Transcript Week 6 - El Camino College

Facial Bone, Nasal Bone Anatomy, Facial
Bone, Nasal Bone Projections
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FACIAL BONES
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14 bones in the face, not including the hyoid bone
6 paired bones
2 unpaired bones
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Nasal
13
bone
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2
1
3
4
11
10
9
88
6
7
5
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Nasal Bones
 Two small, thin bones
 Vary in size and shape in individuals
 Form superior bony wall of nasal cavity
 Commonly called “bridge of nose”
 Articulations
 With each other in midsagittal plane
 Superior = frontal bone
 Posterosuperior = perpendicular plate of ethmoid
bone
 On each lateral side = maxillae
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Lacrimal Bones
 The two smallest bones in the skull
 Located in anterior part of medial wall of orbits
between labyrinth of ethmoid and maxilla
 Each bone contains a lacrimal foramen through
which the tear duct passes
 Articulations
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Frontal
Ethmoid
Maxilla
Inferior nasal concha
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Maxillary Bones
 Largest immoveable bones of face
 Each articulates with all other facial bones, except for
mandible
 Also articulate with frontal and ethmoid cranial bones
 Form part of lateral walls and most of floor of nasal
cavity
 Form part of floor of orbit
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Maxillary Bones
 Form three fourths of roof of mouth
 Have zygomatic process that articulate with zygoma
to form part of cheek
 Body contains large, pyramidal cavity = maxillary
sinus
 Infraorbital foramen = located under each orbit for
passage of infra-orbital nerve and artery
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Maxillary Bones
 Alveolar process = inferior borders of spongy bone
that support roots of teeth
 Anterior nasal spine = forward, pointed process at
their midline junction
 Acanthion = midpoint of this junction
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Maxillary Bone
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Palatine Bones
 Two L-shaped bones composed of vertical and
horizontal plates
 Horizontal plates articulate with maxillae to
complete the posterior fourth of bony palate (roof of
mouth)
 Vertical portions extend upward between maxillae
and pterygoid processes of sphenoid in posterior
nasal cavity
 Superior tips of vertical plates assist in forming
posteromedial orbit
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Palantine Bones
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Hard Palate
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Inferior Nasal Conchae
 Extend diagonally and inferiorly from lateral walls
of nasal cavity at its lower third
 Long, narrow, very thin bones with a lateral curl
 Gives scroll-like appearance
 Upper two nasal conchae are processes of ethmoid
bone
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Inferior Nasal Concha
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Zygomatic Bones
 Articulations
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Superior = frontal bone
Lateral = zygomatic process of temporal bone
Anterior = maxilla
Posterior = sphenoid
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Zygomatic Bones
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Vomer
 Thin plate of bone situated in MSP of floor of nasal
cavity
 Forms inferior nasal septum
 Superior border articulates with body of sphenoid
bone
 Superior part of anterior border articulates with
perpendicular plate of ethmoid bone
 Posterior border is free
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Vomer
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Mandible
 Largest and densest bone of the face
 Body = curved horizontal portion
 Rami = two vertical portions on each side of body
 Angle of mandible = junction of body and ramus
 Also called gonion
 Mental protuberance = anterior, triangular
prominence
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Mandible
 Symphysis = most anterior and central part where
left and right halves of mandible fuse
 Alveolar process = superior border of body; consists
of spongy bone that supports roots of teeth
 Mental foramina = small openings on each side
below the second premolar; transmit nerves and
blood vessels
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Mandible
 Coronoid process = anterior process on top of ramus
 Condylar process = posterior process on top of
ramus; articulates with mandibular fossa of temporal
bone to form temporomandibular joint (TMJ)
 Mandibular notch = concave area at top of ramus
between coronoid and condylar processes
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Anatomy: Mandible
Anterior and lateral aspects of mandible
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Hyoid Bone
 Small U-shaped bone situated at the base of the
tongue
 Accessory bone of axial skeleton – not a facial or
cranial bone
 Only bone in the body that does not articulate with
another bone
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Anatomy: Facial Bones
Lateral aspect of facial bones
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Clicker Question
 Which facial bones form part of the hard palate?
