SCID 243 - Quiz 1 - Pharynx & Larynx

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| By Permphan

Permphan

Community Contributor

Quizzes Created: 15 | Total Attempts: 28,387

Questions: 7 | Attempts: 349 | Updated: Mar 22, 2023

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Questions and Answers

1.

Following thyroid surgery, it was noted that a patient frequently aspirated fluid into her lungs. Upon examination it was determined that the area of the piriform recess above the vocal fold of the larynx was numb. What nerve may have been injured?
- A.
  
  External branch of the superior pharyngeal
- B.
  
  Hypoglossal
- C.
  
  Internal branch of the superior laryngeal
- D.
  
  Lingual
- E.
  
  Recurrent laryngeal
Correct Answer
C. Internal branch of the superior laryngeal

Explanation
The internal branch of the superior laryngeal is a sensory nerve that pierces the thyrohyoid membrane along with the superior laryngeal artery. It supplies sensory fibers to the mucous membrane of the larynx, superior to the vocal folds. Since this area lost sensation, it appears that the internal branch of the superior laryngeal nerve must have been injured.

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2.

The vocalis muscle is most responsible for the fine control of phonation because of its attachment into the: ________
- A.
  
  Arytenoid cartilage
- B.
  
  Cricoid cartilage
- C.
  
  Thyroid cartilage
- D.
  
  Vestibular ligament
- E.
  
  Vocal ligament
Correct Answer
E. Vocal ligament

Explanation
Vocalis represents the innermost fibers of the thyroarytenoid muscle, from the inner surface of the thyroid cartilage. Because vocalis inserts on the vocal ligament, it can relax very specific segments of the vocal ligament to adjust the pitch.

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3.

Twenty-four hours following a partial thyroidectomy where the inferior thyroid artery was also ligated (tied off), the patient now spoke with a hoarse voice (whisper), and had difficulty in breathing. Which nerve was injured?
- A.
  
  Internal branch of superior laryngeal
- B.
  
  Ansa cervicalis
- C.
  
  Ansa subclavia
- D.
  
  Recurrent laryngeal
- E.
  
  External branch of superior laryngeal
Correct Answer
D. Recurrent laryngeal

Explanation
The recurrent laryngeal nerve runs with the inferior thyroid artery toward the lower lobes of the thyroid. This means that the recurrent laryngeal nerve would be at risk in any surgery involving the inferior thyroid artery or the inferior poles of the thyroid.

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4.

A 60-year-old man has occasional blackouts and light-headedness. Studies reveal atherosclerotic plaques within the common carotid arteries and the bifurcation of the vessels. A carotid endartectomy is undertaken. Which nerve bundle running vertically within the carotid sheath must the surgeon be careful not to injure?
- A.
  
  Accessory
- B.
  
  Cervical sympathetic trunk
- C.
  
  Glossopharyngeal
- D.
  
  Hypoglossal
- E.
  
  Vagus
Correct Answer
E. Vagus

Explanation
In a carotid endarterectomy, surgeons enter the carotid artery and excise the diseased endothelium and media of the artery so that the lumen is left with a smooth lining. To do this, the surgeons must enter the carotid sheath, which means that any structure within that sheath or near that sheath might be injured. This question specifically asks which structure in the sheath could be injured, so the correct answer is the vagus nerve.

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5.

A 55-year-old woman has difficulty swallowing and frequently aspirates fluids while drinking. She is diagnosed as having a skull base tumor occupying the space behind the jugular foramen. Involvement of which structure is responsible for the findings?
- A.
  
  Ansa cervicalis
- B.
  
  Cervical sympathetic trunk
- C.
  
  Accessory nerve
- D.
  
  Hypoglossal nerve
- E.
  
  Vagus
Correct Answer
E. Vagus

Explanation
The vagus nerve, which exits the skull through the jugular foramen, is the motor nerve to the pharynx. So, it allows for swallowing. This patient's symptoms and the location of the tumor clearly point to an injury of the vagus nerve.

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6.

The carotid body is innervated by a branch of the: _________
- A.
  
  Glossopharyngeal nerve
- B.
  
  Hypoglossal nerve
- C.
  
  Spinal accessory nerve
- D.
  
  Sympathetic trunk
- E.
  
  Vagus nerve
Correct Answer
A. Glossopharyngeal nerve

Explanation
The carotid body is innervated by the carotid branch of the glossopharyngeal nerve. It is a small, reddish-brown ovoid mass that lies on the medial side of the carotid bifurcation, serving as a chemoreceptor that monitors the level of carbon dioxide in the blood.

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7.

Any manipulation of the superior thyroid artery must be undertaken with care not to damage its small companion nerve, the: ______
- A.
  
  Cervical sympathetic trunk
- B.
  
  External branch of the superior laryngeal
- C.
  
  Inferior root of the ansa cervicalis
- D.
  
  Internal branch of the superior laryngeal
- E.
  
  Recurrent laryngeal
Correct Answer
B. External branch of the superior laryngeal

Explanation
The external branch of the superior laryngeal nerve runs with the superior thyroid artery--this artery and nerve might be damaged when removing the superior pole of the thyroid. If this nerve was damaged, the cricothyroid muscle would be paralyzed, and a patient would be unable to tense the vocal cords.

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Current Version
Mar 22, 2023

Quiz Edited by
ProProfs Editorial Team
Oct 23, 2015

Quiz Created by
Permphan

SCID 243 - Quiz 1 - Pharynx & Larynx

Following thyroid surgery, it was noted that a patient frequently aspirated fluid into her lungs. Upon examination it was determined that the area of the piriform recess above the vocal fold of the larynx was numb. What nerve may have been injured?

The vocalis muscle is most responsible for the fine control of phonation because of its attachment into the: ________

Twenty-four hours following a partial thyroidectomy where the inferior thyroid artery was also ligated (tied off), the patient now spoke with a hoarse voice (whisper), and had difficulty in breathing. Which nerve was injured?

A 55-year-old woman has difficulty swallowing and frequently aspirates fluids while drinking. She is diagnosed as having a skull base tumor occupying the space behind the jugular foramen. Involvement of which structure is responsible for the findings?

The carotid body is innervated by a branch of the: _________

Any manipulation of the superior thyroid artery must be undertaken with care not to damage its small companion nerve, the: ______