🎵 1B. Lyrics
🎵 1B. Lyrics (TCV Correct Version)
Title: “The Wedge-Shaped Shadow (Infarction)”
(Verse 1)
I am Infarction (In-FARK-shun), the parenchymal (pa-REN-ky-mal) cost,
From a vascular occlusion (VASK-yoo-lar o-KLOO-zhun), the blood supply is lost.
An embolus (EM-bo-luss) has lodged, in the lumen (LOO-men) of the vessel,
The distal (DISS-tal) tissue suffocates, it’s sick and it’s displeased.
(Verse 2 – The “Other Signs”)
But I’m not the only sign of PE (PEE-EE), you gotta look around!
The Westermark’s Sign (WESS-ter-marks SINE) is where no blood is found!
(That’s oligemia (ol-i-GEE-mee-ah), a lucency so black),
And the Fleischner Sign (FLYSH-ner SINE) is the artery’s wide track!
(A distended central artery, a high-pressure attack!)
(Chorus)
You’ll know me by my shape! I’m triangular (try-an-GYOO-lar) or a Dome (dome) shaped!
My Base (base) abuts the pleura (a-buts the PLEW-ra), my Apex (AY-peks) points toward the home!
(Of the Hilum (HY-lum)!)
I’m the Hampton’s Hump (HAMP-tonz HUMP), the Wedge-shaped (wedge-shaypt) opacity (oh-PASS-it-tee)!
(Bridge – The “Diagnosis”)
The Iodine Map (EYE-oh-dine MAP) on CT (See-Tee) helps to show the way,
It shows the perfusion defect (per-FEW-zhun DEE-fekt) in shades of black and gray!
But in Acute PE (a-KYOOT PEE-EE), it’s a critical (KRIT-i-kal), key note!
That “infarct” (my wedge) is not necrosis (na-KRO-sis), (to quote)!
It’s edema (ee-DEE-ma) and hemorrhage (Heh-More-ije), a reversible (re-VER-si-bul) thing!
A true infarction is necrosis’s (na-KRO-sis’s) deathly sting!
(Chorus)
You’ll know me by my shape! I’m triangular (try-an-GYOO-lar) or a Dome (dome) shaped!
My Base (base) abuts the pleura (a-buts the PLEW-ra), my Apex (AY-peks) points toward the home!
(Of the Hilum (HY-lum)!)
I’m the Hampton’s Hump (HAMP-tonz HUMP), the Wedge-shaped (wedge-shaypt) opacity (oh-PASS-it-tee)!
Autopsy specimen of a wedge shaped hemorrhagic infarction characteristic of an acute or subacute infarction . The appearance of the thrombus (arrow b) suggests
code lungs pulmonary artery thrombosis embolus PE infarction hemorrhage hemorrhagic wedge shaped grosspathology
Hamptons hump
Ashley Davidoff MD TheCommonvein.net 24f PE Hampton’s hump 001
Ashley Davidoff, M.D.
PE pulmonary embolus infarction heart cardiac enlarged failure
Courtesy Ashley Davidoff MD 39693c04
Ashley Davidoff MD TheCommonvein.net 24f PE Hampton’s hump 003
✒️ 2. The Poem
Title: “The Pleural-Based Wedge”
I am the shadow, shaped like a wedge,
They call me Hampton’s Hump, right at the outer edge.
My base abuts the pleura’s line,
My apex points (a telling sign)
Back to the hilum, whence I came,
The result of an occlusive game.
But I’m not all… look for the Westermark,
(The oligemia, in the growing dark).
Or see the Fleischner sign’s wide-load,
(The central artery, overflowed).
The Iodine Map will show the plea,
The perfusion defect, plain to see.
Am I true necrosis? Or just a stain
Of hemorrhage and edema’s rain?
The timing is the key… to the infarct’s decree.
3. 📜 History, Etymology & Descriptors
| Title (with Wiki link) | Comments |
| History | • Rudolf Virchow (1856) was the first to link the two processes: he proved that an embolus (plug) from the veins causes the infarction (tissue death) in the lung.
• Dr. Hampton & Dr. Castleman (1940) described the “Hampton Hump,” the classic X-ray sign of a wedge-shaped, pleural-based opacity, which is the radiographic infarct. • Nils Westermark (1938) described the X-ray sign of oligemia (lucency) distal to a large embolus. • Felix Fleischner (1959) described the sign of a distended central pulmonary artery in massive PE. |
| Etymology | • From the Latin infarctus, the past participle of infarcire, which means “to stuff into” or “to plug up.”
• This describes the mechanism: the vessel is “stuffed” with an embolus, which then causes the tissue to also “stuff” with blood (hemorrhage). |
| Key Descriptors | • Hampton’s Hump: The classic sign: a wedge-shaped, pleural-based opacity with its apex toward the hilum.
• Westermark’s Sign: A sign of oligemia (less blood flow), where the lung distal to the embolus appears blacker (more lucent) than the surrounding lung. • Fleischner Sign: A prominent, distended central pulmonary artery due to the high pressure and clot burden. • Iodine Map (Perfusion Defect): A modern CT technique (Dual-Energy CT) that creates a color map showing exactly which areas of the lung are not receiving blood (perfusion). • “Not True Infarct”: The critical note that in acute PE, the “Hampton’s Hump” is often just hemorrhage & edema (which is reversible) and not yet necrosis (a true, permanent infarct). |
4. 🏛️ Cultural Context
| Title (with Wiki link) | Comments |
| Food (Pie/Cake Slice) | • The most common visual analogy for Hampton’s Hump.
• The infarct is a “slice of pie.” The “crust” (the wide part) is at the pleura, and the “point” of the slice aims toward the hilum. |
| Geography (River Delta) | • The “river” (pulmonary artery) is blocked (embolus).
• The backed-up water (blood) floods the “land” (lung) in a triangular “delta shape” (the Hampton’s Hump). • The “river” beyond the block dries up (the Westermark’s Sign). • The “dam” itself is bulging from the pressure (the Fleischner Sign). |
| Transportation (Traffic Jam) | • A CTA is a “traffic helicopter.”
• The Embolus is a “massive crash” blocking the highway (pulmonary artery). • The Iodine Map shows which “exits” are no longer receiving traffic (perfusion defect). • The Fleischner Sign is the “highway” before the crash, which is bulging and “jammed” with backed-up cars. |
| Warfare (Blockade) | • An embolus (the “enemy ship”) has blockaded a “port” (the pulmonary artery).
• The “city” (the lung parenchyma) distal to the blockade starves and dies (the infarct). |
5. 👥 Notable People
| Category | Names & Comments |
| Contributors | • Rudolf Virchow: (1821-1902) German pathologist who first proved that an embolus from the legs causes the infarction in the lungs.
• Aubrey Otis Hampton: (1900-1955) American radiologist who described the “Hampton Hump.” • Nils Westermark: (1892-1980) Swedish radiologist who described the “Westermark Sign.” • Felix Fleischner: (1893-1969) Austrian-American radiologist who described the “Fleischner Sign” (distended PA). |
| Patients | • (This is a complication of pulmonary embolism. Patients are the same.)
• Serena Williams: (b. 1981) American tennis player. Her life-threatening pulmonary embolism would have put her at high risk for infarction. • David Bloom: (1963-2003) American journalist who died from a massive PE, the cause of infarction. • Dick Cheney: (b. 1941) Former US Vice President, with a history of DVT/PE, the precursors to infarction. |