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/Understanding cervical radiculopathy is a pain in the neck! But knowing the distributions can help your search
A #tweetorial to help you remember cervical radicular pain distributions
2/First, a rule of thumb—or rather a rule of elbow! You have 10 fingers. If you divide that in half, you get 5.
If you divide your arm in half, that's at the elbow, you'll also get 5--C5 that is! C5 radiates to the elbow. So if it radiates below this, it's > C5 & above is < C5
3/So let’s start with C2. C2 predominantly radiates along the dorsal aspect of the scalp, as it supplies the greater occipital nerve. I remember this bc the number 2 has a swan like neck that mimics the contour of the back of the head and its distribution
1/Time is brain! So you don’t have time to struggle w/that stroke alert head CT.
Here’s a #tweetorial to help you with the CT findings in acute stroke.
2/CT in acute stroke has 2 main purposes—(1) exclude intracranial hemorrhage (a contraindication to thrombolysis) & (2) exclude other pathologies mimicking acute stroke. However, that doesn’t mean you can’t see other findings that can help you diagnosis a stroke.
3/Infarct appearance depends on timing. In first 12 hrs, the most common imaging finding is…a normal head CT. However, in some, you see a hyperdense artery or basal ganglia obscuration. Later in the acute period, you see loss of gray white differentiation & sulcal effacement
2/Remember, you can think of pathology at the skullbase like bad things that can happen while running. Bad things can get you from below—like falling into a pothole. They can come from within—like a sudden heart attack, or bad things can strike from above, like a lightning bolt
3/Same thing w/the skullbase—bad things can come from below, within, or above. Lesions from below are potholes tripping you up. Lesions from w/in the skullbase are like heart attacks strikning from inside. Lesions from above are the lightning, hitting the skullbase from above
2/Think of the skullbase divisions like different countries—each w/their own culture. Each division has lesions that are specific to it—just like countries have food that are specific to them.
I think the central skullbase looks like Italy, hanging down from the ant. skullbase
3/Lesions can involve the central skullbase from below, within, or above
Let’s start from below. Nasopharynx is below the central skullbase. Nasopharyngeal carcinomas (NPC) can invade from below
Using our Italy theme, you can remember this bc NPC look like an Italian meatball
2/Everyone fears the skullbase. It is so complex that not even experts can agree on a classification for the anatomy.
But you don’t need to know detailed anatomy to be able to give a differential diagnosis for a skullbase lesion that accurate & almost as importantly—short.
3/The skullbase is incredibly important. If you think of your brain as master or God of your body, then the skullbase is where the finger of God breathes life into the rest of you. All of the neuronal information from the brain travels through the skullbase to bring you to life