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THE LARYNX

Total questions: 10

Worksheet time: 20mins

Name
Class
Date
1.

A 68-year-old female with a history of uncontrolled hypertension presents to the clinic for follow-up of an abnormal finding on a recent CT scan. She presented to the emergency department 3 days ago for difficulty breathing that had progressively gotten worse over the last few weeks. The CT scan revealed a 5 cm aneurysm compressing the anterior aspect of the trachea at the 8-10 tracheal rings. An open repair of the aneurysm with a prosthetic graft is planned. Due to its location, what structure is most at risk of injury during the surgery?

a)

Esophagus

b)

Right vagus nerve

c)

Left recurrent laryngeal nerve

d)

Phrenic nerve

2.

A 50-year-old female undergoes thyroid lobectomy. During the surgery, the muscle that runs along with the lateral cricoid cartilage and has two bellies is damaged. What is the nerve supply of this muscle?

a)

Superior laryngeal nerve

b)

Recurrent laryngeal nerve

c)

Sympathetic fibers

d)

Internal laryngeal nerve

3.

A 68-year-old man presents to the clinic with loss of appetite, nausea, vomiting, increased thirst, and frequent urination. Physical exam elicits no abnormal findings. Laboratory exam elicits a serum calcium level of 12.5 mg/dL and an elevated PTH level. Parathyroidectomy is performed from an anterior cervical approach. Following the surgery, the patient has a hoarse voice and eventually develops aspiration pneumonia. Which of the following nerves is most likely to have been damaged during the surgery?

a)

Inferior laryngeal nerve

b)

Recurrent laryngeal nerve

c)

Vagus nerve

d)

Superior laryngeal nerve

4.

A 58-year-old man presents to the otolaryngologist with a 4-month history of hoarseness. Flexible laryngoscopy reveals grossly intact laryngeal movement despite hoarseness. The physician suspects that low vocal cord tension is the underlying pathology. Which of the following intrinsic laryngeal muscles is likely damaged?

a)

Thyroarytenoids

b)

Cricothyroid

c)

Thyroepiglottics

d)

Oblique arytenoid

5.

A 50-year-old woman undergoes a thyroid lobectomy. During surgery, the muscle that extends from the cricoid cartilage arch to the muscular process of the arytenoid cartilage is damaged. What is the nerve supply of this muscle?

a)

Superior laryngeal nerve

b)

Recurrent laryngeal nerve

c)

Sympathetic fibers from the superior cervical ganglion

d)

Branches from the ansa cervicalis

6.

During a unilateral thyroid lobectomy, the general surgeon performing the operation damages the thyrohyoid membrane. If the adjacent vascular supply becomes compromised, which muscle could become impaired?

a)

Thyroarytenoid muscle

b)

Thyrohyoid muscle

c)

Sternothyroid muscle

d)

Sternohyoid muscle

7.

A 35-year-old female singer comes to the office for a post op visit from a thyroidectomy. She denies any hoarseness, but can no longer sing high notes since the surgery a week ago. She also describes her voice as "weak." What nerve was injured and which muscle is likely not functioning as a result?

a)

Recurrent laryngeal nerve, Cricothyroid

b)

Superior laryngeal nerve, Cricothyroid

c)

Vagus nerve, posterior cricoarytenoid

d)

Superior laryngeal nerve,posterior cricoarytenoid

8.

Wrong pair of matching regarding the muscles working on vocal cords;

a)

Thyroarytenoid : relaxor

b)

Lateral cricoarytenoid: adductor

c)

Posterior cricoarytenoid : abductor

d)

Cricothyroid: tensor

9.

During a thyroid operation, a nerve coursing along with the superior thyroid artery is injured what can be the possible consequence?

a)

Loss of sensation above vocal cord

b)

Loss of sensation below vocal cord

c)

Paralysis of lateral cricoarytenoid muscle

d)

Paralysis of Cricothyroid muscle

10.

Which muscle is responsible for abduction of vocal cord in the given diagram ?

a)

A

b)

B

c)

C

d)

D