Download - Sialography Spring 2011 FINAL
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SialographySialography
Spring 2011Spring 2011FINALFINAL
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Salivary GlandsSalivary Glands
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Parotid GlandParotid Gland _______ of the glands_______ of the glands
Consists of ________ Consists of ________ superficial portionsuperficial portion
___________ shaped ___________ shaped deep portiondeep portion
Parotid ductParotid duct– ______________________________________
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Submandibular GlandSubmandibular Gland
____________ shaped____________ shaped
Extends posteriorly Extends posteriorly from ________molar from ________molar to almost _________ to almost _________ of mandibleof mandible
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Sublingual GlandSublingual Gland _________________pair_________________pair
Located at floor of mouth Located at floor of mouth beneath _____________beneath _____________
In contact with the In contact with the mandible laterallymandible laterally
Extends posteriorly from Extends posteriorly from the side of _________ to the side of _________ to _________________duct_________________duct
Main sublingual duct Main sublingual duct opens beside the orifice opens beside the orifice of the submandibular ductof the submandibular duct
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SialographySialography
Term applied to radiographic exam of Term applied to radiographic exam of salivary glands salivary glands – Only __________________done at a timeOnly __________________done at a time
– CT and MRI have largely replaced this exam forCT and MRI have largely replaced this exam for Salivary stone or lesion is suspectedSalivary stone or lesion is suspected
– Used when a definitive diagnosis is necessary Used when a definitive diagnosis is necessary for a problem with one of the salivary ductsfor a problem with one of the salivary ducts
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Indications Indications ________________________________________________
________________________________________________
________________________________________________
________________________________________________
__________________________________________________
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Tumors of Salivary GlandsTumors of Salivary Glands
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RanulaRanula
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InfectionsInfections
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StricturesStrictures
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Salivary Gland CalculiSalivary Gland Calculi
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Salivary StonesSalivary Stones
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Sialogram Tray and suppliesSialogram Tray and supplies
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Contrast MediaContrast Media
________________________________________________– When tomography may be usedWhen tomography may be used– Contraindicated if there is a chance of stones Contraindicated if there is a chance of stones
________________________________________________– Stones and stricturesStones and strictures– 1-2ml1-2ml
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ProcedureProcedure1.1. Obtain preliminary radiographsObtain preliminary radiographs
• Any condition that is visibe w/o contrastAny condition that is visibe w/o contrast• Optimum technique obtainedOptimum technique obtained
2.2. _____ before procedure give patient _________ before procedure give patient ____
3.3. Contrast media injected into main ductContrast media injected into main duct
4.4. After procedure _______ to clear contrastAfter procedure _______ to clear contrast
5.5. _____min after procedure take radiograph_____min after procedure take radiograph
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Procedure DifferencesProcedure Differences
1.1. Most manually inject contrastMost manually inject contrast– ________________________________________________
2.2. Others use hydrostatic pressureOthers use hydrostatic pressure– ____________________________________________________________________– ____________________________________________________________________– ____________________________________________________________________
3.3. Some inject under fluoro and obtain spot Some inject under fluoro and obtain spot radiographsradiographs
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Radiation SafetyRadiation Safety Have shields for PT’s, DR and yourselfHave shields for PT’s, DR and yourself
Question LMP and the possibility of being pregnantQuestion LMP and the possibility of being pregnant
Use cardinal rulesUse cardinal rules– TimeTime– DistanceDistance– ShieldingShielding
ALARAALARA– Use pulse if possibleUse pulse if possible– Save the last image on screen when possibleSave the last image on screen when possible
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Tangential SupineTangential Supine
Rotate pt head toward side being Rotate pt head toward side being examined so that parotid gland is examined so that parotid gland is perp to plane of IRperp to plane of IR
Rest head on occipitusRest head on occipitus
Center IR to parotid areaCenter IR to parotid area
Mandibular ramus parallel with Mandibular ramus parallel with longitudinal axis of the IRlongitudinal axis of the IR
Fill mouth with air and puff cheeksFill mouth with air and puff cheeks
CR perp to plane of IR along lateral CR perp to plane of IR along lateral surface of the ramussurface of the ramus
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TangentialTangential Prone Prone
Rotate pt’s head away from Rotate pt’s head away from side being examinedside being examined
Rest pt’s head on chinRest pt’s head on chin– Forehead and nose if parotid Forehead and nose if parotid
duct does not need to be duct does not need to be seenRotate pt head toward seenRotate pt head toward side being examined so that side being examined so that parotid gland is perp to plane parotid gland is perp to plane of IRof IR
Center IR to parotid areaCenter IR to parotid area
Mandibular ramus parallel with Mandibular ramus parallel with longitudinal axis of the IRlongitudinal axis of the IR
Fill mouth with air and puff Fill mouth with air and puff cheekscheeks
CR perp to plane of IR along CR perp to plane of IR along lateral surface of the ramuslateral surface of the ramus
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Tangential RadiographTangential Radiograph
Soft tissue dentisySoft tissue dentisy
Most of parotid gland Most of parotid gland lateral to and clear of lateral to and clear of ramusramus
Mastoid overlapping Mastoid overlapping only the upper portion only the upper portion of parotid glandof parotid gland
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Lateral ParotidLateral Parotid Affected side close to the Affected side close to the IRIR
Extend mandible to clear Extend mandible to clear c-spinec-spine
Center IR 1” superior to Center IR 1” superior to angleangle
Head 15 degrees from Head 15 degrees from MSP toward IRMSP toward IR
CR 1” superior to angleCR 1” superior to angle
Oblique often used as Oblique often used as wellwell
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Lateral Parotid RadiographLateral Parotid Radiograph
Mandibular Rami free Mandibular Rami free from overlap of c-spinefrom overlap of c-spine
Parotid gland SI over Parotid gland SI over the ramusthe ramus
Axiolateral oblique of Axiolateral oblique of mandible can be usedmandible can be used
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LateralLateralSubmandibularSubmandibular
Center IR to inferior Center IR to inferior margin of anglemargin of angle
PT head in true lateralPT head in true lateral
CR at inferior margin CR at inferior margin of angleof angle
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Lateral Submandibular Radiograph Lateral Submandibular Radiograph and Lateral obliqueand Lateral oblique
Rami free from overlap Rami free from overlap of C-spineof C-spine
SI mandibular rami if SI mandibular rami if no angualtion is usedno angualtion is used
Axiolateral oblique of Axiolateral oblique of mandible for better mandible for better demonstrationdemonstration
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Axiolateral Oblique for Axiolateral Oblique for SubmandibularSubmandibular
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SialogramsSialograms