Image Based Question – 66634

From the following given options,all are true about the nerve as shown in the image by arrow,except:

A. It lies close to superior thyroid artery

B. Lies in close proximity to Berry’s Ligament

C. Left side of the nerve is injured more frequently

D. Sensory branch supplies below the level of the vocal folds

Show Answer

Correct Answer » A Explanation

Ans:A. It lies close to superior thyroid artery

The image shown is of both sides of recurrent laryngeal nerve.

RECURRENT LARYNGEAL NERVE

• Arises from the Vagus, travels further on the left where it loops around the arch of Aorta while on the right, it travels around the subclavian artery.

• Left recurrent Laryngeal nerve is injured more frquently because of its longer and more extensive course.

• The RLN is often in close proximity to Berry’s ligament.

• The distal end of the RLN was identified along the tracheoesophageal groove.

• The most common angle that the RLN forms with the tracheoesophageal groove is 15-30 degree.

• When enlarged, tubercle of Zuckerkandl is a consistent landmark for the RLN because the nerve almost always courses medial and deep to it.

• Rarely (0.5% to 1% of individuals), in presence of aberrant right subclavian artery, arising from the aorta after the left subclavian artery has given off, the right RLN passes directly from the vagus nerve in the neck towards the larynx and does not recur around subclavian artery. This uncommon anatomic variation of the RLN makes it highly susceptible to surgical injury and is known as right “nonrecurrent” laryngeal nerve.

• The recurrent laryngeal nerve lies close to inferior thyroid artery.

• Its motor branch supplies all the intinsic muscles of the larynx(Lateral cricoarytenoid, posterior cricorytenoid, transverse and oblique interarytenoid and thyroarytenoid) except Cricothyroid.

• Sensory branch supplies the mucosa of the vocal cord and the subglottis(below the level of the vocal folds).