POSITION OF SKULL |

By: Eman Hamed

 Skull Lateral Skull lateral Skull lateral supine
Standing Erect
Structures seen include :
1. The dorsum sellae.
2. Anterior and posterior clinoids.
3. Greater and lesser wings.
IPL = Interpupillary line is horizontal = parallel.
Position MSP = midsagittal plane is vertical = perpendicular.

Angle True lateral.

No angulation.
1. The beam travels laterally.
2. With 0° of angulation.
centering point 3. Through a point 5 cm above the external auditory meatus. = 5 cm posterior to the outer canthus.

1. patient sits facing the erect Bucky.

2. There is no tube angle.
3. The head is then rotated, such that the median sagittal plane is parallel to the Bucky and the inter-
orbital line is perpendicular to it.
4. The shoulders may be rotated slightly to allow the correct position to be attained.
5. Position the cassette transversely in the erect Bucky, such that its upper border is 5 cm above the
vertex of the skull. By: Eman Hamed
6. A radiolucent pad may be placed under the chin for support.
 Skull lateral
standing erect
Direction & centering of the X-ray beam:
1. The X-ray tube should have been centered previously to the
Bucky.
2. Adjust the height of the Bucky/tube so that the patient is
comfortable.
3. Centre midway between the glabella and the external
occipital protuberance to a point approximately 5 cm
superior to the external auditory meatus.
By:3.
Skull lateral supine
Position of patient and cassette:
1. The patient lies supine, with the head raised and immobilized on a non-
opaque skull pad. This will ensure that the occipital region is included
on the final image.
2. The head is adjusted; the median sagittal plane (MSP) is perpendicular
to the table/trolley and the interorbital line (IPL) is perpendicular to
the cassette.
3. Support the cassette vertically against the lateral aspect of the head
parallel to the median sagittal plane, with its long edge 5 cm above the
vertex of the skull.
Direction & centering of the X-ray beam:
1. The horizontal central ray is directed parallel to the interorbital line,
such that it is at right-angles to the median sagittal plane.
2. Centre midway between the glabella and the external occipital
protuberance to a point approximately 5 cm superior to the external
auditory meatus.
EmanThe long
Hamed axis of the cassette should be aligned with the long axis of the
skull
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1. Mastoid region
2. Occipital bone
3. EAM
4. Lambdoid suture
5. Clivus
6. Dorsum sellae
7. Posterior clinoid process
8. Pituitary fossa
9. Anterior clinoid process
10. Lesser wing
11. Coronal suture
12. Orbital plate
13. Frontal bone
14. Cribriform plate
15. Frontal sinus
16. Nasal bone
17. Ethmoid sinus
18. Sphenoid sinus
19. Greater wing
20. Maxillary sinus
21. Maxillary bone
22. Mandibular Ramus
23. Sella Turcica

By: Eman Hamed

 Cribriform plate

By: Eman Hamed

 Skull PA Skull PA Axial Caldwell Method Skull PA Axial Haas Method
Occipito-frontal
1. Direction and centering of the X-ray beam. Purpose and Structures Shown: Purpose and Structures Shown:
1. A caudally angled PA radiograph of the 1. A PA projection of the skull to visualize
2. The central ray is directed perpendicular to skull to visualize paranasal sinuses the sellar structures projecting into the
the Bucky along the median sagittal plane. mainly ethmoid sinuses. foramen magnum in patients who cannot
2. This projection demonstrates skull be positioned for the AP axial projection.
3. A collimation field includes the vertex of fractures. 2. Structures demonstrated include: the
the skull superiorly, the region immediately 3. Structures shown include: the greater occipital bone, foramen magnum, and
below the base of the occipital bone and lesser sphenoid wings, superior petrous pyramids along with the posterior
inferiorly, and the lateral skin margins. orbital fissures, frontal bone, anterior clinoids and dorsum sellae in the shadow
ethmoid and frontal sinuses, superior of the foramen magnum.
4. It is important to ensure that the tube is orbital margins, and crista Galli. Position of patient:
centered to the middle of the Bucky. 1. Prone with the central ray directed
cephalad at an angle of 25 degrees.
5. Occipito-frontal caudal angulation: 10, 15
and 20 degrees. 2. The midsagittal plane is centered to the
midline of the grid.
6. Ensure that the central ray is always
centered to the middle of the Bucky once 3. The elbows are flexed and the arms are
the tube angulation has been applied and placed in a comfortable position.
not before. 4. The shoulders are adjusted to lie flat
against the table in the same horizontal
plane.
1. IPL = Interpupillary line is horizontal = perpendicular.
By: Eman Hamed
2. MSP = midsagittal plane is vertical = Parallel.
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Radiological skull anatomy (PA view)

By: Eman Hamed

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