On the right side, the recurrent laryngeal nerve loops around which structure before ascending in the tracheoesophageal groove?

• A Ligamentum arteriosum
• B Right subclavian artery ✓
• C Arch of the aorta
• D Right brachiocephalic vein

Explanation

The right recurrent laryngeal nerve leaves the vagus anterior to the right subclavian artery and hooks beneath and behind it, then ascends in the tracheoesophageal groove to supply all intrinsic laryngeal muscles except the cricothyroid. The left nerve loops around the arch of the aorta just lateral to the ligamentum arteriosum. This asymmetry explains why thoracic lesions such as apical lung tumors or aortic aneurysms cause left-sided vocal cord paralysis more often.

Reference: Gray's Anatomy, 42nd ed.

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Written and medically reviewed by the StethoPrep medical team.