Larynx and airway: bronchogenic carcinoma and left vocal cord palsy: practice question

A ENT 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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ENT · Larynx and airway: bronchogenic carcinoma and left vocal cord palsy

Sample item

A 62-year-old smoker has a hoarse breathy voice. The left vocal cord is fixed in the paramedian position and chest X-ray shows a hilar mass. Where is the nerve most likely compressed?

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

The answer and the reasoning

D. Aortopulmonary window

The left recurrent laryngeal nerve loops under the aortic arch near the ligamentum arteriosum, and nodes in the aortopulmonary window can compress it. The right nerve loops under the subclavian artery and can be involved by an apical tumour.

Option by option

  • A. Subcarinal space

    The subcarinal space lies below the nerve's course.

  • B. Right paratracheal region

    The right paratracheal region does not contain the left recurrent nerve.

  • C. Thoracic inlet at the subclavian artery

    The subclavian loop belongs to the right recurrent nerve.

  • D. Aortopulmonary window (correct)

    Correct. The left nerve passes through the aortopulmonary window beneath the arch.

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 ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Aortopulmonary window. The left recurrent laryngeal nerve loops under the aortic arch near the ligamentum arteriosum, and nodes in the aortopulmonary window can compress it.

Why is "Subcarinal space" not the answer?

The subcarinal space lies below the nerve's course.

Why is "Right paratracheal region" not the answer?

The right paratracheal region does not contain the left recurrent nerve.

Why is "Thoracic inlet at the subclavian artery" not the answer?

The subclavian loop belongs to the right recurrent nerve.

What concept does this question test?

It tests Larynx and airway: bronchogenic carcinoma and left vocal cord palsy in ENT. The right nerve loops under the subclavian artery and can be involved by an apical tumour.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 and airway: bronchogenic carcinoma and left vocal cord palsy?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.