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Front Back
PA or Caldwell
1. patient position: prone or seated erect
2. part position
a. head resting on forehead and nose
b. MSP perpendicular to midline of grid device
c. OML perpendicular to cassette
d. respiration: suspended
3. central ray:
a. Caldwell method: direct CR 15 degrees caudad to OML, exiting nasion, for survey exam
b. PA: perpendicular to cassette, exiting nasion, to examine frontal bone
Lateral
1. patient position: seated erect or semiprone
2. part position
a. center a point to cassette that is 2in superior to EAM
b. MSP parallel to cassette
c. IOML parallel to transverse axis of cassette
d. interpupillary line (IPL) perpendicular to cassette
e. respiration: suspended
3. central ray:
a. perpendicular, entering 2in superior to EAM for survey exam
b. when sell turcica is of primary interest, cassette is centered and CR enters 3/4in superior and 3/4in anterior to EAM
Cranium
1. PA or Caldwell
2. Lateral
3. AP axial (Towne)
4. Submentovertex (full basal)
AP axial (Towne)
1. patient position: supine or seated erect
2. part position
a. center MSP to midline of grid device
b. adjust to be perpendicular
c. flex head and adjust OML perpendicular to cassette
d. place top of film at level of cranial vertex
e. respiration: suspended
3. central ray:
a. direct thru foramen magnum w/ caudal angle of 30 degrees to OML or 37 degrees to IOML, entering 2 to 2.5in above glabella
Submentovertex (full basal)
1. patient position: seated erect at head unit or supine on elevated table support
2. part position
a. extend neck
b. rest head on vertex
c. center and adjust MSP perpendicular to cassette
d. adjust IOML parallel to plane of cassette
e. respiration: suspended
3. central ray: direct perpendicular to IOML, entering btwn angles of mandible
Optic Foramen
1. Parieto-orbital oblique (Rhese)
Parieto-orbital oblique (Rhese)
1. patient position: prone or seated erect
2. part position
a. center affected orbit to cassette
b. rest head on zygoma, nose and chin
c. adjust AML perpendicular to cassette
d. rotate MSP 53 degrees from cassette
e. repiration: suspended
3. central ray: perpendicular, entering 1in superior and posterior to top of ear attachement, exiting affected orbit
Facial Bones
1. Lateral
2. Parietocanthial (Waters)
Lateral
1. patient position: semiprone or seated erect
2. part position
a. center zygoma
b. adjust MSP parallel to cassette
c. IOML parallel to transverse axis of cassette
d. IPL perpendicular to cassette
e. respiration: suspended
3. central ray: perpendicular, entering lateral surface of zygomatic bone
Parietocanthial (Waters)
1. patient position: prone or seated erect
2. part position
a. center and adjust MSP perpendicular to cassette
b. rest patient's head on extended chin
c. adjust OML to form 37 degree angle to film plane
d. respiration: suspended
3. central ray: perpendicular, exiting acanthion
Nasal Bones
1. Lateral (bilateral exam)
Lateral
1. patient position: semiprone or seated erect
2. part position
a. center nasion to cassette
b. adjust MSP parallel to cassette
c. IOML parallel to transverse axis of cassette
e. respiration: suspended
3. central ray: perpendicular to bridge of nose, entering 3/4in distal to nasion
Zygomatic Arches
1. Bilateral tangential (basal)
2. Unilateral tangential (May)
Bilateral tangential
1. patient position: seated erect or supine on elevated table support
2. part position
a. have patient extend head and rest on vertex
b. center and adjust MSP perpendicular to cassette
c. adjust IOML parallel to cassette
d. respiration: suspended
3. central ray: perpendicular to IOML, entering midway btwn zygomatic arches, approx. 1in posterior to outer canthi
Unilateral tangential
1. patient position:  prone or seated erect at vertical grid device
2. part position
a. extend neck and rest chin on grid device
b. rotate MSP 15 degrees away from side being examined
c. center cassette 3in distal to most prominent point of zygoma
d. IOML parallel to plane of film
