Lea Alhilali, MD Profile picture
Jun 14, 2022 • 10 tweets • 6 min read • Read on X
1/Like a bad piano player in a run down bar--I take requests! By popular demand, a🧵on how I make those illustrations for my #tweetorials--all in #PowerPoint!
This one shows how to create shadow & highlights to give a 3D effect
#medtwitter #MedEd #FOAMed #powerpointpresentation Image
2/Let's use this french fry illustration I used for my varices🧵
I use the curve function to create shapes. It has the most control for drawing--the freeform function causes uneven lines.
After drawing the shape, I use the shape fill function to fill it in it w/the color I need Image
3/ 3D effects begin w/the gradient fill. I use the gradient fill that powerpoint offers for my selected color--it knows how to chose them so that the gradient is smooth Image
4/ Now to get more advanced w/focal shadows. Using the curve function, I draw shapes where I want shadows. Then I fill these in using the eyedropper function on the Shape Fill menu. I touch the eyedropper to the darkest part of the gradient to fill them in w/a nice dark shadow. Image
5/ Now these shapes need to be blurred so they look more like shadows. I select them and go to the "Shape Effects" menu & select "Soft Edges." I⬆️the size of the soft edge until they look like good shadows. It is different for every shape, but usually you need at least 5 point Image
6/Now for highlights. I use the curve function to draw shapes where I want highlights. Similar to shadows, I use the eyedropper function to fill in the shapes--but instead of putting the eyedropper on the darkest part of the gradient, I put it in the lightest part of the gradient Image
7/However, for highlights, the lightest part of the gradient isn't light enough. So I select the shape, go to shape fill color & select "More colors." This brings up a box where you can lighten the shade of that color--the same way light would lighten it if it was shining on it. Image
8/Now it is time to blur these highlights the same way we blurred the shadows--using the soft edges function, increasing the soft edge until you get desired look of your highlight. Image
9/Now we add details. First, I drew the McDonalds logo using the curve function. Then I used the curve function to draw a single fry. I took that fry & copied & pasted it over &over again--each time rotating it & stretching it to make it look like there were many different fries Image
10/Voila! That is how you make a very professional illustration using only PPT & in only a few easy steps! Excited to see what you will create w/these new skills!
I post more of my tips for creating these illustrations in PPT--so if interested click to follow me @teachplaygrub Image

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More from @teachplaygrub

May 17
1/ I always say, "Anyone can see the bright spot on diffusion images—what sets you apart is if you can tell them why it’s there!”

If you don't why a stroke happened, you can't prevent the next one!

Can YOU tell a stroke’s etiology from an MRI?

Here’s a thread to show you how! Image
2/First a review of the vascular territories.

I think the vascular territories look a butterfly—w/the ACA as the head/body, PCA as the butt/tail, and MCA territories spreading out like a butterfly wings. Image
3/Of course, it’s more complicated than that.

Medially, there are also small vessel territories—the lenticulostriates & anterior choroidal.

I think they look like little legs, coming out from between the ACA body & PCA tail. Image
Read 25 tweets
May 14
1/Got the diagnosis when it comes to vessel stenosis?

Or is your knowledge narrow when it comes to vessel narrowing?

When it comes to vasospasm, do you know why it happens or what to look for?

Here is the thread you NEED to unravel why vessels twist up! Image
2/Vasospasm results from subarachnoid hemorrhage (SAH) & a buildup of multiple factors

It’s like how you can handle 1 nag from your boss on Monday—but after nagging all week, you break down on Friday!

Same w/vasospasm—it doesn’t happen until the end of the week after SAH! Image
3/So what is nagging that causes the vessel to shut down?

When the body breaks down blood from SAH, it releases free heme

And this free heme causes a cascade of negative consequences, call heme-related inflammation

So free heme is the annoying boss! Image
Read 21 tweets
May 13
1/ “Now listen carefully!”

Everyone has so much fear about the anatomy where they hear!

Do you dread temporal bone anatomy?

Do find the understanding ossicles impossible?

Do you know the ice cream cone sign on CT & then nada?

Then you need this thread on ossicular anatomy! Image
2/For the middle ear, I have a rule of 3s.

Middle ear is divided into 3 parts & it contains 3 ossicles.

Today we will focus on the ossicles—each of which has 3 parts! Image
3/First ossicle you meet when you enter the middle ear is the malleus.

It’s called the malleus because it acts like a mallet that hits a drum—literally—the ear drum!

I think it looks like Dr. Evil’s mini me, with its short body and round bald head Image
Read 19 tweets
May 8
1/Asking “How old are you?” can be dicey—both in real life & on MRI!

Do you know how to tell the age of blood on MRI?

Here’s a thread on how to date blood on MRI!

After reading this, when you see a hemorrhage, your guess on its age will always be in the right vein! Image
2/If you ask someone how to date blood on MRI, they’ll spit out a crazy mnemonic about babies that tells you what signal blood should be on T1 & T2 imaging by age.

But mnemonics are crutch—they help you memorize, but not understand

If you understand, you don’t need to memorize Image
3/If you look at the mnemonic, you will notice one thing—the T1 signal is all you need to tell if blood is acute, subacute or chronic.

T2 signal will tell if it is early or late in each of those time periods—but that type of detail isn’t needed in real life

So let’s look at T1 Image
Read 21 tweets
May 3
1/Time to go with the flow!

Hoping no one notices you don’t know the anatomy of internal carotid (ICA)?

Do you say “carotid siphon” & hope no one asks for more detail?

Here’s a thread to help you siphon off some information about ICA anatomy! Image
2/ICA is like a staircase—winding up through important anatomic regions like a staircase winding up to each floor Lobby is the neck.

First floor is skullbase/carotid canal. Next it stops at the cavernous sinus, before finally reaching the rooftop balcony of the intradural space. Image
3/ICA is divided into numbered segments based on landmarks that denote transitions on its way up the floors.

C1 is in the lobby or neck.

You can remember this b/c the number 1 looks elongated & straight like a neck. Image
Read 10 tweets
Apr 25
1/Have some confusion about tumor perfusion?

Do you go into a coma looking at scans for glioma?

Never fear!

Read on for this month's @theAJNR SCANtastic for what you need to know on the latest in brain tumor imaging!

ajnr.org/content/45/4/4…
Image
@TheAJNR 2/Since the prehistoric days of medicine (1979!), we knew that some brain tumor patients treated w/radiation (XRT) initially declined, but then get better.

Today, we see this on imaging, where it looks worse early, but then gets better.

Now we call this pseudoprogression. Image
@TheAJNR 3/Why does this happen?

XRT induces a lot of inflammatory changes—from initiating the complement cascade to opening the blood brain barrier (BBB)

It’s these inflammatory changes that make the imaging look worse. Image
Read 21 tweets

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