Skull - Lateral

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Skull - Lateral (Erect)
Area Covered	Entire skull
Pathology shown	Fractures and pathologies of the skull
Radiographic Anatomy	Skull Radiographic Anatomy
IR Size & Orientation	24 x 30 cm Landscape
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or Stationary Grid
Filter	No
Exposure	70 kVp 16 mAs
FFD / SID	100 cm
Central Ray	Directed to 5 cm superior to the EAM (External Auditory Meatus) Perpendicular to the bucky
Collimation	Outer skin margins of the skull
Markers	Inferior and Anterior Marker orientation AP, indicating the side of the skull closest to the bucky
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Suspended
Positioning	Patient standing or sitting facing the bucky Place the side of interest of the skull closest to the bucky Oblique the body slightly to assist with positioning and patient comfort The interpupillary line is parallel to the floor The radiographic baseline (OrbitoMeatal Line) is also parallel to the floor The midsaggital plane is parallel to the bucky
Critique PACEMAN	Positioning No rotation is evidenced by The greater wings of sphenoid are superimposed (see notes below) No tilt is evidenced by There is superimposition of the superior orbital plates of the frontal bone Area Covered Entire skull Collimation Centre: 5 cm (2 inches) superior to the EAM Shutter A: Open to include the skin margins of the top of skull superiorly, and the base of the occiput inferiorly Shutter B: Open to include the skin margins of the anterior and posterior skull Exposure Assess for adequate penetration of the thickest part of the skull seen on the lateral view Bony trabecular patterns and cortical outlines are sharply defined Soft tissues are visualised
Special Notes	Determining the direction of head rotation Identify the greater wing of sphenoid which is closer to the bucky. Compared to the other greater wing of sphenoid it will appear sharper and less magnified. Look at the position of the one furthest from the bucky to decide how to reposition the patient. For instance, in the case of a left lateral skull view, the greater wing of sphenoid which is less sharp and more magnified will be on the right side of the patient. If this is more anterior than the one on the left, it means the patient is looking towards the bucky, so bring the midsaggital plane parallel to the bucky to rectify this.