2/Everyone needs some support. Just like the tongue is supported by the hyoid, the main laryngeal support is the cricoid cartilage. It's like your favorite chair, with all the remotes next to it--not only does the cricoid provide support, it also connects structures in the larynx
3/ Although not official, the cricoid is like the real first ring of the trachea. Except it has an odd signet ring shape. The bulbous back part that makes it look like a signet ring provides the important articulation with the arytenoids
4/Arytenoid cartilages are these funny elf-hat shaped cartilages that are attached to the vocal cords. When the arytenoids move, your vocal cords move, and that's how phonation is created.
5/Arytenoids move by muscles that are stretched out between them, in a criss-cross pattern like shoe laces (transverse/oblique arytenoid muscles). When these muscles contract, it is like tightening shoe laces, which pull and rotate the arytenoids together
6/When the shoe laces are tightened or loosened, the arytenoids swing open or closed like an old fashioned saloon door--and open and close the vocal cords with them!
7/How the cricoid & arytenoids look on imaging depends on the level. Higher up, you are at the articulation of the arytenoids w/the signet ring & you see the crico-arytenoid joint. Lower down, you only see the posterior signet ring, & only at the bottom is entire ring visible
8/Larynx is so important to breathing & phonation that it needs protection--that is the thyroid cartilage. Thyroid cartilage is like a shield for the larynx. But it's huge, like those old Roman shields covering almost the entire body--that's the thyroid cartilage for the larynx
9/Thyroid cartilage is shaped like a bad tiara--except it has points going both up & down. It looks like one of those tiaras you thought would look great w/your prom dress at 16 &now you are stuck w/horrible photos where you look like a bad Disney princess--or was that just me?
10/Because it is open posteriorly, like a tiara, and slightly pointed, on imaging--in cross section--it looks like a upside down letter V
11/So here's the summary of laryngeal supporting structures & how they relate to other structures. Hopefully this has shined some light on the black box of voice box anatomy!
Laryngeal anatomy is too complex for one tweetorial--this is just the beginning--stay tuned for more 😉
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If you don’t know the time of stroke onset, are you able to deduce it from imaging?
Here’s a thread to help you date a stroke on MRI!
2/Strokes evolve, or grow old, the same way people evolve or grow old.
The appearance of stroke on imaging mirrors the life stages of a person—you just have to change days for a stroke into years for a person
So 15 day old stroke has features of a 15 year old person, etc.
3/Initially (less than 4-6 hrs), the only finding is restriction (brightness) on diffusion imaging (DWI).
You can remember this bc in the first few months, a baby does nothing but be swaddled or restricted. So early/newly born stroke is like a baby, only restricted
1/”I LOVE spinal cord syndromes!” is a phrase that has NEVER, EVER been said by anyone.
Do you become paralyzed when you see cord signal abnormality?
Never fear—here is a thread on all the incomplete spinal cord syndromes to get you moving again!
2/Spinal cord anatomy can be complex. On imaging, we can see the ant & post nerve roots. We can also see the gray & white matter. Hidden w/in the white matter, however, are numerous efferent & afferent tracts—enough to make your head spin.
3/Lucky for you, for the incomplete cord syndromes, all you need to know is gray matter & 3 main tracts. Anterolaterally, spinothalamic tract (pain & temp). Posteriorly, dorsal columns (vibration, proprioception, & light touch), & next to it, corticospinal tracts—providing motor
1/Do you get a Broca’s aphasia trying remember the location of Broca's area?
Does trying to remember inferior frontal gyrus anatomy leave you speechless?
Don't be at a loss for words when it comes to Broca's area
Here’s a 🧵to help you remember the anatomy of this key region!
2/Anatomy of the inferior frontal gyrus (IFG) is best seen on the sagittal images, where it looks like the McDonald’s arches.
So, to find this area on MR, I open the sagittal images & scroll until I see the arches. When it comes to this method of finding the IFG, i’m lovin it.
3/Inferior frontal gyrus also looks like a sideways 3, if you prefer. This 3 is helpful bc the inferior frontal gyrus has 3 parts—called pars
1/Need help reading spine imaging? I’ve got your back!
It’s as easy as ABC!
A thread about an easy mnemonic you can use on every single spine study you see to increase your speed & make sure you never miss a thing!
2/A is for alignment
Look for: (1) Unstable injuries
(2) Malalignment that causes early degenerative change. Abnormal motion causes spinal elements to abnormally move against each other, like grinding teeth wears down teeth—this wears down the spine
3/B is for bones.
On CT, the most important thing to look for w/bones is fractures. You may see focal bony lesions, but you may not
On MR, it is the opposite—you can see marrow lesions easily but you may or may not see edema associated w/fractures if the fracture is subtle