A fish bone lodges in the pyriform fossa of a 40-year-old man, triggering violent coughing and gagging. The afferent limb of this protective cough reflex from the laryngeal inlet above the vocal cords travels via:
- A Recurrent laryngeal nerve
- B External laryngeal nerve
- C Internal laryngeal nerve ✓
- D Glossopharyngeal nerve
Correct answer: C. Internal laryngeal nerve
Explanation
The internal laryngeal nerve, a branch of the superior laryngeal nerve, carries all sensory fibres from the laryngeal mucosa above the vocal cords, including the pyriform fossa and epiglottis, and mediates the protective cough reflex. Below the vocal cords, sensation is carried by the recurrent laryngeal nerve. The external laryngeal nerve is purely motor to cricothyroid, and the glossopharyngeal supplies the oropharynx, not the larynx.
Reference: Gray's Anatomy for Students, 4th ed.
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