Larynx: internal laryngeal nerve: 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 · Larynx: internal laryngeal nerve

Sample item

After neck trauma a patient coughs poorly when food touches the right piriform fossa and aspirates liquids. The pitch of his voice is normal. Which nerve is injured?

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

The answer and the reasoning

B. Internal laryngeal nerve

The internal laryngeal nerve pierces the thyrohyoid membrane and supplies sensation to the larynx above the vocal folds and to the piriform fossa. Loss of this sensation abolishes the cough reflex and predisposes to aspiration. The cricothyroid, which controls pitch, is supplied by the external laryngeal nerve, so the voice is preserved.

Option by option

  • A. Glossopharyngeal nerve

    The glossopharyngeal nerve supplies the oropharynx and posterior third of the tongue.

  • B. Internal laryngeal nerve (correct)

    Correct. Sensory loss above the cords with preserved voice pitch points to the internal laryngeal nerve.

  • C. External laryngeal nerve

    The external laryngeal nerve supplies cricothyroid, and its loss would alter pitch.

  • D. Recurrent laryngeal nerve

    The recurrent laryngeal nerve supplies sensation below the vocal folds and all other intrinsic muscles.

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.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Internal laryngeal nerve. The internal laryngeal nerve pierces the thyrohyoid membrane and supplies sensation to the larynx above the vocal folds and to the piriform fossa.

Why is "Glossopharyngeal nerve" not the answer?

The glossopharyngeal nerve supplies the oropharynx and posterior third of the tongue.

Why is "External laryngeal nerve" not the answer?

The external laryngeal nerve supplies cricothyroid, and its loss would alter pitch.

Why is "Recurrent laryngeal nerve" not the answer?

The recurrent laryngeal nerve supplies sensation below the vocal folds and all other intrinsic muscles.

What concept does this question test?

It tests Larynx: internal laryngeal nerve in Anatomy. Loss of this sensation abolishes the cough reflex and predisposes to aspiration. The cricothyroid, which controls pitch, is supplied by the external laryngeal nerve, so the voice is preserved.

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 Larynx: internal laryngeal nerve?

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.