USMLE Forum Archives - USMLE Step 2 CK - General Surgery- Post-Surg Hoarseness
General Surgery- Post-Surg Hoarseness
InSitu - 05-02-09 02:22
30 yo female presents with hoarseness 2 days after undergoing a thyroidectomy removing a cancerous lesion. Which of the following nerve most likely injured?
InSitu - 05-02-09 02:22
30 yo female presents with hoarseness 2 days after undergoing a thyroidectomy removing a cancerous lesion. Which of the following nerve most likely injured?
The correct answer and explanation will be available after you answer.
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#1
Re: General Surgery- Post-Surg Hoarsenes bingousmle - 05-02-09 02:42 she has a damaged recurrent laryngeal nerve since it supplies the laryngeal muscles except the cricothyroid..
#2
Re: General Surgery- Post-Surg Hoarsenes
InSitu - 05-02-09 02:44 This new feature is great but there is an interactive component that will soon be added.
#4
Re: General Surgery- Post-Surg Hoarsenes InSitu - 05-03-09 23:17 thanks ... can you tell me where classically this nerve wraps around and usually gets affected by a disease condition causing hoarseness as well?
#5
Re: General Surgery- Post-Surg Hoarsenes ammara - 05-04-09 01:33 The nerve is best known for its importance in thyroid surgery, as it runs immediately posterior to this gland
the right recurrent laryngeal nerve loops around subclavian artery while left 1 loops around arch of aorta
#6
Re: General Surgery- Post-Surg Hoarsenes bingousmle - 05-04-09 01:41 left atrial hypertrophy in mitral stenosis is known to produce hoarseness due to pressure on the recurrent laryngeal nerve..
#7
Re: General Surgery- Post-Surg Hoarsenes InSitu - 05-04-09 01:49 
posted by bingousmle on 05-04-09 01:41
left atrial hypertrophy in mitral stenosis is known to produce hoarseness due to pressure on the recurrent laryngeal nerve..
left atrial hypertrophy in mitral stenosis is known to produce hoarseness due to pressure on the recurrent laryngeal nerve..
left or right branch? I know that maybe a step 1 question but why not review.
#9
Re: General Surgery- Post-Surg Hoarsenes InSitu - 05-04-09 01:52 Actually ammara answered that in specific in relation to which branch.... I got the 2 answers i was waiting from form both of you...thanks :)
#11
Re: General Surgery- Post-Surg Hoarsenes InSitu - 05-04-09 02:35 posted by bingousmle on 05-04-09 02:27
so which branch is it?
so which branch is it?
Normal anatomy of the recurrent laryngeal nerve. Right side the recurrent laryngeal nerve hooks around behind the subclavian artery, while on the left side this nerve passes around behind the aortic arch before ascending in the neck.
So for thyroid surgery the right branch is affected and in Left atrial hypertrophy the Left branch is affected.
You mentioned the Left atrial hypertrophy so its the left recurrent laryngeal nerve in that case.
#12
Re: General Surgery- Post-Surg Hoarsenes ammara - 05-04-09 02:39 thank u so much 4 telling..i think i understood half of the question only ;p
#13
Re: General Surgery- Post-Surg Hoarsenes bingousmle - 05-04-09 02:50 posted by InSitu on 05-04-09 02:35
Normal anatomy of the recurrent laryngeal nerve. Right side the recurrent laryngeal nerve hooks around behind the subclavian artery, while on the left side this nerve passes around behind the aortic arch before ascending in the neck.
So for thyroid surgery the right branch is affected and in Left atrial hypertrophy the Left branch is affected.
You mentioned the Left atrial hypertrophy so its the left recurrent laryngeal nerve in that case.
Normal anatomy of the recurrent laryngeal nerve. Right side the recurrent laryngeal nerve hooks around behind the subclavian artery, while on the left side this nerve passes around behind the aortic arch before ascending in the neck.
So for thyroid surgery the right branch is affected and in Left atrial hypertrophy the Left branch is affected.
You mentioned the Left atrial hypertrophy so its the left recurrent laryngeal nerve in that case.
thyroid surgey can affect either of the branches , isnt it?
#14
Re: General Surgery- Post-Surg Hoarsenes InSitu - 05-04-09 03:00 posted by bingousmle on 05-04-09 02:50
thyroid surgey can affect either of the branches , isnt it?
thyroid surgey can affect either of the branches , isnt it?
yes most likely since both ascent upward on both sides they are both affected or need to watch for in thyroid surgery. I think the most to take form this the way the LEFT loops arround the aortic arch and how it is affected by left atrial hypertrophy and that is commonly tested specially in step 1.
#15
Re: General Surgery- Post-Surg Hoarsenes bingousmle - 05-04-09 03:10 yeah the concept is high yield for step one..
#55
Re: General Surgery- Post-Surg Hoarsenes conym5 - 12-13-09 13:44 The recurrent laryngeal nerve (RLN) innervates all of the intrinsic muscles of the larynx with the exception of the cricothyroid muscle, which is innervated by the superior laryngeal nerve (SLN). The consequence of an RLN injury is true vocal-fold paresis or paralysis.
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