Head Section Procedures: Key Points and Tips

Overview

• 18 Questions: Potential areas for questions.
• Primary Focus: Skull, facial bones, sinuses, mandible, zygomatic arches, TMJs, nasal bones, orbits.
• Positioning Lines: Know 7 degrees of separation between lines and landmarks.

Positioning Tips

• Skull:
  • Central rays and tube angles.
  • Alternative views for trauma (PA to AP reversal).
• Sinuses:
  • Upright position for air-fluid levels.
  • Cross-table lateral for trauma.
• Feature Surges: Critical for correct positioning.

Common Lines and Methods

• Frequently Used Lines: OML, IOML, AML.
• Less Common: GML, LML.
• Charting: Create a chart to remember lateral, Caldwell, AP/PA, Townes, Waters, SMD.

Petrous Ridges Location

• PA Skull: Inferior to the maxillary sinus.
• Caldwell Method: Lower third of the orbit.
• Waters Method: Lower half of the maxillary sinus.
• Modified Waters: A slight degree change.

Technique Tips

• "Malhala" or "Hang Ten" Trick: Position thumbs in ears, pinkies near eyes to assess Petrous ridges.
• Townes Method: 30° for OML, 37° for IOML.
• Caldwell Exit: 15° degree angle, lower third.

Visual Identification

• AP vs. PA: Size of orbits helps to identify.
• Lateral Skull: Center 2 inches above EAM, check sella turcica.
• Cross-table Trauma: Used in kyphotic patients.

Facial Bones

• Anatomy Knowledge: Essential, ideally upright.
• Waters Method: Chin up, visualizing MML.
• Caldwell Method: 15° angle, lower third.

Sinus Positioning

• Upright Orientation: Critical for air-fluid level visibility.
• Open Mouth Waters: Alternate view for SMB.

Mandible and TMJ

• OML for PA Mandible: Exiting at lips.
• Townes Method for Mandible: Variation of angles (35° and 42°).
• TMJ Exams: Open and closed mouth views.

Arches, Nasal Bones, and Orbits

• Zygomatic Arches: SMV position.
• Nasal Bones: Waters, Caldwell, and laterals.
• Orbits: Reese view not common in specs.

Additional Suggestions

• Practical Exercises: Create and fill out charts regularly.
• Image Evaluation: Practice assessing for rotation, tilt, and artifacts.
• Photo Timing: Avoid overexposure, especially for sinuses.