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Chapter 13 Bontrager
Facial and Paranasal Sinuses
| Question | Answer |
|---|---|
| What is the only paranasal sinus not contained in a cranial bone? a. Ethmoid b. Maxillary c. Frontal d. Sphenoid | b. Maxillary |
| The term "antrum of Highmore" refers to the: a. Ethmoid sinuses b. Nasal cavity c. Frontal sinuses d. Maxillary sinuses | d. Maxillary sinuses |
| Which sinuses may accumulate blood with a basilar skull fracture? a. Ethmoid b. Frontal c. Sphenoid d. Maxillary | c. Sphenoid |
| Where are the ethmoid sinuses located within the ethmoid bone? a. Pterygoid processes b. Lateral labyrinth c. Perpendicular plate d. Cribiform plate | b. Lateral labyrinth (The labyrinth are suspended from the undersurface of the cribiform plate on each side of the perpendicular plate. |
| Where is the cribriform plate located? a. Above the Crista Galli b. below the Crista Galli c. On the side of the Crista Galli | b. Below the Crista Galli (Cribriform plate contains many small openings or foramina which olfactory nerves or nerves of smell pass thru) |
| All the sinuses intercommunicate with each other and with the nasal cavity. a. True b. False | a. True |
| Infections involving the upper teeth may involve the ethmoid sinuses. a. True b. False | b. False (Maxillary Sinuses are affected) |
| The _____ passageway drains the maxillary sinus into the middle nasal conchae. a. Uncinate process b. Inferior nasal concha c. Infundibulum c. Ethmoid bulla | c. Infundibulum (the uncinate process makes up the medial wall of bone, the ethmoid bulla receives drainage from the frontal and ethmoid sinus cells to the middle nasal meatus to inferior, inferior nasal concha is wall supporting the inferior nasal meatus |
| The _____ sinuses develop last and are not fully developed until the teenage years. a. Ethmoid b. Nasal c. Maxillary d. Sphenoid | a. Ethmoid |
| The eustachian tube connects the typanic cavity with the: a. Nasopharynx b. Maxillary sinuses c. Epitympanic recess d. Antrum | b. Nasopharynx (Epitympanic recess is top of middle ear above the ossicles (MIS), Antrum is the large chamber within the mastoid portion, nasopharynx = nose and throat) |
| Which of the following is not a division of the temporal bone? a. Antrum b. Petrous c. Squamous d. Mastoid | a. Antrum |
| Which division of the temporal bone contains the organs of hearing and equilibrium? a. Antrum b. Mastoid c. Petrous d. Squamous | c. Petrous (houses the organs of hearing and equilibrium) (Squamous is the upper wall of the temporal bone and thin) (Mastoid process or tip contains many air cells) |
| Which of the following structures is part of the middle ear? a. Tragus b. Eustachian tube c. Tympanic cavity d. Cochlea | c. Tympanic cavity |
| With what part of the ear or temporal bone does the eustachian tube communicate? a. Middle ear b. Inner ear c. Mastoid air cells d. External ear | a. Middle ear |
| The aditus is: a. An opening between the epitympanic recess and the mastoid air cells b. A thin plate of bone separating the mastoid air cells from the brain c. A large chamber containing the mastoid air cells d. A passageway for the auditory nerve | a. An opening between the epitympanic recess and the mastoid air cells |
| What lies posteroinferior aspect of the petrous pyramid just superior to the jugular foramen? a. Tympanic cavity b. external acoustic meatus c. internal acoustic meatus d. aditus | c. Internal acoustic meatus (serves to transmit the nerves of hearing and equilibrium) |
| Which two are the oval window connected to: a. cochlea and vestibule b. vestibule and stapes c. stapes and cochlea d. stapes and semicircular canals | b. vestibule and stapes |
| Which of the following is a thin plate of bone that forms the roof of the antrum, aditus and attic area of the typanic cavity? a. Tegman tympani b. External acoustic meatus c. Tympanic membrane d. Auditory tube | a. Tegmen tympani (tympanic membrane is considered part of the middle ear even though it serves as a partition between the external and middle ears) |
| The mastoid air cells communicate with the: a. Inner ear b. Base of the brain c. Middle ear d. External ear | c. Middle ear |
| Which of the following structures of the inner ear is resposible for hearing? a. Round window b. Semicircular canals c. Vestibule d. Cochlea | d. Cochlea (provides sense of hearing) (semicircular canals relates to sense of direction or equilibrium) (vestibule houses the the semicircular canals and cochlea) |
