Facial bone anatomy and positioning

1. Facial Bone Anatomy
& Positioning
By MR
Abdalrahman-noor

2. Anterior Aspect of Facial Bones
 2 Maxillae
 2 Zygomatic bones
 2 Lacrimal bones
 2 Nasal bones
 2 Inferior nasal conchae
 2 Palatine bones (not visualized
 1 vomer
 1 mandible

3. There are 14 bones that make up the facial bones. 6
of which are paired and 2 single bones: mandible
and vomer.
The facial bones contribute to the shape and form of
a person’s face. They also serve as protective
housing for the eyes. There are cavities of the orbits,
nose and mouth that are largely made up of the
facial bones.

5. Palatine Bones
 L-shaped bones
 Horizontal portion forms
posterior hard palate
 Vertical portion extends
between 1maxillae and 1
pterygoid plate of sphenoid
bone
 Articulates with 2 cranial
bones and 4 facial bones

6. Very difficult to visualize of a dry skull because
they are internally located.
Articulates with 2 cranial bones:
1) Sphenoid
2) Ethmoid
Articulates with 4 facial bones:
1) Maxilla
2) Inferior nasal conchae
3) Vomer
4) Adjacent palatine

7. Zygomatic Bones
 Forms cheeks
 Forms lower outer
margin of orbits
 Articulates with 3 cranial
bones
 Frontal
 Sphenoid
 Temporal
 Articulates with maxillae

8. Sometimes called malar bones.
Projecting posteriorly from the zygoma is a
thin process connecting to the zygomatic
process of the temporal bone.
The zygomatic prominence is a landmark on
the zygoma and refers to the prominent
portion of the zygoma.

9. Inferior Nasal Cochae
 The only pair of conchae
that are separate facial
bones
 Articulates with 1 cranial
bone and 3 facial bones
 Covered with mucous
membranes to warm,
moisten and cleanse
inhaled air

10. The superior and inferior nasal conchae are
processes of the ethmoid bone, while the inferior
nasal conchae are separate facial bones.
The inferior nasal conchae are thin, narrow and
extremely thin bones which curl laterally and look like
miniature scrolls.
The inferior nasal conchae articulate with the
ethmoid bone and the maxilla, lacrimal and palatine
bones.

11. Lacrimal Bones
 About the size & shape of a
fingernail
 Lacrimal foramen for tear
duct
 Lie anteriorly on the medial
side of orbit
 Can be seen on PA and
lateral projections
 Articulates with 2 cranial
bones and 2 facial bones

12. Lacrimal means “tear” and is appropriate
because the lacrimal bones along with the
maxilla form the lacrimal fossae which
accommodates the lacrimal sacs.
The lacrimal bones articulate with the frontal
and ethmoid bones.
They also articulate with the maxilla and
inferior nasal conchae.

13. Nasal Bones
 Fused and form bridge
of nose
 Vary in size considerably
 The point of junction
with the frontal bone is
the nasion
 Articulates with 2 cranial
and 2 facial bones

14. Vomer
 Forms inferosuperior
part of nasal septum
 Deviated nasal septum
 Depressions for blood
vessels
 Articulates with 2 cranial
bones & 4 facial bones

15. The vomer has small furrow-like depressions
for blood vessels. In a trauma this can be a
source for nosebleed.
Articulates with the sphenoid and ethmoid
bones of the cranium.
Articulates with the R/L palatine bones and the
R/L maxillae.

16. Mandible
 Only movable bone in
the skull
 Densest & largest facial
bone
 2 bones at birth
 Contains mental
foramina

17. The mandible is the largest and densest bone of the
face. It is also the only movable bone in the adult skull.
At birth the mandible consists of bilateral pieces held
together by a fibrous symphysis that ossifies during
the first year of life.
There are 2 holes of each side for the transmission of
nerves and blood vessels. These openings are called
the mental foramina

18. Pathologic Indications for
Facial Radiography
 Fractures
 Blowout
 Tripod
 LeFort
 Coutrecoup
 Foreign Body
 Osteomyelitis
 Neoplasms
 Secondary
Osteomyelitis
 TMJ Syndrome

19. Positioning: Lateral Facial bones
 Semiprone or seated
 MSP parallel
 IPL perpendicular
 Suspend respiration
 CR is perp and enters
lateral zygomatic bone ½
way between outer
canthus and EAM.

20. Lateral Facial Radiograph
 All facial bones in with
zygomatic bone in center

 Almost SI mandibular
rami
 SI orbital roofs (no tilt)
 No rotation of sella
turcica

24. Lateral Skull Anatomy
 A) zygomatic arch
 B) RT zygomatic bone
 C) RT nasal bone
 D) Frontal process of
maxilla
 E) Anterior nasal spine
 F) Alveolar process of
maxilla
 G) Alveolar process of
mandible
 H) Mentum
 I) Mental foramen
 J) Body of mandible
 K) Angle (gonion)
 L) Ramus of mandible
 M) Coronoid process
 N) Mandibular notch
 O) Neck of mandibular
condyle
 P) Condyle or head of
mandible
 Q) EAM

25. Positioning: Waters
 Prone or seated upright
 Chin on bucky -OML 37
angle with plane of cassette
 MML & MSP perp
 Nose 3/4 inch from IR
 Suspend respiration
 CR perpendicular to exit
acanthion

26. Waters Radiograph
 Distance from lateral
border of skull and orbit
equal on each side
 Petrous ridges projected
immediately below
maxillary sinuses