Vascular surgery: nerve injury in carotid endarterectomy: 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 · Vascular surgery: nerve injury in carotid endarterectomy

Sample item

After a right carotid endarterectomy, a man's tongue deviates to the right when he protrudes it, and he has difficulty moving food around his mouth. Which nerve was injured during the operation?

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

The answer and the reasoning

C. Hypoglossal nerve

The hypoglossal nerve crosses the internal and external carotid arteries just above the bifurcation and is at risk during dissection. Paralysis of genioglossus makes the protruded tongue deviate toward the injured side.

Option by option

  • A. Vagus nerve

    Vagus or recurrent laryngeal injury causes hoarseness, not tongue deviation.

  • B. Marginal mandibular branch of the facial nerve

    Injury to the marginal mandibular nerve causes drooping of the corner of the lower lip.

  • C. Hypoglossal nerve (correct)

    Correct. Hypoglossal palsy makes the tongue deviate toward the side of the lesion.

  • D. Glossopharyngeal nerve

    The glossopharyngeal nerve injury mainly affects pharyngeal sensation and stylopharyngeus, and does not deviate the tongue.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Hypoglossal nerve. The hypoglossal nerve crosses the internal and external carotid arteries just above the bifurcation and is at risk during dissection.

Why is "Vagus nerve" not the answer?

Vagus or recurrent laryngeal injury causes hoarseness, not tongue deviation.

Why is "Marginal mandibular branch of the facial nerve" not the answer?

Injury to the marginal mandibular nerve causes drooping of the corner of the lower lip.

Why is "Glossopharyngeal nerve" not the answer?

The glossopharyngeal nerve injury mainly affects pharyngeal sensation and stylopharyngeus, and does not deviate the tongue.

What concept does this question test?

It tests Vascular surgery: nerve injury in carotid endarterectomy in General Surgery. Paralysis of genioglossus makes the protruded tongue deviate toward the injured side.

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 Vascular surgery: nerve injury in carotid endarterectomy?

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.