Skull and Facial

Anatomy

 

Skull and Facial

CALDWELL

 

 

 

 

 

 

FACIAL Adult Facial Bones - Occipito Mental (OM) (Waters) View

 

NASAL WATERS SINUSES CALDWELL SINUSES WATERS MODIFIED WATER

PA MANDIBLE

SMV

FACIAL TOWNES

LAT SINUSES LAT SKULL LAT FACIAL LAT MANDIBLE LAT NASAL

ORBIT

 

TMJ CLOSED MOUTH

TMJ CLOSED MOUTH

TMJ OPEN MOUTH

TMJ OPEN MOUTH

 

MANDIBLE

Positioning

 

SKULL AP AXIAL (TOWNE) Pt supine. IOML & EAM perpendicular to the table, Check for no rotation and body is aligned. 36 CR 40 DEGREE CAUDAD ANGLE, ENTERTING AT HAIR LINE (2INCHES ABOVE GLABELLA) PETROUS RIDGE IS A “V: WITH DORSUM SELLAE INSIDE THE FOREMAN MAGNUM. OCCIPITAL BONE IS VISULIZE. ( INCREASE ANGLE  OR LOWER CHIN. IF DORSUM SELLA IS ON TOP OF FOREMAN MAGNUM)
LAT Pt semi prone and slightly oblique pt to get head true lateral (on affected side). Make sure IPL (interpupillary line) is perpendicular to table& midsagittal plane is parallel to the table. 40 CR @ 2 inches above EAM and perpendicular to the table Sella Turcica. Orbital plates, PETROUS PYRAMID, EAM ARE S/I. CRANIAL HALVES ARE S/I.. INCLUDE WHOLE SKULL CAP. SHOULD SEE FRONTAL, SPHENOID, ETHMOID SINUS.
PA (CALDWELL) Pt prone.  OML & EAM perpendicular to the table. 40 CR @ 15 degree caudal angle. Exiting at nasion. No rotation with the petrous ridge running through the lower 1/3 of the orbits.
PA NO ANGLE Pt prone. IOML and EAM is perpendicular to the table 40 CR Perpendicular to table exiting at Nasion. All these Caldwell should show. Frontal Bone, Greater & Lesser wing of the sphenoid. Anterior ethmoid sinuses
PA 25-30 DEGREE ANGLE (HAAS) PT PRONE, OML PERPENDICULAR TO IR, ALIGN MID SAGITTAL PLANE. 40 CR 25 DEGREE CEPHALAD, EXIT AT GLABELLA (1 1/2 INCH SUPERIOR TO NASION) SAME AS AP
FACIAL LAT
PERIETOACANTHIAL (WATERS) Pt erect OR SUPINE. With MML and EAM perpendicular to the IR (slightly drop chin a little more without the nose touching) 40 CR PERPENDICULAR , EXITS ACANTHION. Petrous ridge line is under the maxillary sinus.  (to get petrous ridge higher drop the chin more)
PA (CALDWELL) LIKE SKULL
PA (MODIFIED WATERS) Pt erect/prone. With AML/LML MML and EAM perpendicular to the IR (slightly drop chin a little more without the nose touching) 40 CR is Perpendicular exiting Acanthion Petrous Ridge is running through maxillary sinus.
MANDIBLE AXIOLATERAL OB Pt erect. In a lateral position. Have pt lift the chin and tilt head. 40 TT. CR is 25-30 Degrees entering between the gonions. Rami, condylar and coronoid processes, body and mentum of mandible nearest the IR
PA NO ANGLE Pt prone. IOML and EAM is perpendicular to the table 40 CR Perpendicular to table exiting between the lips Whole mandible. Mandibular rami and lateral portion of body is visible.