| The osseous labyrinth includes the cochlea, the vestibule, and the semicircular canals. a. True b. False | a. True |
| The sensory apparatus of both equilibrium and hearing are contained in the internal ear. a. True b. False | a. True |
| The vestibule is located in the middle ear. a. True b. False | b. False |
| Which of the following technical factors does not apply to sinus radiography? a. Tight collimation b. Small focal spot c. Detail screen d. High kVp range | d. High kVp range (a medium kV range of 70 to 80 kV is used to provide adequate contrast of air-filled sinuses) |
| Bone destruction most commonly involving middle ear. a. Polyp b. Cholesteatoma c. Mastoiditis d. Sinusitis | b. Cholesteatoma |
| Increased densities replace mastoid air cells. a. Sinusitis b. Polyp c. Mastoiditis d. Otosclerosis | c. Mastoiditis |
| Bone destruction with widened internal auditory canal. a. Acoustic neuroma b. Otosclerosis c. Polyp d. Sinusitis | a. Acoustic neuroma |
| Opacified sinus with air/fluid levels demonstrated. a. Polyp b. Cholesteatoma c. Otosclerosis d. Sinusitis | d. Sinusitis |
| Increased density in affected sinus generally showing rounded borders. a. Polyp b. Acoustic neuroma c. Otosclerosis d. Mastoiditis | a. Polyp |
| Excessive bone formation generally involving both the middle and inner ear. a. Mastoiditis b. Otosclerosis c. Cholesteatoma d. Sinusitis | b. Otosclerosis |
| Along with the use of erect positions, what other technical factor is important to demonstrate air/fluid levels in sinuses? a. Use of detail screens b. Small focal spot c. Use of medium kVp d. Horizontal x-ray beam | b. Small focal spot |
| Where is the CR centered for a lateral projection of the sinuses? a. Upside EAM (side away from IR) b. Midway between the outer canthus and the EAM c. At the level of the nasion d. Midway between the acanthion and the EAM | b. Midway between the outer canthus and the EAM |
| Which sinuses are best demonstrated with the PA projection? a. Frontal and maxillary b. Maxillary and sphenoid c. Sphenoid and ethmoid d. Frontal and ethmoid | d. Frontal and ethmoid |
| Which sinuses are best demonstrated with a parietoacanthial projection? a. Maxillary only b. Frontal, maxillary, and ethmoid c. Sphenoid and maxillary d. Frontal and maxillary | a. Maxillary only |
| Which positioning line is perpendicular to the IR for a parietoacanthial projection? a. MML b. IOML c. OML d. AML | a. MML |
| Which sinus is projected through the oral cavity with a parietoacanthial transoral projection? a. Sphenoid b. Frontal c. Maxillary d. Ethmoid | a. Sphenoid |
| Which of the following projections requires a 25o to 30o caudad CR angle with the head in a true lateral position? a. Posterior profile (Stenvers) b. Axiolateral (Schuller) c. AP axial (Towne's) d. Axiolateral oblique (modified Law) | b. Axiolateral (Schuller) |
| Which of the following projections of the mastoids provides a lateral view of the mastoids? a. Modified Law method b. Mayer method c. Stenvers method d. Arcelin method | a. Modified Law method |
| Which of the following projections will provide an anterior profile image of the petrous bone? a. Arcelin method b. Modified Law method c. Schuller Method d. Mayer method | a. Arcelin method |
| What CR angulation is required for the posterior profile (Stenvers) projection of the mastoids? a. 10o caudad b. 20o cephalad c. 45o caudad d. 12o cephalad | d. 12o cephalad |
| The reverse of a Stenvers position is the Schuller method. a. True b. False | b. False (Arcelin method is the reverse) |
| What CR angulation is required for the Mayers position? a. 0o b. 12o c. 15o d. 45o | d. 45o (also the MSP is in a 45o angle) |
| Other than image receptor size and CR centering, positioning for the AP axial of the mastoids is identical to the AP axial for cranium. a. True b. False | a. True |
| What CR angulation is required for the Schuller method? a. 25o to 30o caudad b. 10o caudad c. 12o caudad d. 15o caudad | a. 25o to 30o caudad |
| Which of the following projections will provide an "end-on" perspective of the petrous bone? a. Mayer b. Arcelin c. Stenvers d. Schuller | a. Mayer |
| Which projection for the mastoids requires a double 15o angle (head rotation and CR angle)? a. Axiolateral oblique (modified Law) projection b. Axiolateral (Schuller) projection c. AP axial oblique (Mayer) d. Axioanterior oblique (Stenvers) | a. Axiolateral oblique (modified Law) projection |
