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X-Ray Images the Skull

You have a request for an X-ray examination of the skull. You have the assistance of additional personnel if required. You will need a properly equipped X-ray exposure room with various sizes of film in cassettes, sandbags, lead apron, letter markers, and various sponges.

1.  Select the required view(s) based on the request.

2.  Gather the necessary materials and supplies.

a.  Appropriate cassettes.

b.  Lead apron.

c.  Letter markers.

3.  Prepare the patient.

a.  Bring the patient into the X-ray room.

b.  Ensure the patient is properly dressed.

(1)  Ensure foreign objects are removed from the patient as necessary.

(2)  Ensure the patient is dressed in a gown, if necessary.

c.  Explain the procedure if applicable.

d.  Assist the patient onto the X-ray table except for the submentovertex view (SMV).

4.  Measure the body part through the entry-exit site of the central ray.

5.  Set the control panel.

a.  Consult the technique chart.

b.  Set the control panel.

6.  Select the proper size cassette.

NOTE: Use a 10" X 12" cassette for all views.

7.  Place the cassette in the bucky lengthwise for the PA and the Chamberlain-Towne (CT), and crosswise for the lateral view.

8.  Position the overhead tube.

a.  Set the tube angle perpendicular to the film.

(1)  Angle the tube 15 degrees caudad for the PA view.

(2)  Angle the tube 30 degrees caudad for the CT view.

(3)  Perpendicular for the lateral view.

b.  Set the source to image receptor distance (SID) to 40 inches (101 cm).

c.  Center the tube to the cassette.

d.  Adjust the cone fields to full field coverage.

9.  Position the skull.

NOTE: Because of the extreme mobility of the head on the back of the neck, all positions of the skull require a two-way head alignment (TWHA) for exact positioning of the skull.

a.  PA view (TWHA).

(1)  Place the patient prone on the table.

(2)  Place the median plane perpendicular to and over the centerline of the table.

(3)  Adjust the orbitomeatal line (OML) perpendicular to the cassette.

(4)  Project the nasion to the center of the cassette.

b.  CT view (TWHA).

(1)  Place the patient supine on the table.

(2)  Place the median plane perpendicular to and over the centerline of the table.

(3)  Adjust the OML perpendicular to the cassette.

(4)  Adjust the vertex of the skull even with the upper edge of the cassette.

c.  Lateral view (bilateral) (TWHA).

(1)  Place the patient semiprone on the table.

(2)  Place the median plane parallel to the table.

(3)  Adjust the interpupillary line to the table

(4)  Adjust the infraorbitomeatal line (IOML) perpendicular to the front edge of the cassette.

(5)  Place the midpoint between the external occipital protuberance (EOP) and the glabella over the centerline of the table.

(6)  Adjust the vertex of the skull 2 inches below the upper edge of the cassette.

10.  Place the appropriate letter marker on the cassette.

11.  Place the lead apron across the patient's lap.

12.  Tell the patient, "DO NOT BREATHE OR MOVE."

13.  Make the exposure.

14.  Tell the patient, "BREATHE NORMALLY AND RELAX."

15.  Develop the exposed cassette(s) with patient identification for processing.

David L. Heiserman, Editor

Copyright   SweetHaven Publishing Services
All Rights Reserved

Revised: June 06, 2015