AP side downPA side up

21

Caldwell Sinus Projection Film

• This view will provide a clear view of the frontal and ethmoid sinuses.

• The super orbital rims can be evaluated for fracture when facial bone are of interest.

• To project the petrous ridges farther down, increase angle to 30 degrees

Sinus Lateral

• Lateral – External auditory meatus externally and mandible inferiorly with supracillary arch superiorly in view.

• CR centered to zygoma, midway between outer canthus and EAM

• Midsagittal plane is parallel to IR• IPL is perpendicular to IR

Lateral Sinus Anatomy

Positioning: Waters

• Prone or seated upright

• Chin on bucky -OML 37 angle with plane of cassette

• Mentomeatal line should be perpendicular to film with mouth closed.

• Nose 3/4 inch from IR

• Suspend respiration

• CR perpendicular to exit acanthion

Waters Radiograph

• Distance from lateral border of skull and orbit equal on each side

• Petrous ridges projected immediately below maxillary sinuses

Modified Parietoacanthial (Modified Waters)

• OML 55 degrees to the IR• Chin and nose on table• Petrous pyramids are seen mid-maxillary sinus• CR exits acanthion• Blowout Fractures

• See pg. 355 (Merrill’s 12th Edition)

Modified Waters Radiograph

• Petrous ridges projected immediately below the inferior border of the orbits

• Equal distance from lateral orbit to lateral skull on both sides

Reverse Waters

• Supine

• Extend neck so OML is 37 degree with plane of IR

• MML perp

• Suspend respiration

• CR perpendicular and enters acanthion

Lateral Nasal Bones

• Semiprone

• IPL perpendicular

• CR perpendicular to the bridge of nose at a point ½ inch distal to the nasion

Bilateral Arches - SMV

• IOML parallel to IR and perpendicular to CR

• CR midsaggital and collimate to outer edges of zygoma

Oblique Tangential

• Same position as SMV except head tilt 15 degrees toward side of interest

(Merrill’s p. 362 12 ed)

Esophagus

• RAO• Left side elevated

35-40 degrees• Center at T-5 or T-6

Stomach• PA

– Center at pylorus L2 (midway between xiphoid and umbilicus)

– Expiration• RAO

– L side elevated 40-70 degrees– Between vertebrae and elevated

surface– Center at duodenal bulb– Expiration

• Lateral– Recumbant (R lateral), Erect (L

lateral)– Between axilla and anterior

surface – Center at pylorus

Small Bowel

• Central ray at iliac crest (or slightly above for early exposures)

Colon

• PA or AP– Center at iliac crest

• PA Axial (may be done AP)– Prone– Center @ iliac crest– CR 30-40 degrees caudad– Sigmoid Colon– Smaller IR; CR enters @ ASIS

• Bilat Obliques• Lateral Decubitus• Lateral Rectum

– Enter at ASIS

Intravenous Urography

• KUB• Obliques– Rotated 30 degrees –

kidney farthest from IR is parallel; kiney closest is perpendicular to film

• AP Bladder– CR at ASIS

Cystography

• AP Axial– 10-15 degrees caudal– CR 2-3 in above pubic

syphysis• Oblique

– 40-60 degrees• PA Bladder

– CR 1 in distal to tip of coccyx– 10-15 degree cephalad

angle• Lateral