Skull X-Ray

radiology of skull, base of the skull, anatomy of base of the skull

1. Basic Skull X-ray findings Evaluator: Mr L Anand Presenter : Shruti Shirke [ Asso professor, CON AIIMS BBSR ] M.Sc Neuroscience Nursing

2. Introduction X - rays  were discovered in 1895 by Wilhelm Conrad Roentgen (1845-1923) who was a Professor at Wuerzburg University in Germany.

3. Purpose of the skull X-ray Presence of skull fracture Abnormal calcification Bone erosion Shape and size of skull bone

4. Indications Evaluation of skeletal dysplasia. Diagnostic survey in abuse. Abnormal head shapes. Infections and tumors affecting the skull bones. Metabolic bone disease, leukaemia and Multiple myeloma

5. X rays positions

6. PATIENT PREPARATION Ensure that all metal objects are removed from the patient e.g. :- hair clips and hair pins Bunches of hair often produce artifacts and this should be untied. If the area of interest include the mouth , then false teeth containing metal and metal dental bridges should be removed . Patient should be provided with a clear explanation of any movements and film positions associated with the normal operation of the skull unit.

7. Basic S kull Anatomy

8. Views Norma frontalis (anterior) Norma lateralis (lateral view) Norma verticalis (superior) Norma occipitalis (inferior) Norma basalis (base of the skull) Internal of the skull (internal of calvarium & internal of base of the skull)

9. N orma frontalis Neurocranium (8) (unpaired ethmoid( middle, superior nasal concha is a part of ethmoid), sphenoid, frontal & occipital bone) (paired 2 parietal, 2 temporal) Splanchno cranium (14) (2 unpaired mandible, vomer) (6 paired maxilla, zygomatic bone, nasal bone, lachrymal bone, palatine bone, inferior nasal concha)

10. Anterior cranial fossa 1) Foramen cecum Emissary vein (connecting nose with superior sagittal sinus ) 2) Anterior ethmoid foramen Anterior ethmoid vessels & nerve (epistaxis) 3) Cribriform plate CN 1 4) Posterior ethmoid foramen Posterior ethmoidal vessels & nerves Middle cranial fossa 5) Optic canal Ophthalmic artery & optic nerve CN2 6) Superior orbital fissure (Superior 2 artery 3 nerve 1 vein)(middle 5 nerve)(1 vein) 7) Foramen Rotandum CN 5 B (Maxillary) 8) Foramen Ovale CN 5 C (Mandibular), Accessary middle meningeal artery, lesser petrosal N. & E missary veins. 9) Foramen Spinosum Middle meningeal artery & nervous Spinosum -> branch of mandibular nerve 10) Foramen Lacerum /carotid canal Internal carotid artery c sympathetic plexus, greater petrosal nerve, emissary vessels, meningeal branch of ascending pharyngeal artery Posterior cranial fossa 11) Internal acoustic meatus CN 7, 8 & labyrinthine vessels 12) Jugular canal Inferior petrosal sinus, CN 9,10,11 13) Hypoglossal canal CN12, Emissary vein  Sigmoid sinus 14) Foramen of magnum Vertebral artery, posterior &anterior spinal artery, ligaments

11. Common abnormal findings in skull X-ray

12. Conclusion: The skull x-ray is one of the diagnostic procedure and is done as a part of trauma diagnostic protocol. It helps to rule out, major to minor abnormalities mainly concerned with the bone but not give much details about soft tissue.

13. Thankyou

14. Purpose of spine X-ray Wedging of collapsed vertebra Erosion of bone caused by neoplasm Irregular calcification Narrowing of vertebral canal Spurs (sharp projection of the bones) Spondylosis Trauma to vertebral column