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.
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.
7. Place the cassette in the bucky lengthwise.
8. Position the overhead tube.
a. Angle the tube 25 to 30 degrees caudad.
b. Set the source to image receptor distance (SID) to 40 inches (101 cm).
c. Center the tube to the cassette.
d. Adjust the conefield to 4" X 4" coverage.
9. Position the temporomandibular joints (schuller's bilateral, open and closed) two-way head alignment (TWHA).
NOTE: Because of the extreme mobility of the head on the neck, all positions of the skull require a TWHA for exact positioning of the skull.
a. Place the patient semiprone on the table.
b. Place the median plane parallel to the table.
c. Adjust the interpupillary line perpendicular to the cassette.
d. Adjust the infraorbitomeatal line (IOML) perpendicular to the lateral edge of the cassette.
e. Instruct the patient to open or close mouth.
NOTE: Place the appropriate letter marker (open or closed) within the conefield.
f. Project the tragus nearest the table to the center of the cassette.
10. Place the appropriate identification marker on the cassette.
11. Place the led apron across the patient's lap.
12. Instruct the patient:
a. "OPEN MOUTH AND DO NOT BREATHE OR MOVE."
b. "CLOSE MOUTH AND 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
16. Return the patient to the waiting area.