Chapter 11

Facial BonesPart 3

Facial Bones14 Bones

• 2 Maxillae• 2 Zygomatic• 2 Lacrimal• 2 Nasal• 2 Inferior nasal conchae• 2 Palatine• 1 Vomer• 1 Mandible

Maxillary• Largest _________________ facial bone

• Upper jaw

• __________– Central portion lateral to nose

• __________________– Superior projection off body lateral to nose

Maxillary• __________________

– Lateral projection

• __________________– Inferior spaces for upper teeth

• ____________________– Hard palate (cleft palate location)

Maxillary

• Fused ________________to nose

• ____________________– Anterior projection at fusion

• _____________– Positioning landmark at base of anterior

nasal spine

Palatine

• ‘L’ shaped

• Vertical portion between _____________ of sphenoid

• Horizontal portion makes up ___________________________

Zygomatic(Malar)

• Cheek bones

• Articulations– ____________– Temporal – ____________– Sphenoid

Zygomatic• ______________________

– Prominent lateral portion

• _______________________– Thin bone extending from zygomatic

prominence to temporal bone

Nasal

• 2 fused bones

• ________________– Positioning landmark superior to nasal bone

fusion

• Majority of nose ________________

Nasal Septum

• Bony - _____________ of ethmoid and _________

• Septal cartilage anterior

• _____________-– Forms mid to inferoposterior nasal septum.

Nasal ConchaeTurbinates

• _______________________– Bony projection from lateral wall of nasal

cavity projecting medially.

• __________________nasal conchae – Extensions from ethmoid bone

Lacrimal

• Small facial bone

• Posterior to frontal process of maxilla

Imaging the Facial Bones

Routine• PA Caldwell• Waters• Lateral• 70 – 80 kV• 40” SID

PA Caldwell

• Prone• Pt’s forehead and nose touching table• _______________to IR • No tilt or rotation• __________tube angle• CR to exit the ___________________

PA Caldwell cont’d

• ________________ should be in lower 3rd of orbits

• _______________of orbits should be ____________from lateral skull

• Shows Orbits, Petrious ridges, nasal septum, frontal, maxillary sinus

WatersParietoacanthial

• Prone• Tip of pt’s _____________• OML forms ___________to IR• __________perpendicular• ____________plane perpendicular• CR to exit __________• Shows majority of facial bones and sinuses • ______________inferior to maxillary sinuses

Lateral• Right or left depending on area of interest• Put area of interest ______________• Pt in ________________• Rotate head so ________________is

parallel• _________________perpendicular• ______ perpendicular to front of cassette• CR at ___________________

Imaging the Nasal Bone

Routine• Waters• Laterals• Waters 70 – 80 kV• Laterals 50 – 60 kV• 40” SID

Laterals

• Right and Left Lateral• Position as ____________• CR directed through ____________-• Tight collimation• Soft tissue technique

Imaging the Zygomatic Bones

Routine• AP Towne• SMV• Tangential (If Zygos not seen on SMV)• 50 – 65 kV• BONE TECHNIQUE

AP TowneZygo

• Supine• Tuck chin so ________________to IR• Angle CR ____________• Or Tuck chin so _______________and

angle ________• Center ________________to pass

through mid arches

SMVSubmentovertex

• Many ways to position• _______________to IR• ______________perpendicular• CR through arches• Technique is soft tissue to visualize zygos

Tangential

• Position as ________

• Rotate and tilt head __________affected side

• CR to “shave” Zygo arch