Cherry red epiglottis

In the neck region the airway (larynx) and the passage (esophagus) for food, drink and so on  are near each other. If food and other material accidentally go into the airway death from airway obstruction can result.

The epiglottis is a flexible flap of tissue that prevents food and other material from going into the airway during swallowing. Due to for example, bacterial infection, the epiglottis and adjacent tissues can become (inflamed) swollen and red – cherry red epiglottis.

When inflamed, the epiglottis itself can obstruct the airway with fatal consequences; consequently visualizing the cherry red epiglottis should only be done for instance in an operating theatre with airway management specialists in attendance.

Vaccination with the Haemophilus influenzae type b (Hib) vaccine helps prevent epiglottitis (inflammation of the epiglottis) and other diseases caused by the bacterium Haemophilus influenzae.

Reference

Hung TY  et al. Bedside ultrasonography as a safe and effective tool to diagnose acute epiglottitis. Am J Emerg Med, 2011, 29(3):359.e1-3. Go to reference
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Epiglottis, Cherry

Image from Wikimedia Commons

Image from Wikimedia Commons

Salt and pepper retinopathy

Salt and pepper retinopathy refers to tiny light specks (hypopigmentation) interspersed among tiny dark specks (hyperpigmentation) that may be seen in those affected by the rubella virus when the eye’s back (retina) is viewed using special equipment.

These specks resemble salt and pepper in appearance – salt and pepper retinopathy. Besides rubella virus infection, syphilis and the toxic effects of some drugs can produce salt and pepper retinopathy. Salt and pepper retinopathy normally does not affect vision.

Vaccination of both males and females against the rubella virus helps prevent harmful effects of the rubella virus on the baby such as blindness, deafness, heart defects and other dreadful manifestations of the congenital rubella syndrome.

Please see also the celery-stick sign (click here).

Reference:

Damasceno N, Damasceno E, Souza E. Acquired unilateral rubella retinopathy in adult. Clin Ophthalmol, 2011 5:3-4. Go to reference
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Salt and pepper shakers, salt and paper retinopathy

Image from Wikimedia Commons

Image from the University of Michigan Kellogg Eye Centre

Carrot-shaped nuclei

Headache, vomiting and weakness can be the initial manifestations of medulloblastoma, the most common malignant brain tumor of childhood. The nuclei of some medulloblastomas when seen under the microscope can in shape remind you of carrots – carrot-shaped nuclei.

Medulloblastomas affect the cerebellum, a part of the brain concerned with fine-tuning movements but not initiating movements. At times medulloblastoma cells may spread to other regions via the cerebrospinal fluid, which is a clear colorless fluid surrounding the brain and spinal cord.

Surgery, radiotherapy and chemotherapy are forms of treatment for medulloblastoma.

Reference:

Kroh H, Bidziński J . Glial differentiation in medulloblastoma. Case report. Neuropatol Pol, 1993 31(1-2):75-82. Go to reference
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Carrots, Medulloblastoma (white blob)

Image from Wikimedia Commons

Image from Wikimedia Commons

Peaches and cream complexion

Located in the neck’s front region is the thyroid, a gland which produces and releases thyroid hormones that regulate the body’s metabolic rate.

A deficiency of thyroid hormones (hypothyroidism) can come about because of several reasons such as iodine deficiency (iodine is a component of thyroid hormones), destruction of the thyroid gland by disease or radiation, dysfunction of the structures which control the thyroid.

Individuals with hypothyroidism can gain weight, tolerate the cold poorly, be depressed, feel fatigued, have slow speech, menstrual cycle abnormalities, dry skin and in those with fair skin a complexion likened to peaches and cream – peaches and cream complexion.

Reference:

O'Callaghan JM, Bewick J, Paice A, Ng P. Stabbing? Cause. BMJ Case Rep, 2009;2009. pii: bcr12.2008.1312. Go to reference
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Peaches and cream

Image from Wikimedia Commons

Image from Wikimedia Commons

Nutcracker syndrome

The aorta, the body’s main artery originates from the heart; in the tummy region it gives off several other arteries that supply organs with blood. The inferior vena cava (IVC) returns blood from the lower body back to the heart. In the tummy, the aorta and IVC lie side by side; the aorta lies on the IVC’s left side.

One of the aorta’s tummy branches is the superior mesenteric artery (SMA) which supplies the intestines with blood.

Blood returning from the left kidney (within the left renal vein) must cross in front of the aorta to reach the IVC because of the relationship between the aorta and IVC - the aorta lies on the IVC’s left side.

Rarely, the left renal vein can become compressed between the SMA and aorta causing it to dilate. The SMA and aorta in this situation have been likened to the handles of a nutcracker squashing a nut which in this case is the left renal vein – nut cracker phenomenon (renal vein entrapment syndrome).

When the nutcracker phenomenon causes disease such as blood in the urine, tummy pain, the situation is then known as the nutcracker syndrome.

Reference:

Navarro J, Azua-Romeo J, Tovar MT, Lopez JA. Nutcracker syndrome: a rare anatomic variant. BJUI, 2012 DOI: 10.1002/BJUIw-2011-092-web Go to reference
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Anatomy, Nutcracker

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Image from Wikimedia Commons

Image from Wikimedia Commons