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.

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

5. 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

6. X rays positions
1) Lateral view of the skull.
2) Frontal view.
3) Towne`s view.
4) Basal view.
5) Water view.
6) Caldwell`s view.

7. 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.

8. Basic Skull Anatomy

9. Views
1. Norma frontalis (anterior)
2. Norma lateralis (lateral view)
3. Norma verticalis (superior)
4. Norma occipitalis (inferior)
5. Norma basalis (base of the skull)
6. Internal of the skull (internal of calvarium & internal of base of the
skull)

10. Norma 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)

18. 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. & Emissary
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

34. Common abnormal findings
in skull X-ray

45. 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.

46. •Thankyou

47. 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