AP AXIAL (TOWNE) LIKE TMJ 40 SAME TMJ Condyloid processes of mandible and TMF are shown
PA SEMI-AXIAL, 20-25 DEGREE CEPHALAD
PA (MODIFIED WATERS) SAME FACIAL
SUBMENTOVERTICAL (FULL BASAL) SAME AS SINUS ENTIRE MANDIBLE AND CORONOID AND CONDYLOID PROCESSES IS SEEN.
ZYGOMATIC ARCH SUBMENTOVERTICAL (FULL BASAL) Pt supine. With IOML parallel to the IR. Cr is Perpendicular to IR. 40 CR is perpendicular to IR. Entering 1 inch posterior of the submento. Zygomatic arches are symmetrical
PARIETOACANTHAIL (WATERS) LIKE FACIAL
AP AXIAL (TOWNE) LIKE MANDIBLE
AXIAL OB Like SMV, except have pt rotate their head 15 degrees to the affected side. 40 CR is skimming the cheeks Affected side (zygomatic arch) is open
LAT
TMJ LAT (LAW) Pt erect/semi prone. Head lateral and rotate towards the IR 15 degrees with a caudal angle 15 degree exiting downside TMJ. (IOML is perpendicular to edge of table, for no tilt) 40 CR 15 degree caudal angle. Exiting downside TMJ. Closed(Condyle is in the TMF) Open(Condyle Is moved anteriorly out of the TMF
LAT (SCHULLER) Pt is erect/semi prone. Head is lateral. IOML is perpendicular to edge of the table for no tilt 40 CR is 30 degree caudal angel. Exiting downside TMJ SAME
AP AXIAL (TOWNE) LIKE SKULL 40 CR @ NASION 40 DEGREE CAUDAD ANGLE. CONDYLOID PROCESS IS SYMMETRICAL. CLEAE VISUAL OF CONDYLE AND TEMPROMANDIBULAR FASSAE RELATIONSHIP.
NASAL PARIETOACANTHAIL (WATERS) LIKE FACIAL 40 LIKE FACIAL LIKE FACIAL
LAT LIKE FACIAL 40 CR @ INNER CANTHUS, FINGER TECHNIQUE TT. NASAL BONE IN PROFILE
PA (CALDWELL) LIKE SKULL, COLLIMATE TIGHT 40 LIKE SKULL LIKE SKULL
ORBITS PARIETOACANTHAIL (WATERS) LIKE FACIAL 40 LIKE FACIAL LIKE FACIAL
LAT LIKE FACIAL 40 LIKE FACIAL LIKE FACIAL
PA (CALDWELL) LIKE SKULL, COLLIMATE TO EYES 40 LIKE SKULL LIKE SKULL
SINUSES LAT SAME LAT FACIAL. EXCEPT ERECT. 40 CR @ OUTER CANTHUS, PERPENDICULAR SAME AS LAT, WILL VISUALIZE, SPHENOID, ETHMOID, FRONTAL, AND MAXILLARY SINUSES.
PA (CALDWELL) Pt ERECT, FACING CHEST UNIT.  IOML & EAM perpendicular to IR. 40 CR Perpendicular EXITING NASION, HORIZIONTAL BEAM. Sinus: frontal, sinus, and ethmoid sinus . LIKE SKULL
PARIETOACANTHAIL (WATERS) LIKE FACIAL, EXCEPT ERECT 40 CR PERPENDICULAR EXITING ACANTHION, HORIZONTAL BEAM TO VISULIZE MAXILLARY SINUS.
SUBMENTOVERTICAL (FULL BASAL) LIKE SMV , INCREASE TECHNIQUE 40 ETHMOID AND SPHEINOID SINUS
OPEN MOUTH PARIETOACANTHAIL (WATERS) EXTEND NECK, PLACING CHIN AND NOSE AGAINST UPRIGHT BUCKY, OML FORMS A 37 DEGREE ANGLE WILL MML (MML WILL BE PERPENDICULAR WITH MOUTH CLOSE. INSTRUCT PT TO DROP JAW WITH OUT MOVING HEAD. 40 CR PERPENDICULAR @ ACANTHION MAXILLARIY SINUSES FREE FROM S/I. SPHENOID SINUSES VISUALIZED THOURGH THE MOUTH.