NBCRNA EXAM QUESTIONS AND CORRECT
ANSWERS| LATEST UPDATE
What muscle abducts the vocal cords?
posterior cricoarytenoid
What is the only muscle that tenses (elongates) the vocal cords?
cricothyroid "cords tense"
What muscle opens the glottis?
thyroepiglottic
What two muscles close the glottis?
aryepiglottic
oblique arytenoid
What muscles adduct the vocal cords and arytenoids?
- there are two
lateral cricoarytenoid
transverse arytenoid
What muscle shortens the vocal cords? (relaxes?)
,- there are two
thyroarytenoid "they relax"
vocalis
The cricothyroid muscle is innervated by?
external branch of SLN
- the only branch that tenses (elongates) the VCs
The internal branch of the SLN is purely?
- sensory or motor?
sensory
Recurrent laryngeal innervates...
below vocal cords --> the trachea
Branches off vagus in thorax
Motor: all intrinsic except cricothyroid
Glossopharyngeal innervates...
the vallecula
topside of epiglottis
soft palate
oropharynx
post 1/3 of tongue
,tonsils
afferent limb of gag reflex
CN IX - sensory
Superior laryngeal innervates...
posterior epiglottis --> vocal cords
Internal branch is sensory - underside of epiglottis
External branch is motor - cricothyroid muscle
Trigeminal (V) V3 innervates...
anterior 2/3 tongue
Trigeminal nerve (V) contains what 3 branches?
V1 ophthalmic (anterior ethmoidal) - nares/ant 1/3 septum
V2 maxillary (sphenopalatine) - turbinates/septum
V3 Mandibular (lingual)
Superior laryngeal nerve block:
3ml at the inferior aspect of the greater cornu of hyoid bone bilaterally
- helps tolerate FO intubation once past the oropharynx
Glossopharyngeal block:
, 1-2 ml at the tonsillar pillar bilaterally
Transtracheal block:
3-5 ml through the cricothyroid membrane
What is most likely to injure the left RLN while sparing the right RLN?
Mitral stenosis (LA enlargement compresses the nerve and may present as
hoarseness)
PDA ligation
Aortic arch aneurysm
Thoracic tumor
Causes of left OR right RLN injury:
parathyroid or thyroid surgery
external pressure from LMA/ETT
neck tumor
neck extension
Where does the right RLN loop?
left RLN loop?
ANSWERS| LATEST UPDATE
What muscle abducts the vocal cords?
posterior cricoarytenoid
What is the only muscle that tenses (elongates) the vocal cords?
cricothyroid "cords tense"
What muscle opens the glottis?
thyroepiglottic
What two muscles close the glottis?
aryepiglottic
oblique arytenoid
What muscles adduct the vocal cords and arytenoids?
- there are two
lateral cricoarytenoid
transverse arytenoid
What muscle shortens the vocal cords? (relaxes?)
,- there are two
thyroarytenoid "they relax"
vocalis
The cricothyroid muscle is innervated by?
external branch of SLN
- the only branch that tenses (elongates) the VCs
The internal branch of the SLN is purely?
- sensory or motor?
sensory
Recurrent laryngeal innervates...
below vocal cords --> the trachea
Branches off vagus in thorax
Motor: all intrinsic except cricothyroid
Glossopharyngeal innervates...
the vallecula
topside of epiglottis
soft palate
oropharynx
post 1/3 of tongue
,tonsils
afferent limb of gag reflex
CN IX - sensory
Superior laryngeal innervates...
posterior epiglottis --> vocal cords
Internal branch is sensory - underside of epiglottis
External branch is motor - cricothyroid muscle
Trigeminal (V) V3 innervates...
anterior 2/3 tongue
Trigeminal nerve (V) contains what 3 branches?
V1 ophthalmic (anterior ethmoidal) - nares/ant 1/3 septum
V2 maxillary (sphenopalatine) - turbinates/septum
V3 Mandibular (lingual)
Superior laryngeal nerve block:
3ml at the inferior aspect of the greater cornu of hyoid bone bilaterally
- helps tolerate FO intubation once past the oropharynx
Glossopharyngeal block:
, 1-2 ml at the tonsillar pillar bilaterally
Transtracheal block:
3-5 ml through the cricothyroid membrane
What is most likely to injure the left RLN while sparing the right RLN?
Mitral stenosis (LA enlargement compresses the nerve and may present as
hoarseness)
PDA ligation
Aortic arch aneurysm
Thoracic tumor
Causes of left OR right RLN injury:
parathyroid or thyroid surgery
external pressure from LMA/ETT
neck tumor
neck extension
Where does the right RLN loop?
left RLN loop?
