Thyroid: nerve injury: practice question

A General Surgery 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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General Surgery · Thyroid: nerve injury

Sample item

After thyroidectomy, a professional singer finds that she cannot reach high notes and her voice tires easily, though her voice is otherwise normal and there is no stridor. Which nerve is most likely injured?

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

The answer and the reasoning

B. External branch of the superior laryngeal nerve

The external branch of the superior laryngeal nerve supplies cricothyroid, which tenses the vocal cords for high pitch. It runs close to the superior thyroid vessels, so it is at risk when the upper pole is ligated, and the injury is often unrecognised except by voice professionals.

Option by option

  • A. Vagus nerve trunk

    Vagal injury would produce a paralysed cord with other deficits beyond this isolated change.

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

    Correct. Cricothyroid paralysis loses pitch range and causes vocal fatigue.

  • C. Unilateral recurrent laryngeal nerve

    Unilateral recurrent injury causes hoarseness from a paralysed, medially placed cord rather than just loss of pitch.

  • D. Internal branch of the superior laryngeal nerve

    The internal branch is sensory to the supraglottic larynx, and injury risks aspiration rather than loss of 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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

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

Why is "Vagus nerve trunk" not the answer?

Vagal injury would produce a paralysed cord with other deficits beyond this isolated change.

Why is "Unilateral recurrent laryngeal nerve" not the answer?

Unilateral recurrent injury causes hoarseness from a paralysed, medially placed cord rather than just loss of pitch.

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

The internal branch is sensory to the supraglottic larynx, and injury risks aspiration rather than loss of pitch.

What concept does this question test?

It tests Thyroid: nerve injury in General Surgery. It runs close to the superior thyroid vessels, so it is at risk when the upper pole is ligated, and the injury is often unrecognised except by voice professionals.

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 Thyroid: nerve injury?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.