1" superior and posterior to the TEA
- AML perpendicular
- MSP is 53 degrees
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in the rhese method, how is the optic foramen demonstrated?
in the lower lateral quadrant of the orbit
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give the projection criteria for the orbito-parietal oblique projection (Reverse Rhese Method):
- CR is perpendicular
- pt supine
- center over the up side orbit
- AML perpendicular
- MSP is 53 degrees
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give the projection criteria for the lateral facial bones projection:
- CR is perpendicular
- pt lateral
- center 1/2way between outer canthus and EAM
- IOML and MSP is parallel
- IPL is perpendicular
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give the projection criteria for the parieto-acanthial projection (Waters Method):
- CR is perpendicular
- PA projection
- center at acanthion
- MML and MSP are perpendicular
- OML is 37 degrees
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give the projection criteria for the modified parieto-acanthial projection (Modified/Shallow Waters Method):
- CR is perpendicular
- PA projection
- center at acanthion
- LML and MSP are perpendicular
- OML is 55 degrees
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give the projection criteria for the acanthio-parietal projection (Reverse Waters Method):
- CR is perpendicular
- AP projection
- center at acanthion
- MML and MSP are perpendicular
- OML is 37 degrees
- **for trauma, angle tube to get central ray parallel to MML
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give the projection criteria for the lateral nasal bones projection:
- CR is perpendicular
- pt is lateral
- center 1/2" below nasion
- IOML and MSP are parallel
- IPL is perpendicular
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give the projection criteria for the submentovertical (SMV) or basal projection for zygomatic arches:
- CR is perpendicular
- center 1" posterior to outer canthus of eye
- IOML parallel
- MSP perpendicular
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give the projection criteria for the tangential projection of the zygomatic arches:
- CR is perpendicular
- center to zygomatic arch
- MSP is 15 degrees toward affected side
- Forehead moved 15 degrees away from affected side
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give the projection criteria for the AP axial projection of the zygomatic arches (Modified Townes Method):
- CR is 30 degrees caudal
- center to glabella (one inch above nasion)
- OML and MSP are perpendicular
- **if pt can't duck chin, use IOML and 37 degree caudal
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give the projection criteria for the PA projection of the mandibular rami:
- CR is perpendicular
- center to acanthion
- OML and MSP are perpendicular
- ** mark down side
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give the projection criteria for the PA axial projections of the mandibular rami:
- CR is 20-25 degrees cephalic
- center to have light exit acanthion
- OML and MSP are perpendicular
- ** mark down side
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give the projection criteria for the PA projection of the body of the mandible:
- CR is perpendicular
- center at the lips
- AML and MSP are perpendicular
- ** mark down side
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give the projection criteria for the PA axial projection of the body of the mandible:
- CR is 30 degrees cephalic
- center at the TMJs (basically at the EAM)
- AML and MSP are perpendicular
- ** mark down side
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give the projection criteria for the axiolateral projection for the ramus of the mandible:
- CR is 20-25 degrees cephalic
- center at the ramus of the mandible
- place head lateral and extend the chin
- ** mark down side
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give the projection criteria for the axiolateral oblique projection of the body of the mandible:
- CR is 20-25 degrees cephalic
- center slightly posterior to gonion
- rotate face 30 degrees inward (toward film)
- body of mandible parallel to film
- **general survey: rotate face 15 degrees inward (toward film)
- ** mark down side
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give the projection criteria for the axiolateral oblique projection of the mandibular symphysis:
- CR is 20-25 degrees cephalic
- center at the symphysis
- rotate face 45 degrees inward (toward film)
- ** mark down side
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give the projection criteria for the submentovertical (SMV) projection of the mandible:
- CR is perpendicular
- center at the gonion/angle of mandible
- IOML is parallel
- MSP is perpendicular
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give the projection criteria for the AP axial projection for the temporomandibular joint (TMJ):
- CR is 35 degrees caudal
- center 3" above nasion
- OML and MSP are perpendicular
- ** closed mouth, cheeks puffed out
- ** open mouth, jaw dropped
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give the projection criteria for the axiolateral projection for the TMJ (Schuller Method):
- CR is 25-30 degrees caudal
- center 1/2" anterior and 2" superior to upside EAM
- IOML and MSP are parallel
- IPL perpendicular
- ** open mouth and closed mouth, both right and left
- ** mark down side and whether open or closed
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give the projection criteria for the axiolateral oblique projection of the TMJ (Modified Law Method):
- CR is 15 degrees caudal
- center 1 1/2" to 2" superior to EAM
- AML is parallel
- MSP is 15 degrees inward (toward IR)
- ** 4 views, open and closed: both right and left
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give the projection criteria for the parietoacanthial projection of the sinuses (Waters Method):
same as waters for facial bones!!
