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Anatomy Head & Neck 8a782af1

All of the following are features of Horner's syndrome EXCEPT:

A
Ptosis
B
Miosis
C
Heterochromia iridis
D
Exophthalmos
High-Yield Explanation
Ans. (d) ExophthalmosRef: Gray's 41sted./469* Horner syndrome presents with:# Ptosis# Miosis# Anhydrosis and,}TRIAD# Apparent enopnthalmos (and not exophthalmos;.* This enophthalmus is due to paralysis of the orbitalis muscle of the orbit, which normally keeps the eyeball prominent. Its nerve supply is sympathetic -T1 and when paralyzed leads to appearance of sunken eyeball.* Most cases are idiopathic, but it could be due to brainstem lesions, carotid dissection, or neoplasm compressing upon the sympathetic chain (E.g., Pancoast tumour).* Symptoms of horners syndrome are secondary to sympathetic nerve (Tl) lesion.* Sympathetic nervous system is concerned with the fright/fight/flight (Emergency) reaction and leads to:# Elevation of upper eyelid by Muller muscle (wide open eyes)# Pupillary dilatation by Dilator pupillae (wide open pupils)# Sweating (sudomotor)# Pallor of the skin (vasomotor)* This activity is under Sympathetic T-l nerves in the face, and are lesioned in Horner syndrome leading to:# Drooping of upper eyelid (ptosis) - due to unopposed orbicularis oculi# Pupillary constriction (miosis) - due to unopposed sphincter papillae# Loss of sweating (anhydrosis)# Red flushed face - due to loss of vasoconstrictive tone to the skin.

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