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Published on : Jul 28, 2021 | Views : 2364 | Downloads : 6

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Slide 1-

Dr.Pankaj Kaira JR-I Radiodiagnosis SRMSIMS Bareilly
Slide 2-

Orbital anatomy Roof Floor Medial wall Lateral wall Superior orbital fissure Inferior orbital fissure Optic canal
Slide 3-

Frontal bone with frontal sinus Anteriorly thin Fossa for lacrimal gland
Slide 4-

Orbital plate of maxilla Orbital process of palatine bone Orbital surface of zygomatic bone
Slide 5-

Lacrimal groove Lacrimal bone Ethmoid bone Sphenoid bone Frontal process of maxillary bone
Slide 6-

Zygomatic bone Geater wing of Sphenoid
Slide 7-

Location Between roof and lateral wall Surrounded by sphenoid Beneath optic canal Optic strut
Slide 8-

Content Superior opthalmic vein CN III, IV, VI CN V1 >> Conduit between orbital apex-cavernous sinus
Slide 9-

Location Lies in the floor of the orbit inferior to the superior orbital fissure. Bounded superiorly by the greater wing of sphenoid ,inferiorly by the maxilla and orbital process of palatine bone and laterally bye the zygomatic bone.
Slide 10-

Content Maxillary branch of trigeminal nerve. Emissary veins connecting the inferior opthalmic vein to pterygoid plexus . Infraorbital vessels. Zygomatic nerve Neural branches from the pterygopalatine ganglion
Slide 11-

Optic canal Leads from the middle cranial fossa to the apex of the orbit. Boundaries- -Medially- Body of the sphenoid -Laterally- Lesser wing of the sphenoid Contents Optic nerve + ophthalmic artery (in dural shealth)
Slide 12-

WATERS VIEW CALDWELL’S VIEW LATERAL VIEW SUBMENTOVERTEX VIEW RHESE VIEW
Slide 13-

The most important view for sinus problems or injury involving the maxilla or orbits. By taking the view erect, fluid levels within the maxillary sinuses can be seen. 13
Slide 14-

Measure: A-P at Glabella Protection: Half apron over back of chair or coat apron backwards No tube angle Film: 8” x 10” regular I.D. Down (portrait) 14
Slide 15-

Patient is seated facing the Bucky. Get the chair as close to the Bucky as possible. May also be taken standing. Mentomeatal line should be perpendicular to film with mouth closed. 15
Slide 16-

The nose will be 1-2 cms from Bucky with chin resting on Bucky. The mouth may be opened to see the sphenoid sinus. When this is done, the canthomeatal line should be 35 to 40 degrees to the Bucky. 16
Slide 17-

Facial bones and sinuses There should be no rotation. The petrous ridges must be below the floor of the maxilla. 17
Slide 18-

(a, frontal sinus; b, medial orbital wall; c, innominate line; d, inferior orbital rim; e, orbital floor; f, maxillary antrum; g)superior orbital fissure; h, zygomatic- frontal suture; i, zygomatic arch
Slide 19-

Patient is seated facing Bucky. Their legs should be under the Bucky. Get chair as close to the Bucky as possible. Ask patient to place their nose and forehead on center line of Bucky. Check for rotation. 19
Slide 20-

Horizontal CR: exits through the Glabella or Nasion Vertical CR: mid-sagittal Center film : the x-ray beam is directed downward 15 degrees to 23 degrees to the canthomeatal line Collimation: 6” or 7” square. Breathing Instructions: Suspended Respiration 20
Slide 21-

This view will provide a clear view of the frontal and ethmoidal sinuses. The superior orbital rims can be evaluated. To project the petrous ridges farther down, increase angle to 25 degrees 21
Slide 22-

The most important view for sinus problems or injury involving the maxilla or orbits. By taking the view erect, fluid levels within the maxillary sinuses can be seen. 22
Slide 23-

Measure: A-P at Glabella Protection: Half apron over back of chair or coat apron backwards No tube angle Film: 8” x 10” regular I.D. Down (portrait) 23
Slide 24-

Patient is seated facing the Bucky. Get the chair as close to the Bucky as possible. May also be taken standing. Mentomeatal line should be perpendicular to film with mouth closed. 24
Slide 25-

The nose will be 1-2 cms from Bucky with chin resting on Bucky. The mouth may be opened to see the sphenoid sinus. When this is done, the canthomeatal line should be 35 to 40 degrees to the Bucky. 25
Slide 26-

Facial bones and sinuses There should be no rotation. The petrous ridges must be below the floor of the maxilla. 26
Slide 27-

(a, frontal sinus; b, innominate line; c, inferior orbital rim; d, posterior orbital floor; e, superior orbital fissure; f, greater wing of sphenoid;g, ethmoid sinus; h, medial orbital wall; i, petrous ridge; j, zygomatic-frontal suture; k, foramen rotundum)
Slide 28-

Patient seated or standing facing the Bucky. Rotate the body into an oblique position. Turn skull so the affected side is next to the Bucky. The interpupillary line must be perpendicular to film and tube. Mid sagittal plane parallel to the film. 28
Slide 29-

Horizontal CR: 3/4”superior to EAM Vertical CR: 3/4” anterior to EAM or mid skull Center film to horizontal CR. Collimation: slightly less than film size Breathing Instructions: Suspended respiration Make exposure and let patient relax. 29
Slide 30-

Entire skull must be on the film. There should be no rotation of the skull, orbits and mandible ramus superimposed. The facial bones and sinuses will be dark (over exposed). Usually both lateral views are taken. 30
Slide 31-

Radiograph of a lateral projection. (a, orbital roof; b, frontal sinus; c, ethmoid sinus; d, anterior clinoid process; e, sella turcica; f, planum sphenoidale)
Slide 32-

Measure: A-P at Glabella Protection: Half apron SID: 40” Bucky Tube Angle: None, but if patient cannot extend head back far enough to get inferior orbital -meatal line perpendicular to horizontal CR , tube angle may be needed. 32
Slide 33-

Film Size: 10” x 12” regular I.D. down (Portrait) Patient is seated in a reclining chair. The chair is placed about 6” to 10” from Bucky. Patient is asked to extend neck back until inferior orbital meatal line is parallel to film with top of skull touching the Bucky. 33
Slide 34-

Horizontal CR: EAM Vertical CR: mid-sagittal Center film to horizontal CR The x-ray beam is directed at right angles to the infraorbitomeatal line Collimation: slightly less than film size or skin of skull Breathing Instructions: suspended respiration Make exposure 34
Slide 35-

Assist patient get out of the position. Be very careful that the patient does not hit face on x-ray tube. The ability of the patient to lay back in the chair will make the view much easier for all concerned. 35
Slide 36-

The entire skull is visualized. The mandible and frontal region of skull are superimposed. With a bright light, the zygomatic arches can usually be seen. 36
Slide 37-

(a, zygomatic arch; b, orbit; c, lateral orbital wall; d, posterior wall of maxillary sinus; e, pterygoid plate; f, sphenoid sinus
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THANK YOU