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 table.
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 appropriate mAs and kVp on the control panel.
6. Select the proper size cassette.
NOTE: Use an 8" X 10" cassette for all views.
7. Place the cassette in the bucky lengthwise for the PA view and crosswise for the lateral view.
8. Position the overhead tube.
a. Set the tube angle perpendicular to the film.
NOTE: Angle the tube 25 degrees cephalic for the lateral view.
b. Set the source to image receptor distance (SID) to 40 inches (101cm).
c. Center the tube to the cassette.
d. Adjust the conefield to full field coverage.
9. Position the mandible
NOTE: Because of the extreme mobility of the head on 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 with the nose and forehead in contact with 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) Center the junction of the lips to the film.
b. Lateral (bilateral) view (TWHA).
(1) Place the patient semiprone with the head turned and the side of the face down in contact with the table.
(2) Adjust the elevated shoulder down and out of the conefield.
(3) Tilt the median plane of the skull 15 degrees (vertex down) to the tabletop.
(4) Adjust the inferior border of the chin parallel with the lower edge of the cassette.
(5) Project the midpoint of the inferior margin of the mandibular body of the side up to the cassette.
10. Place the appropriate identification 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 the patient identification for processing.
16. Return the patient to the waiting area.