Head and Neck Anatomical Structures · USMLE Step 1

A patient develops hoarseness after thyroid surgery. Injury to which nerve is the most likely cause?

  1. Internal branch of superior laryngeal nerve
  2. External branch of superior laryngeal nerve
  3. Recurrent laryngeal nerve
  4. Glossopharyngeal nerve
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Correct answer: Recurrent laryngeal nerve

The recurrent laryngeal nerve innervates all intrinsic laryngeal muscles except cricothyroid. Damage results in hoarseness due to impaired vocal cord movement.

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