e. respiration: suspended
3. central ray:
a. perpendicular to IOML
b. directed thru zygomatic arch 1.5in posterior to outer canthus
Mandible
1. PA
2. Axiolateral oblique (for mandibular body)
3. Axiolateral oblique (for mandibular rami)
4. Submentovertex (basal)
PA
1. patient position: prone or seated erect
2. part position
a. have patient rest head on nose and chin
b. for mandibular body, center cassette at level of lips
c. for rami and temporomandibular joint (TMJ), center to tip of nose
d. MSP perpendicular to film
e. respiration: suspended
3. central ray:
a. for mandibular body, direct perpendicular to cassette at level of lips
b. for rami and condylar processes, direct midway btwn TMJs at 30 degree cephalad angle
Axiolateral oblique (for mandibular body)
1. patient position: semiprone or seated erect
2. part position
a. adjust cassette under affected cheek
b. extend neck to place long axis of mandibular body parallel to cassette
c. center to first molar region
d. adjust broad surface of mandibular body parallel to cassette
e. respiration: suspended
3. central ray: direct slightly posteriorly to mandibular angle fartherst from film at a 25 degree cephalad angle
Axiolateral oblique (for mandibular rami)
1. patient position: semiprone or seated erect
2. part position
a. center cassette 1/2in anterior and 1in inferior to affected side EAM
b. extend chin
c. adjust broad surface of ramus parallel to cassette
d. respiration: suspended
3. central ray: direct 25 degrees cephalad, entering 2in distal to mandibular angle on side farthest from film
Submentovertex (basal)
1. patient position: seated erect or supine on elevated table support
2. part position
a. extend neck and rest haed on vertex
b. center and adjust MSP perpendicular to cassette
c. adjust IOML parallel to plane of film
d. respiration: suspended
3. central ray: perpendicular to IOML, entering midway btwn mandibular angles
Temporomandibular articulations (open and closed mouth laterals)
1. patient position: seated erect or semiprone
2. part position
a. center to a point 1/2in anterior and 1 in inferior to EAM to cassette
b. MSP angled 15 degrees (nose toward film)
c. AML adjusted parallel to transverse axis of cassette
d. IPL perpendicular to cassette
e. after first exposure (w/ mouth closed and patient still), cassette is changed and second exposure is made w/ patient's mouth fully open
f. respiration: suspended
3. central ray: direct 15 degrees caudad, exiting TMJ against cassette
Paranasal sinuses
1. Lateral
2. PA axial (Caldwell)
3. Parietocanthial (Waters)
4. Submentovertex (basal)
Lateral
1. patient position: seated erect
2. part position
a.center cassette 1/2 to 1in posterior to outer canthus
b. adjust head to true lateral position
c. MSP parallel and IPL perpendicular to cassette
d. IOML adjusted parallel to transverse axis of cassette
e. respiration: suspended
3. central ray: perpendicular, entering 1/2 to 1in posterior to outer canthus
PA axial (Caldwell)
1. patient position: seated erect at vertical grid device
2. part position
a. rest head on forehead and nose
b. MSP perpendicular to midline of cassette
c. OML perpendicular to cassette
d. respiration: suspended
3. central ray: direct to nasion at angle of 15 degrees caudal to OML
Parietocanthial (Waters)
1. patient position: seated erect; use horizontal CR to demonstrate fluid level
2. part position
a. center and adjust MSP perpendicular to cassette
b. rest head on extended chin
c. adjust OML to form 37 degree angle to cassette
d. respiration: suspended
3. central ray: horizontal and perpendicular to cassette, exiting acanthion
Submentovertex (basal)
1. patient position: seated erect at vertical grid device
2. part position
a. extend head and rest on vertex
b. center and adjust MSP perpendicular to cassette
c. adjust IOML parallel to cassette
d. respiration: suspended
3. central ray: perpendicular to IOML thru sell turcica, approx. 3/4in anterior to level of EAM
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