2/ When you look on the coronal plane at the tongue, the first thing you notice are two column like structures that look like a pair of jeans—genioglossus—or as I like to say “jean-ee-o-glossus.” Genioglossus is latin for jeans of the tongue, right?
3/Right below the jeans are what look like a pair of clown shoes—the geniohyoid. So you see a pair of legs going right into a pair of shoes.
4/The clown shoes look like they are balancing on a tight rope—the tight rope is the mylohyoid. The mylohyoid is easy to remember as the tight rope b/c it is often called the mylohyoid sling—a sling is like a tight rope
5/ So every time I look at the tongue on imaging, I am looking to make sure I can see my clown walking on a tight rope. Any distortion of that is pathologic.
6/ And although it’s not quite the tongue, right beneath the tight rope are two tubular looking structures pointed at you—the anterior bellies of the digastric muscles. I think they look like two gun barrels pointed at you.
7/ So next time some asks you about tongue anatomy, you can tell them about the clown on a tight rope above two gun barrels and they can say, “Aaaaah, now I get it.”
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1/My hardest thread yet! Are you up for the challenge?
How stroke perfusion imaging works!
Ever wonder why it’s Tmax & not Tmin?
Do you not question & let RAPID read the perfusion for you? Not anymore!
2/Perfusion imaging is based on one principle: When you inject CT or MR intravenous contrast, the contrast flows w/blood & so contrast can be a surrogate marker for blood.
This is key, b/c we can track contrast—it changes CT density or MR signal so we can see where it goes.
3/So if we can track how contrast gets to the tissue (by changes in CT density or MR signal), then we can approximate how BLOOD is getting to the tissue.
And how much blood is getting to the tissue is what perfusion imaging is all about.
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