Escolar Documentos
Profissional Documentos
Cultura Documentos
Bones, 2 Parietal Bones, Sphenoid Bone, Ethmoid Bone, Frontal Bone), and 14 Bones of
the Facial (Vomer, 2 Conchae, 2 Nasal Bones, 2 Maxilla, Mandible, 2 Palatine Bones, 2
Zygomatic Bones, 2 Lacrimal Bones).
The Skull also contains the Sinus Cavities, which are Air-Filled Cavities.
Paranasal sinuses are a group of four paired air-filled spaces that surround the Nasal
Cavity.
Patient Preparation
Before undertaking skull radiography, the following specific considerations should be
made:
• Ensure that all metal objects are removed from the patient, e.g. hair clips and hairpins.
• Bunches of hair often produce artifacts and thus should be untied.
• If the area of interest includes the mouth, then false teeth containing metal and metal
dental bridges should be removed.
• The patient should be provided with a clear explanation of any movements and film
positions associated with the normal operation of the skull unit.
Useful Accessories
• The usefulness of foam pads as an aid to immobilization cannot be overstated. The
photograph opposite shows a specially designed pad for skull radiography. It is available
in a range of sizes to accommodate different age groups.
• Forty-five-degree triangular pads are extremely useful for immobilizing children. They
can be held by the parent and support the head without the parent placing their hands in
the primary beam.
• Individual side markers are essential for skull radiography, as the clip-type side markers
are easily lost in the collimation, particularly when using a skull unit.
• Velcro straps are of great use when immobilizing a patient on a skull unit.
General Image Quality Guidelines and Radiation Protection considerations:
• Images should have a visually sharp reproduction of all structures, such as outer and inner
lamina of the Cranial Vault (Cranial Cavity), the trabecular structure of the cranium, the
various sinuses and sutures where visible, vascular channels, Petrous part of the temporal
bone and the pituitary fossa.
• Important image details should be visualized.
• Whenever possible, use an Occipito-frontal (PA) rather than a fronto-occipital (AP) since
this vastly reduces the dose to the eyes.
• Exposure Factors: 70 – 85 kVp. Portrait:
20 mAs. Lengthwise.
• Cassette (IR) Size: 24 x 30 cm, (10 x 12 inches).
• Cassette Orientation: Portrait but in Lateral View Landscape. Landscape:
Crosswise.
• FFD / SID: 100cm, (40 in).
• Always using Bucky (Grid).
• Projections of the skull may be taken with the Patient sitting, standing or Laying
depending on the patient's condition.
1. AP (Fronto occipital).
2. PA (Occipito frontal).
3. Lateral View.
4. Fronto occipital ( AP Axial - TOWNE’S View).
5. Occipito frontal ( PA - CALDWELL’S View).
6. Submentovertex (SMV – Schüller Method).
7. PA Axial (Haas Method).
Positioning:
• The patient typically presents in a supine position in trauma cases.
• Rotate the e Head of Patient to make the Radiographic Baseline (OML) perpendicular to
IR.
Prone
• Rest patients nose and forehead against table/ Bucky.
• Flex neck to align OML perpendicular to IR.
Cassette Orientation:
Landscape.
Evaluation Criteria
No tilt is evidenced by There
is superimposition of the
superior orbital plates of the
frontal bone.
Area Covered Collimation:
Shutter A: Open to include the
skin margins of the top of skull
superiorly, and the base of the
Occipito inferiorly
Shutter B: Open to include the
skin margins of the anterior and
posterior skull
Exposure:
• Assess for adequate
penetration of the thickest part
of the skull, the frontal bone.
• Bony trabecular patterns and
cortical outlines are sharply
defined.
• Soft tissues are visualized.
Positioning:
• Patient is in an erect position, either standing or sitting or Supine.
• Position the patient so that their back and posterior skull are touching the Bucky.
• Bring the patients chin down until the radiographic baseline Orbitomeatal line (OML) is
perpendicular the Bucky. If the patient is not able to do this, the central ray angle may have
to be increased caudally so that there is a 30 degree angle between the radiographic
baseline (OML) and the central ray.
Centering Point: Directed to 6 cm superior to the Glabella (this is typically the hairline).
Central Ray: CR 30° caudal.
Collimation: Outer skin margins of the skull.
Evaluation Criteria
No rotation is evidenced by The lateral
borders of the foramen magnum are
equidistant from the lateral borders of the
skull.
No tilt is evidenced by The Petrous ridges
are horizontal.
The central ray is at 30 degrees to the
radiographic baseline, evidenced by The
dorsum sellae & posterior clinoid processes
are seen in the foramen magnum.
Collimation
• Shutter A: Open to include the outer skin
margins of the skull laterally
• Shutter B: Open to include the superior
aspect of the skull
Exposure
• Assess for adequate penetration of the
thickest part of the skull
• The dorsum sellae and posterior clinoid
processes are seen in the foramen magnum
Bony trabecular patterns and cortical outlines
are sharply defined
• Soft tissues are visualized.
Positioning:
• Let the patient's nose and forehead rest the against table or Bucky surface.
• Slowly flex the patient's neck as needed to align Orbitomeatal Line (OML) perpendicular
to Image Receptor.
Centering Point: Directed at the point midway between the Angles of Mandible.
Central Ray: Perpendicular to the IR / Bucky.
Collimation: Outer skin margins of the skull.
Evaluation Criteria
No rotation is evidenced by The
lateral borders of the foramen
magnum are equidistant from the
lateral borders of the skull.
No tilt is evidenced by The
Vomer and the bony nasal septum
are aligned with the long axis of
the film.
Collimation
• Shutter A: Open to include the
soft tissue and lateral borders of
the skull
• Shutter B: Open to include the
mandible superiorly and the
Occipito of the skull inferiorly.
Exposure
• Assess for adequate penetration
of the thickest part of the skull.
• Bony trabecular patterns and
cortical outlines are sharply
defined.
• Soft tissues are visualized.