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X-Ray Images the Nose

You received a request for a radiologic examination of the nose. You have the assistance of additional personnel if required. You will need a properly equipped X-ray exposure room with cassettes of various sizes, letter markers, lead shielding, sandbags, calipers, and positioning sponges.

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

2.  Gather the necessary materials and supplies.

a.  Appropriate cassette.

b.  Lead shielding.

c.  Letter markers.

d.  Calipers

e.  Positioning sponges.

3.  Prepare the patient.

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

b.  Ensure all foreign objects are removed from the patient as necessary.

(1)  Glasses.

(2)  Dentures.

(3)  Hair pins or clips.

c.  Explain the procedure.

d.  Assist the patient onto the table.

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

5.  Set the control panel.

a.  Consult the technique chart.

b.  Set the proper mAs and kVp on the control panel.

6.  Place the lead shielding across the patient's lap.

7.  Select the appropriate size cassette.

NOTE: Use 1/2 of an 8" x 10" for the lateral views. Use an 8" x 10" for the Water's view.

8.  Place the cassette on the table crosswise for the lateral views and lengthwise for the Water's view.

9.  Position the overhead tube.

a.  Set the tube angle perpendicular to the film.

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

c.  Center the tube to the portion of the film being used.

10.  Position the nose.

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

a.  Water's view.

(1)  Place the patient in the prone position.

(2)  Extend neck, resting chin against the top.

(3)  Adjust head until mentomeatal line is perpendicular to the film.

(4)  OML will form a 37 degree angle to the tabletop.

(5)  Position the midsagittal plane perpendicular to the midline of the tabletop.

NOTE: Ensure there is no rotation to the head.

(6)  Center cassette to acanthion.

(7)  Collimation will be full film coverage.

b.  Lateral (bilateral) view.

(1)  Place the patient in the prone position.

(2)  Rest the lateral side of head against the table.

NOTE: The side of interest should be place closest to the cassette.

(3)  Position the nasal bone centered on the portion of the unused cassette.

(4)  Adjust head into a true lateral position.

NOTE: Oblique body as needed for patient's comfort. Placing a positioning sponge underneath the patient's torso help them maintain the position.

(5)  Align midsagittal plane parallel to the tabletop.

(6)  Align interpupillary line (IPPL) perpendicular to the tabletop.

(7)  Position the infraorbitomeatal line perpendicular to the front edge of the cassette.

(8)  Center the central ray 1/2 inch inferior and posterior to the nasion.

(9)  Collimation will be 4 x 4 inch conefield.

11.  Place the appropriate identification marker on the cassette.

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

13.  Make the exposure.

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

15.  Develop the exposed film with the proper patient identification.


David L. Heiserman, Editor

Copyright   SweetHaven Publishing Services
All Rights Reserved

Revised: June 06, 2015