Hemineglect mnemonic + clock drawing

Hemineglect - where is the lesion ? Which side is neglected?

Mnemonic: Hemineg-left. Left side is neglected. 

Lesion located in the right parietal lobe (non dominant lobe).

Interesting fact: Right-brain-damaged (RBD) individuals with spatial neglect often depict an object with left-sided features absent on drawing.

Usually, the patient is asked to draw a clock.

The drawing of patients with hemineglect contain empty space on the left, as if the clock were covered by an opaque semicircle.

However, this metaphoric occlusion frequently leaves the rim of the clock unaffected. The circular outline is rarely compromised in neglect patients’ clock drawings and is almost always the first feature produced in the task.

Interesting, isn't it?

-IkaN

Torn meniscus and inability to extend the knee

Doubt: Why does torn meniscus present with inability to extend the knee? I don't understand the anatomy correlation.

If there is complete tear, the meniscus (a piece of it) gets dislodged. It gets stuck in the knee joint.

This causes:
Inability to extend the knee.
Pain on extension of the knee.

Why is it called "bucket handle"?

A bucket handle meniscus tear represents a complete tear of the mensicus support or the ligament that holds the meniscus in place. This allows the meniscus to flop over like the handle on a bucket.  When the meniscus flips over it becomes stuck in the middle of the knee joint, you lose the ability to fully straighten the knee then you have a “locked knee”.

Explained by Dr. Mustufa Poonawala

The meaning of valgus (with doubt + mnemonic)

Meaning of valgus: A deformity involving oblique displacement of part of a limb away from the midline.

Doubt: Why is genu valgum knock knees? The knees (genu) are displaced towards the midline!

Answer: It's not the knees we consider during the deformity... It's the relationship of distal part with the proximal part at a joint.

Mnemonic: L in vaLgum is for Lateral displacement.

(Conversely, varuM is medial displacement.)

That's all!
Hate the inaccurate naming.
-IkaN

Study group discussion: Queckenstedt Sign

Suppose there is an obstruction to cerebral venous drainage in the left side, and u r doing an LP with manometry. If u occlude the left internal jugular vein, there will be no change in pressure but if u do it on the right side, there will be increase in csf pressure.

Response of Vagus to Systemic Injury.

Hello!

Let's learn/revise.

The vagus nerve exerts several homeostatic influences, including enhancing gut motility, reducing heart rate, and regulating inflammation.

Central to this pathway is the understanding of neurally controlled anti-inflammatory pathways of the vagus nerve.

This neurally mediated anti-inflammatory pathway allows for a rapid response to inflammatory stimuli and also for the potential regulation of early proinflammatory mediator release, specifically tumor necrosis factor (TNF).

Vagus nerve activity in the presence of systemic inflammation may inhibit cytokine activity and reduce injury from disease processes such as pancreatitis, ischemia and reperfusion, and hemorrhagic shock.
This activity is primarily mediated through nicotinic acetylcholine receptors on immune mediator cells such as tissue macrophages.

Furthermore, enhanced inflammatory profiles are observed after vagotomy, during stress conditions. 

Let's learn Together!
-Medha.

Greenish discoloration of Urine

The common causes of greenish discolouration of urine are :

(1) Phenol containing compounds: Promethazine, Propofol, Thymol,
(2) Dyes: Indigo-blue, Indigo carmine, Carbolic acid, Flavin derivatives,
(3 Biliverdin (in cases of long standing obstructive jaundice),
(4) Amitryptyline (anti-depressant),
(5) Pseudomonas infection,
(6) Cemetidine,
(7) Indomethacin,
(8) Methylene blue (bluish )

CerebelloPontine Angle Syndrome

13th and 14th Cranial Nerves.

13th and 14th cranial nerves

Congenital Corneal Opacities

Congenital Corneal Opacities

Rhinosporidium seeberi

Rhinosporidium seeberi

Hilton's law

Hilton's law.

The nerve which supplies a muscle of a joint, will also supply the joint and the overlying skin.
Conversely, any nerve that is innervating a joint will also supply the muscles of the joint and the overlying skin.

In humans, we find only 2 exceptions to this general rule:

1) Buccal branch of Mandibular nerve as we all know, pierces the Buccinator muscle. But it doesn't supply the muscle. The innervation of Buccinator is by the Buccal branch of Facial nerve.
2) Sciatic nerve in the Gluteal region....is very closely related to the Pyriformis muscle.... And may occasionally send a fibre that pierces the muscle. But it doesn't supply it. Pyriformis is supplied directly by the sacral plexus(the nerve to pyriformis).

Mithil Jagannath.
Medicowesome 2017.

Vasculitis Classification : A way out

Here's my way out of the necrotising vasculitis. Pan intended ;;).

So depending on the size of the vessel involved you can classify it as -

1. Large Vessel Vasculitis
2. Medium Vessel Vasculitis
3. Small Vessel Vasculitis

For the first two Remember :

TT PK

So Large vessel = TT
Takayasu Arteritis
Temporal Arteritis (Giant cell Arteritis)

And Medium Vessel = PK
Polyarteritis Nodosa
Kawasaki disease

Now Small Vessel Vasculitis can be classified further. It can be positive for a particular antibody called ANCA or it can be negative. This antibody is purely an association and not a causative one.

ANCA Negative : HCC

H - Henoch Schonlein Purpura
C - Cryoglobulinemia related
C - Cutaneous Leukocyto-angiitis

(Think of crying babies.
Cry = Cryoglobulinemia related Vasculitis
And another baby related Vasculitis​ is HSP).

Now ANCA positive Vasculitis can be either c-ANCA or p-ANCA depending on what part it stains.

Remember - WC
(Like Western commode)
Wegner's is c-ANCA.

Remember - PCM
p-ANCA in Churg Strauss and Microscopic Poly-angiitis.

Please note - The names of Wegner's and Churg Strauss have been changed to Granulomatosis with Polyangiitis , and Eosniophilic GPA respectively. This is said  to be because the scientist Wegener had been discovered to be possibly related to some Nazi war time activities and this opportunity was made the most of to also take a step towards  a more pathology-specific name-calling by altering the honorific name given to the disease.

That's all!
Happy studying.
And Stay Awesome !

~ A.P.Burkholderia.

Pills of knowledge in Ophthalm- Retinal haemorrhages

1. Flame shaped haemorrhages are seen when they occur in the superficial layers of the retina because the blood can spread as tight junctions are not present there.

2.Dots and blots show up into the deeper layers because the space to spread for the blood is relatively lesser.

That's all!

Sushrut Dongargaonkar