| Identifier |
Anhidrosis_1080p_Lee |
| Title |
Anhidrosis |
| Creator |
Andrew G. Lee, MD; Chelsea Livingston |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (CL) Class of 2022, Baylor College of Medicine, Houston, Texas |
| Subject |
Anhidrosis; Horner's Syndrome; Oculosympathetic Pathway |
| Description |
Dr. Lee lectures medical students on the subject of anhidrosis. |
| Transcript |
So today we're going to be talking about anhidrosis and its relationship to the Horner's syndrome which is the oculosympathetic pathway lesion. ‘An' means ‘not,' ‘hydrosis' is the sweating. So as you will recall, the hypothalamus is the starting point of the first order neuron in the three neuron chain. And then we've got posterolateral descent caudally of the first order neuron all the way down to ciliospinal center of Budge or ‘boojay' (or whatever the name's pronunciation is) and then exit white rami second order neuron over the apex of the lung. In that location, Pancoast tumor can occur. Then rides up the sympathetic chain passing without synapse through the inferior and the middle cervical ganglions to reach the angle of the jaw, and at that location is the superior cervical ganglion. At that location we have the synapse. It goes on to the internal carotid artery, passing through the skull base at the foramen lacerum to enter into the cavernous sinus. And in the cavernous sinus, the oculosympathetics jump for a short course on cranial nerve 6. In that location a 6 plus a Horner so that's called a Parkinson sign. That localizes to the cavernous sinus. And then to V, the fifth nerve, trigeminal subdivision 1, so the target organs. And what that means is the anhidrosis, which is not a normal complaint, can either be half your body if it's a hypothalamic lesion on the ipsilateral side, or it could be half your face(V1, V2, and V3) if the lesion is here at this superior cervical ganglion. But the body parts have already, the sweating parts have already left the primary first order neuron. And once you start getting into the cavernous sinus, V3 not really in the cavernous sinus, V2 in the posterior cavernous sinus. So when you just have V1 you're going to be anterior cavernous sinus and superior orbital fissure. And then finally you can just have this little branch of V1 which is right above your brow here, this supraorbital, supra trochlear branch. And those patients the lesion is obviously in the orbit. So the pattern of the anhidrosis in the patient with the Horner's syndrome can help us differentiate whether we're dealing with a first order neuron, a second order neuron, or a third order neuron in the oculosympathetic pathway. So when they say ‘I don't have sweat' you'd like to know is it half your body, half your face, just V1,or just this little strip right here. And that helps us localize. |
| Date |
2021-06 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6ns6tph |
| Setname |
ehsl_novel_lee |
| ID |
1701555 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6ns6tph |
