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RT 233 ORBITS FACIAL BONES PROJECTION REVIEW Parieto-acanthial (Waters) projection Modified Parieto-acanthial (shallow Waters) projection PA Axial (Caldwell) projection Lateral projection Acanthio-parietal (reverse Waters) projection Modified Acanthio-parietal(reverse shallow Waters) projection Submentovertex for Zygomatic Arches Submentovertex Tangential for Zygomatic Arches Modified AP Axial (Townes) for Zygomatic Arches Posterior view of facial bones BONES THAT MAKE UP THE ORBIT Frontal Sphenoid Ethmoid Maxillary Lacrimal Palatine Zygoma ORBITS ORBITS Circumference of orbits 3 bones Frontal bone Maxiilla Zygoma Interior of orbits 4 bones Ethmoid Sphenoid Palatine Lacrimal DIVISION OF THE ORBITS 1. Roof Primarily composed of orbital plate of frontal bone 3. Two Walls Medial 2. Floor Zygoma (small amount) Maxilla Palatine Lacrimal Very thin and delicate Lateral Zygoma (large amount) Thickest wall 7 OPENINGS IN POSTERIOR ORBIT 1. Optic Foramen Optic canal Sphenoid strut 2. Superior Orbital Fissure 3. Inferior Orbital Fissure 8 OPENINGS IN THE ORBIT OPENINGS IN THE ORBIT Lateral view of the lateral orbital wall and its relationships. Key: FZS, frontozygomatic suture; FPZ, frontal process of the zygoma; ZB, zygomatic bone; ZA, zygomatic arch; ZFF, zygomaticofacial foramen; ZTF, zygomaticotemporal foramen; IOF, inferior orbital fissure; MS, maxillary sinus; TB, temporal bone; FB, frontal bone; GWS, greater wing of sphenoid. ANGLE OF ORBITS 1. Each orbit projects 30 degrees superiorly 37 degrees toward MSP 11 ANGLE OF ORBITS ORBITAL IMAGING Methods of imaging: Indications for imaging: CT MRI Ultrasound Plain film Angiography Possible Fractures Blowout Tripod Lefort Foreign body of the eye BASIC AND SPECIAL PROJECTIONS 1. Orbits 1. Basic 1. Parietoorbital (Rhese Method) Parietoacanthial (Waters method) Special 1. Eyes 1. Basic Lateral PA Axial Modified Parietoacanthial (Modified Waters method) Modified Parietoacanthial (Modified Waters method) PA Caldwell, (exag) 14 ORBITS-PARIETOACANTHIAL PROJECTION (WATERS) ORBITS-PARIETO-ORBITAL OBLIQUE (RHESE) ORBITS-PARIETO-ORBITAL OBLIQUE(RHESE) ORBITS-PARIETO-ORBITAL OBLIQUE (RHESE) RHESE PROJECTION Rhese positioning NOT A RHESE VIEW BUT CLOSE NOT A RHESE VIEW LATERAL FOR FOREIGN BODY IN EYE ORBITS-ORBITAL-PARIETAL OBLIQUE (REVERSE RHESE NAME THE PROJECTION AND BODY PART ORBITS SERIES Waters Modified Waters (Shallow) Acanthioparietal Rhese PA Axial Caldwell orbital rims, zygoma, inferior orbital foramen inferior orbital rim in profile, same as Waters but magnified optic foramen superior sphenoid fissure Lateral Eye Waters Modified Waters PA Axial foreign body, soft tissue foreign body, soft tissue foreign body, soft tissue foreign body, soft tissue