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give the projection criteria for the parietoacanthial projection of the sinuses (Open Mouth Waters Method):
- CR is perpendicular
- center at acanthion
- MML and MSP are perpendicular
- **lower bottom jaw (this changes the MML)
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give the projection criteria for the lateral sinus projection:
- CR is perpendicular
- center 1/2" to 1" posterior to outer canthus
- IOML and MSP are parallel
- IPL is perpendicular
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give the projection criteria for the PA axial projection (Caldwell Method) for sinus:
- CR 15 degrees caudal
- center to nasion
- OML and MSP are perpendicular
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give the projection criteria for the submentovertical (SMV) projection of the sinuses:
- CR is perpendicular
- center 3/4" anterior to EAM
- IOML and MSP are parallel
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where is the mental point?
at the center of the mental protuberance
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which is the largest, densest facial bone?
mandible
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what is the only moveable bone of the skull?
mandible
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where is the hyoid bone and what is its function?
- above the larynx at the base of the tongue
- helps you to speak and swallow
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what is a fracture of the inferior rim of the orbit and what projection best demonstrates it?
- blow-out fracture
- Modified Waters Method (or Waters if only option)
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what positioning error is present if the optic foramen is not in the lower outer quadrant of the Rhese Method?
- AML is not aligned (too far up or down in orbit)
- or the head is not obliqued 53 degrees (too far left or right)
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what is the disadvantage of the Reverse Rhese Method as compared to the Rhese Method?
- the orbits are magnified
- there is more exposure to the lens of the eye
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what should be visualized in the Waters Method for facial bones?
- the petrous pyramids are completely below the maxillary sinuses
- the mandible makes an upside down U
- the dens is in the foramen magnum
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what should be visualized in the Modified/Shallow Waters method for facial bones?
- the petrous pyramids are in the lower portion of the maxillary sinuses
- the mandible is straighter
- you cannot see the foramen magnum
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why do you have pt fill cheeks with air on some views of the mandible?
to increase contrast
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what should be seen in the SMV for the mandible?
- condyles should be anterior to petrous pyramids
- (if not, head is not tilted back enough)
- foramen ovale and spinosum are demonstrated
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in which projection is the foramen rotundum best demonstrated?
Waters Method
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in which projection are the foramen ovale and spinosum best demonstrated?
SMV
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for the Modified Law projections of the TMJs, what is seen differently between an open mouth projection and a closed mouth projection?
- open mouth: condyle is at the level of the tubercle
- closed mouth: condyle is at the level of the mandibular fossa
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what is another name for the maxillary sinuses?
antrum of highmore
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at what age do the different sinuses develop?
- maxillary: at birth
- frontal and sphenoid: age 6-7
- ethmoid: at puberty
- all sinuses completely formed by age 17 - 20
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what projection best demonstrates the sphenoid sinuses?
lateral and SMV
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why is technique especially sensitive when imaging the sinuses?
- overpenetrate: you burn out pathology
- underpenetrate: you create pathology
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what techniques should be used for sinuses?
- 75 kVp for all
- PA projections: 20-25mAs
- Waters and SMV: 25-30mAs
- Laterals: 8-10mAs
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name the projection and label:
- Rhese Method (Parietal-Orbital Optic Canal)
- A. SOM
- B. lateral orbital margin
- C. optic canal
- D. IOM
- E. medial orbital margin
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name the projection and label:
- lateral facial bones
- A. orbital roofs
- B. zygomatic bone
- C. sella turcica
- D. mandibular rami
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name the projection and label:
- Waters Method (Parietoacanthial projection)
- A. orbit
- B. zygoma
- C. zygomatic arch
- D. maxillary sinus
- E. maxilla
- F. petrous ridge
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name the projection and label:
- Modified Waters (parietoacanthial facial bones)
- A. IOM
- B. zygomatic bone
- C. nasal septum
- D. maxillary sinuses
- E. petrous ridge
- F. mandible
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name the projection and label:
- lateral nasal bones
- A. nasofrontal suture
- B. nasal bone
- C. anterior nasal spine of maxillae
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name the projection and label:
- SMV for zygomatic arches
- A. temporal process of zygomatic bone
- B. zygomatic arch
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