Head and neck: thyroid surgery: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Head and neck: thyroid surgery

Sample item

After total thyroidectomy a singer reports loss of high-pitched notes and easy voice fatigue, with a normal-sounding speaking voice and normal cords on laryngoscopy. Which structure was injured?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. External branch of the superior laryngeal nerve

The external laryngeal nerve supplies the cricothyroid muscle, which tenses the vocal cords for high pitch. It runs close to the superior thyroid artery, so it is at risk during ligation of the upper pole. Recurrent laryngeal injury instead causes hoarseness and cord paralysis.

Option by option

  • A. Internal branch of the superior laryngeal nerve

    The internal branch is sensory to the supraglottic larynx and does not control pitch.

  • B. Recurrent laryngeal nerve

    Recurrent laryngeal injury causes hoarseness with an immobile cord, not isolated loss of pitch.

  • C. External branch of the superior laryngeal nerve (correct)

    Correct. Loss of cricothyroid function reduces pitch range.

  • D. Hypoglossal nerve

    The hypoglossal nerve is motor to the tongue and does not alter pitch.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, External branch of the superior laryngeal nerve. The external laryngeal nerve supplies the cricothyroid muscle, which tenses the vocal cords for high pitch.

Why is "Internal branch of the superior laryngeal nerve" not the answer?

The internal branch is sensory to the supraglottic larynx and does not control pitch.

Why is "Recurrent laryngeal nerve" not the answer?

Recurrent laryngeal injury causes hoarseness with an immobile cord, not isolated loss of pitch.

Why is "Hypoglossal nerve" not the answer?

The hypoglossal nerve is motor to the tongue and does not alter pitch.

What concept does this question test?

It tests Head and neck: thyroid surgery in Anatomy. It runs close to the superior thyroid artery, so it is at risk during ligation of the upper pole. Recurrent laryngeal injury instead causes hoarseness and cord paralysis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck: thyroid surgery?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.