An adult inhales a peanut that lodges above the right vocal fold. The patient coughs violently. The afferent limb of the cough reflex arising from the laryngeal mucosa above the vocal folds is carried by which nerve?

• A Glossopharyngeal nerve
• B External branch of the superior laryngeal nerve
• C Recurrent laryngeal nerve
• D Internal branch of the superior laryngeal nerve ✓

Explanation

Mucosa above the vocal folds, including the vestibule, ventricle and laryngeal surface of the epiglottis, is supplied by the internal laryngeal nerve, which pierces the thyrohyoid membrane with the superior laryngeal vessels and carries general sensation to the nucleus of the tractus solitarius via vagus. Below the folds the recurrent laryngeal nerve takes over, so option C covers only infraglottic mucosa.

Reference: Gray's Anatomy for Students, 4th ed.

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