Skull - Lateral Horizontal RayThis is a featured page

Radiographic Positioning


Adult
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Name of projection Skull - Lateral Horizontal Ray (Supine)
Area Covered Entire skull
Pathology shown Fractures and pathologies of the skull
Radiographic Anatomy Skull Radiographic Anatomy
IR Size & Orientation 24 x 30 cm
Landscape (with the longest side parallel to the table top)
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or Stationary Grid
Filter No
Exposure 70 kVp
16 mAs
FFD / SID 100 cm
Central Ray Directed to 5 cm superior to the EAM (External Auditory Meatus)
Perpendicular to the film
Collimation Outer skin margins of the skull
Markers Inferior and Anterior
Marker orientation AP, indicating the side of the skull closest to the film
Shielding Gonadal (check your department's policy guidelines)
Respiration Suspended
Positioning
  • The patient typically presents in a supine position in trauma cases
  • If the patient has not been cleared of a cervical spine injury, do not reposition the patient
  • Position the film and grid so that they are parallel to the midsaggital plane of the skull
  • Angle the central ray so that it is
    • Perpendicular to the film and grid (and, therefore, also the midsaggital plane)
    • Parallel to the interpupillary line
Critique

 Positioning

  • No rotation is evidenced by
    • The greater wings of sphenoid are superimposed (see notes below)
  • No tilt is evidenced by
    • There is superimposition of the superior orbital plates of the frontal bone
Area Covered

  • Entire skull
Collimation

  • Centre: 5 cm (2 inches) superior to the EAM
  • Shutter A: Open to include the skin margins of the top of skull superiorly, and the base of the occiput inferiorly
  • Shutter B: Open to include the skin margins of the anterior and posterior skull
Exposure

  • Assess for adequate penetration of the thickest part of the skull seen on the lateral view
  • Bony trabecular patterns and cortical outlines are sharply defined
  • Soft tissues are visualised
Special Notes Determining the direction of head rotation
Identify the greater wing of sphenoid which is closer to the film. Compared to the other greater wing of sphenoid it will appear sharper and less magnified. Look at the position of the one furthest from the film to decide how to reposition the film and grid.



AndyC
AndyC 		Latest page update: made by AndyC , Jun 6 2011, 8:35 AM EDT (about this update About This Update AndyC Edited by AndyC

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Keyword tags: skull hori ray skull horizontal ray skull lateral skull positioning skull trauma
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