| An x-ray of a PA of the sinuses reveals the petrous ridges are projected over the ethmoid sinuses. What modifications will eliminate this superimposition, while not compromising diagnostic quality? | See below for next choices |
| a. Angle the CR 5o to 10o caudad b. Increase flexion of the head and neck c. Have the patient open his mouth d. Increase extension of the head and neck | d. Increase extension of the head and neck |
| A radiograph of a Waters' projection for sinuses reveals that the alveolar processes of the maxilla are projected over the maxillary sinuses. What positioning error is present on this radiograph? | See below for choices |
| a. Rotation of the head b. Excessive flexion c. Excessive extension d. Excessive CR angulation | c. Excessive extension |
| A radiograph of a SMV reveals the mandible is superimposed over the ethmoid and maxillary sinuses. Which of the following modifications will eliminate this problem? | See below for choices |
| a. Increase the extension of the head and neck b. Increase the flexion of the head and neck c. Perform the axiolateral oblique instead of the smv d. Perform the projection with the patient supine | a. Increase the extension of the head and neck |
| A radiograph of a open-mouth Waters' reveals that the mouth is open but the sphenoid sinus is superimposed over the upper teeth. What positioning error led to this radiographic outcome? | See below for choices |
| a. Insufficient extension of the head and neck b. Insufficient CR angulation c. Insufficient flexion of the head and neck d. Excessive CR angulation | a. Insufficient extension of the head and neck |
| A radiograph of a posterior profile projection of the petrous bone reveals that the petrous bone is foreshortened. The following positioning factors were used: 35o rotation of skull (from PA position), 12o cephalad angle, IOML perp to film, 75 kVp, CR | centered to the downside petrous bone. Which of the following modifications need to be made to produce a more diagnostic image? See below for choices |
| a. Place the AML perpendicular to the film b. Increase the CR angulation to 20o cephalad c. Center the CR to upside petrous bone d. Increase the rotation of the skull to 45o | d. Increase the rotation of the skull to 45o |
| A radiograph of an axiolater (Schuller) projection of the mastoids reveals that the upside mastoid is superimposed on the downside mastoid. What modification is needed to prevent this superimposition during repeat exposure? | See below for choices |
| a. Rotate the skull 15o away from the film b. Increase the CR angulation c. Rotate the skull 15o toward the film d. Extend the skull to place the OML perpendicular to the film | b. Increase the CR angulation |
| A patient comes to radiology for a sinus series. She is unable to stand or sit erect for any of the projections. Which of the following projections will best diagnose any air/fluid levels present in the maxillary sinus? | See below for choices |
| a. Parietoacanthial transoral b. PA c. Horizontal beam lateral d. Parietoacanthial | C. Horizontal beam lateral |
| A patient comes to radiology for a mastoid series. He is unable to stand or sit erect, nor can he lie prone on the table. Which of the following routines would be best for this patient? | See below for choices |
| a. AP axial, modified Law and Stenvers projection b. Arcelin, AP axial and Mayer projection c. AP axial, Stenvers and Mayer projections d. Stenvers, modified Law and Mayer projections | b. Arcelin, AP axial and Mayer projections |
| A radiologist orders a projection to best demonstrate the internal acoustic meatus. Which of the following projections will best demonstrate this structure? | see below for choices |
| a. Axiolateral 15o oblique (modified Law) projection b. Posterior profile (Stenvers) projection c. PA with a horizontal beam d. Parietoacanthial (Waters') projection | b. Posterior profile (Stenvers) projection |
| A patient comes to radiology for a sinus series. She cannot fully extend her head and neck for the smv projection. What else can the technologist do to produce an image of SMV proj? | see below for choices |
| a. Place sandbags on the forehead to extend the skull b. Angle the CR to place it perpendicular to IOML c. Perform the projection with the patient recumbent d. Angle the CR to place it perpendicular to the OML | b. Angle the CR to place it perpendicular to IOML |
| The axiolateral oblique (modified Law method)best demonstrates the upside (side away from IR) mastoids. a. True b. False | b. False |
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