Unit 5 (Facial Bones)

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CoLinRadTechs
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216386
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Unit 5 (Facial Bones)
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2013-04-28 15:27:01
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Procedures III
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Unit 5. Do not rely solely upon these cards. last revised fall2012.
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  1. 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
  2. which bone is sometimes referred to as the "anchor bone" of the face?
    the maxillae
  3. ridges of bone that the roots of the teeth fit into:
    alveolar processes
  4. what is the largest immovable bone of the face?
    maxillae
  5. what is the largest and densest bone of the face?
    mandible
  6. where are the maxillary sinuses located?
    the body of the maxillae
  7. 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
  8. 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)
  9. 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
  10. what two bones make up the zygotic arch?
    • the zygoma
    • the zygomatic process of the temporal bone
  11. a dislocation of the zygoma from all three articulations (with frontal bone, temporal bone, and maxilla):
    • tripod fracture
    • also called a free-floating malar
  12. 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
  13. the bone that forms the inferior section of the nasal septum:
    vomer
  14. name the bone and label:
    • 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
    • A. hyoid bone
    • B. body
    • C. lesser cornu
    • D. greater cornu
  15. 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
    • A. optic canal
    • B. ethmoid bone
    • C. lacrimal bone
    • D. maxilla
    • E. frontal bone
    • F. sphenoid bone
    • G. zygomatic bone
    • H. palatine bone
  16. at what age does the symphysis of the mandible unite?
    one year old
  17. give the two angles the orbits make within the skull?
    • angled 37 degrees toward MSP
    • angled 30 degrees upward from the OML
  18. what projection is commonly used to best view the orbits?
    • the Rhese Method
    • (a parieto-orbital oblique projection)
  19. for the rhese method of the orbit, what side is best demonstrated?
    the down side
  20. for the reverse rhese method of the orbit, what side is best demonstrated?
    the up side
  21. 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
  22. in the rhese method, how is the optic foramen demonstrated?
    in the lower lateral quadrant of the orbit
  23. 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
  24. 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
  25. 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
  26. 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
  27. 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
  28. 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
  29. 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
  30. 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
  31. 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 
  32. 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
  33. 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
  34. 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
  35. 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
  36. 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
  37. 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
  38. 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
  39. 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
  40. 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
  41. 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
  42. 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
  43. give the projection criteria for the parietoacanthial projection of the sinuses (Waters Method):
    same as waters for facial bones!!
  44. 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)
  45. 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
  46. 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
  47. 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
  48. where is the mental point?
    at the center of the mental protuberance
  49. which is the largest, densest facial bone?
    mandible
  50. what is the only moveable bone of the skull?
    mandible
  51. 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
  52. 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)
  53. 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)
  54. 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
  55. 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
  56. 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
  57. why do you have pt fill cheeks with air on some views of the mandible?
    to increase contrast
  58. 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
  59. in which projection is the foramen rotundum best demonstrated?
    Waters Method
  60. in which projection are the foramen ovale and spinosum best demonstrated?
    SMV 
  61. 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
  62. what is another name for the maxillary sinuses?
    antrum of highmore
  63. 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
  64. what projection best demonstrates the sphenoid sinuses?
    lateral and SMV
  65. why is technique especially sensitive when imaging the sinuses?
    • overpenetrate: you burn out pathology
    • underpenetrate: you create pathology
  66. what techniques should be used for sinuses?
    • 75 kVp for all
    • PA projections: 20-25mAs
    • Waters and SMV: 25-30mAs
    • Laterals: 8-10mAs
  67. 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
  68. name the projection and label:
    • lateral facial bones
    • A. orbital roofs
    • B. zygomatic bone
    • C. sella turcica
    • D. mandibular rami
  69. name the projection and label:
    • Waters Method (Parietoacanthial projection)
    • A. orbit
    • B. zygoma
    • C. zygomatic arch
    • D. maxillary sinus
    • E. maxilla
    • F. petrous ridge
  70. 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
  71. name the projection and label:
    • lateral nasal bones
    • A. nasofrontal suture
    • B. nasal bone
    • C. anterior nasal spine of maxillae
  72. name the projection and label:
    • SMV for zygomatic arches
    • A. temporal process of zygomatic bone
    • B. zygomatic arch

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