A. Palatine
B. Mandible
C. Zygoma
D. Lacrimal
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Clicker Question
 All of the following are part of the bony orbit, except:
A. Palatine
B. Zygoma
C. Lacrimal
D. Vomer
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Essential Projections:
Facial Bones
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Lateral
Parietoacanthial (Waters method)
Acanthioparietal (reverse Waters method)
Posteroanterior (PA) axial (Caldwell method)
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Lateral Facial Bones
 Patient position
 Semi-prone or seated in upright anterior oblique
 Part position
 MSP of head parallel with image receptor (IR)
 Interpupillary line (IPL) perpendicular to IR
 Infraorbitomeatal line (IOML) perpendicular to front
edge of IR
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Lateral Facial Bones
 Central ray (CR)
 Perpendicular to IR center
 Enters patient on lateral surface of zygomatic bone
halfway between outer canthus and external acoustic
meatus (EAM)
 Collimated field
 8 x 10 inches (18 x 24 cm)
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Lateral facial bones
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Lateral facial bones
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Lateral
facial
bones
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PA Axial (Caldwell)
 Patient position
 Seated erect or prone
 MSP centered to midline
 Forehead and nose resting on table or upright Bucky
 Part position
 OML perpendicular to IR plane
 MSP perpendicular to IR
 IR centered to nasion
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PA Axial (Caldwell)
 CR
 Angled 15 degrees caudad
 Exits nasion
 For orbital rims, angle 30 degrees caudad
(“exaggerated” Caldwell)
 Collimated field
 10 x 12 inches (24 x 30 cm)
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PA Axial (Caldwell)
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PA Axial(Caldwell)
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PA
Axial
(Caldwell)
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Parietoacanthial
(Waters) Facial Bones
 Patient position
 Prone or seated upright
 Center MSP to midline of upright Bucky
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Parietoacanthial
(Waters) Facial Bones
 Part position
 Rest head on tip of extended chin
 Place orbitomeatal line (OML) to form 37-degree angle
with plane of IR
 Mentomeatal line (MML) perpendicular to IR
 MSP perpendicular to IR
 Center IR to level of acanthion
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Parietoacanthial
(Waters) Facial Bones
 CR
 Perpendicular to exit acanthion
 Collimated field
 8 x 10 inches (18 x 24 cm)
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Parietoacanthial
(Waters) Facial Bones
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Parietoacanthial
(Waters) Facial Bones
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Parietoacanthial
(Waters)
Facial
Bones
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Parietoacanthial
(Waters) Facial Bones
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Parietoacanthial
(Waters) Facial Bones
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Parietoacanthial
(Waters) Facial Bones
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Modifications for the Water’s projection:
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done to see entire orbital rims
OML at a 55° angle to IR
(use the LML for positioning)
petrous ridges just below IOM
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Parietoacanthial (Waters)
Facial Bones-Modified
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Parietoacanthial
(Waters)
Facial
Bones
Modifications
for the Water’s
projection:
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Acanthioparietal
(Reverse Waters) Facial
Bones
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Acanthioparietal
(Reverse Waters) Facial
Bones
 CR
 Perpendicular to enter acanthion
 Center IR and CR
 Collimated field
 10 x 12 inches (24 x 30 cm)
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Acanthioparietal (Reverse
Waters) Facial Bones
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Acanthioparietal (Reverse
Waters) Facial Bones
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Acanthioparietal (Reverse
Waters) Facial Bones
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Acanthioparietal (Reverse
Waters) Facial Bones
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Acanthioparietal (Reverse
Waters) Facial Bones
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Essential Projections:
Nasal Bones
 Lateral
 Water’s
 Caldwell
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Lateral Nasal Bones
 Patient position
 Semiprone
 MSP of head horizontal
 Part position
 MSP parallel with tabletop
 IPL perpendicular to tabletop
 IOML is parallel with transverse axis of IR
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Lateral Nasal Bones
 CR
 Perpendicular to bridge of nose
 Enters at a point ½ inch (1.3 cm) distal to nasion
 Collimated field
 3 x 3 inches (8 x 8 cm)
 Field should extend from the glabella to the acanthion
and ½ inch beyond the tip of the nose
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Lateral Nasal Bones
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Lateral Nasal Bones
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Lateral Nasal Bones
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Lateral Nasal Bones
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Pathologic Indications for
Facial Radiography
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 Fractures
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Blowout
Tripod
LeFort
Coutrecoup
 Foreign Body
 Neoplasms
 Secondary Osteomyelitis
 TMJ Syndrome
 Osteomyelitis
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