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Paranasal Sinuses

Paranasal Sinuses Anatomy & Postioning Ch 13

QuestionAnswer
What is an older term for the Maxillary Sinuses? Antrum of Highmore
An infection of the teeth may travel upward & involve which sinus? The Maxillary Sinus, or Antrum of Highmore
Specifically, where are the frontal sinuses located? Between the inner & outer tables of the skull, posterior to the glabella.
The frontal sinuses rarely become aerated before which age? 6 years
Which specific aspect of the Ethmoid bone contains the Ethmoid Sinus? The Lateral Masses, or Labyrinth.
What is the drainage pathway for the paranasal sinuses called? Osteomeatal complex
Which sinus will be projected through the open mouth with a PA axial transoral projection? The Sphenoid Sinus
What is the name of the passageway between the Maxillary Sinuses & the middle nasal meatus? Infundibulum
Which position is most often used when performing a CT study of the sinuses? Do most CT studies of the sinuses require contrast media? Prone is the most often used body position for CT scans of the sinuses. Most CT scan studies of the sinuses do not require contrast media.
What kV range should be used for sinus radiography? 65-80 kV. A little less than skull radiography.
What 2 things are important to demonstrate possible air fluid levels within the sinuses? Use of a horizontal x-ray beam. To perform exams erect whenever possible.
Are ultrasound exams of the maxillary sinuses possible to rule out sinusitis? Yes
What imaging modality is the preferred method to study soft tissue changes & masses within the sinuses? MRI
What are the 4 most commonly performed basic, or routine projections for paranasal sinuses? Lateral, PA Caldwell (OML perpendicular to IR), PA Water's-ParietoAcanthial (MML perpendicular to IR,/OML at 37 degree angle to IR), SMV (IOML parallel to IR).
Which single projection of the paranasal sinuses routine provides an image of all 4 sinus groups? The lateral.
Which projection of the paranasal sinuses is the only one that shows the Sphenoid Sinuses without any superimposition? The lateral projection
Which projection is best for the Ethmoid Sinuses? Are they still superimposed? The lateral projection.
Which projection are the Maxillary sinuses best demonstrated? What is brought out of the way? What is the alternate of this method? What does this alternate projection get out of the way of the sphenoid sinus on the radiograph? The PA-Water's-ParietoAcanthial Projection. The nasal cavity is brought out of the way. The Open Mouth Water's. The sphenoid sinus is free of bony & soft tissue (tongue) superimposition.
If the patient cannot stand for the lateral projection of the paranasal sinuses, it should still be taken with what? A horizontal beam
What sinuses are best demonstrated with the PA Caldwell projection? the frontal Sinuses. They are not superimposed over air filled cavities.
To avoid angling the CR for the erect PA Caldwell Sinus Projection, the head should be adjusted so the OML is how many degrees from horizontal? 15 degrees
How many degrees does the OML form with the IR for PA Waters Sinus projection? Which positioning line is perpendicular to the IR? What 2 portions of the patient's face are on the IR? OML will form a 37 degree angle. The MML will be perpendicular to the IR. The chin & nose will be against the Bucky/IR.
Where are the Petrous Ridges located on a well positioned PA-Water's-ParietoAcanthial Projection of the sinuses? Just below the maxillary sinuses.
If the Petrous bone is in the Maxillary sinus, what is the positioning error? If the roots of the teeth are in the maxillary sinus, what is the positioning error? The head was not extended at the neck enough (the chin was not up high enough) if the petrous bone is in the maxillary sinus. The head was extended too much (the chin was up to high) if the roots of the teeth are in the maxillary sinus.
Which paransal sinuses are demonstrated with an SMV projection? The SMV projection is primarily for demonstrating the Sphenoid Sinus, but also for the Ethmoid & Maxillary sinuses.
Where should the CR exit for the PA-Water's-ParietoAcanthial Projection & the PA-Open Mouth Water's-Transoral Projection? Through the Acanthion.
Where are the Sphenoid SInuses located? In the body of the sphenoid bone directly below the sella turcica & anterior to the dorsum sellae.
What might the indication be if an air fluid level is demonstrated in the sphenoid sinus following a skull trauma? Why is this? A basal skull fracture. Because the sphenoid sinuses are close to the base of the floor of the cranium.
What are the 3 collections the Ethmoid sinuses are grouped into? Do they all intercommunicate? Anterior, Middle & Posterior. All the collections intercommunicate.
How many Frontal sinuses are there? Is there always this many? If not, why? There are generally 2 frontal sinuses. There is not always 2. The frontal sinuses are separated by a septum & if there's no septum, there's only 1 frontal sinus.
What is the appearance of chronic sinusitis? Conic Sinusitis, mucous membrane of the sinuses are swollen & not necessarily full of fluid.
What is the appearance of acute sinusitis? Why is this? Acute Sinusitis, there is fluid collected at the bottom of the sinus. The pathway for communication with the nasal cavity is superior portion the maxillary sinus. The fluid doesn't drain & collects at the bottom.
A quadripalegic patient with chronic sinusitis presents for a sinus study & cannot be placed erect. Which single projection will demonstrate any possible air fluid levels in the sinuses? The most diagnostic position would be any that utlizes a horizontal beam.
What positioning line is 25 degrees from the IR for the PA-Caldwell-Sinus projection? What 2 structures on the patient's face are on the IR? Where is the CR centered to exit at? If the patient cannot hold this position, what can be done? The OML will be 15 degrees from the IR. The patient's nose & forehead will be against the bucky. The CR should exit at the Nasion. The bucky can be tilted 15 degrees towards the floor, with the CR still perpendicular.
Where is the CR centered for the lateral sinuses? The CR should be centered midway between the outer canthus & the EAM for lateral sinuses.
Created by: jamestkelley