During total thyroidectomy for a 5 cm right lobe nodule, the surgeon identifies a nerve entering the larynx just posterior to the cricothyroid joint. It runs in the tracheo-oesophageal groove and passes posterior to the inferior thyroid artery. Which statement about this nerve is correct?

• A This is the external branch of the superior laryngeal nerve which runs with the superior thyroid vessels
• B This is the right recurrent laryngeal nerve which loops around the aortic arch
• C This is the right recurrent laryngeal nerve which loops around the right subclavian artery ✓
• D This is the left recurrent laryngeal nerve which loops around the aortic arch

Explanation

The right recurrent laryngeal nerve loops around the right subclavian artery (not the aortic arch). It ascends in or near the tracheo-oesophageal groove, passes posterior to the inferior thyroid artery in most cases, and enters the larynx posterior to the cricothyroid joint. The left RLN loops around the aortic arch. The description fits the anatomical course of the right RLN perfectly.

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

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Written and medically reviewed by the StethoPrep medical team.