This picture is to do with the twelve cranial nerves. The young girl in this image had a fairly minor viral respiratory tract infection for which the X-ray was taken, probably a simple cold, but woke one morning with paralysis of muscles of just one side of the face – a condition known as Bell’s Palsy. It’s due to viral infection causing acute swelling of the Facial nerve passing out of the skull through a narrow channel to innervate the facial muscles. This is an unfortunate disorder, especially in a young person, particularly in a girl. The angle of the mouth and the eyelid droop, the unlucky victim is unable to drink properly and dribbles from one side of the mouth, there is loss of movement of half the tongue and the face seems to flatten out. The recommended treatment is steroids. Although some cases resolve, many don’t.
There are twelve cranial nerves; given Roman numerals l – Xll, of which the Facial nerve ( Vll ) is one. It is every medical student’s nightmare in the neuro-anatomy class trying to remember which they innervate, where they originate, their course, and whether they are muscular, sensory, or both. For this reason several mnemonics have been devised (though I found it easier simply to remember their names) and we were taught ‘On Old Olympus Towering Top, A Finn And German Viewed A Hop’. Actually, that is pretty boring, hardly memorable. As is the way of medical students (predominantly male at that time) a profane ditty was composed to help learn and remember them: ‘Oh, Oh, Oh To Touch And Feel A Genuine Virgin. Ah, Heaven!’ ( I – Olfactory, II – Optic, III – Oculomotor, IV-Trochlear, V-Trigeminal, VI-Abducent, VII-Facial, VIII-Audio-vestibular, IX-Glossopharyngeal, X-Vagus, XI-Accessory, and XII-Hypoglossal ) This mnemonic is so widely disseminated and so well-known it’s not necessary to apologise for explaining it here.
The image, apart from the X-ray, is made up of a single picture of a heavily veined pebble. It was copied, superimposed, given a Difference filter, warped slightly to emphasise the veins of contrasting stone which were segmented and overlaid, these were then “painted” to make them stand out, like nerves coursing through the tissues.
I’d originally intended to make it a monochrome image, but that is not in my nature, and just couldn’t help introducing colour.