Today's Veterinary Practice

MAY-JUN 2014

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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May/June 2014 Today's Veterinary Practice 57 ImagIng EssEnTIals | RaDIogRaPhy of ThE small anImal skull: TEmPoRomanDIbulaR JoInTs & TymPanIC bullaE tvpjournal.com from mid mandible to C1. One of the TMJs and tympanic bulla should appear rostral to the other; the more rostral structures should be those on the recumbent side of the patient. CLOSED-MOUTH ROSTROCAUDAL ObLIQUE PROJECTION (Figure 6) This projection is used for rostrocaudal eval- uation of the tympanic bulla in brachyce- phalic dogs and cats, and replaces the open- mouth rostrocaudal projection described earlier. Positioning 1. Place the patient in dorsal recumben- cy, supporting the body in a V-trough, as needed. 2. Flex the neck, tilting the hard palate and mandibles 10- to 15-degrees rostral to the perpendicular plane of the table and x-ray collimator system. 3. Use small triangle sponges under the ex- ternal occipital protuberance to help main- tain symmetry of the skull on the table. 4. Flex the skull—then take tape, and start- Figure 6. Position- ing for a closed-mouth 10- to 15-degree ros- trocaudal oblique ra- diograph of the TMJ and tympanic bullae in a boxer/mixed breed dog (A) and corre- sponding radiograph (B). This view can be used for brachyce- phalic dog breeds and in cats for evaluating the tympanic bullae. A b Figure 5. Dog positioned in left lateral recumbency for a 30-degree rostrocaudal oblique radiograph of the nonrecumbent, right tympanic bulla (A) and corresponding radiograph that depicts caudal position of the nonrecumbent tympanic bulla, which is best visualized in this position (B). The marker in this image denotes that, despite the left lateral recumbency position of the dog, the right tympanic bulla is caudal and, therefore, better visualized in this projection. b A ing from one side of the table at the level of the abdomen, pass it around the patient's nose, fastening it to the other side of the table at the same level. 5. Secure the endotracheal tube rostrally to the maxilla, keep- ing the mouth closed. Collimation 1. Direct the central beam to the tympanic bulla. 2. Take care to ensure the crani- um is straight, without lateral rotation. 3. Assess this positioning by standing at the patient's head and placing your hands on ei- ther side of the cranium, at the level of mandibular rami, verifying both rami are equi- distant to the table. Ensuring Image Quality This closed-mouth rostrocaudal oblique projection should in- clude the tympanic bullae with- out rotation or superimposition of the endotracheal tube. 2014-0506_IE_Skull2.indd 57 5/23/2014 12:59:40 PM

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