Hoarseness is a clinical feature of invasion of which nerve?

Prepare for your CVP and GI Pathology Exam. Study using flashcards and multiple choice questions with hints and explanations to excel in your test.

Hoarseness arises when the vocal cords cannot be moved properly, which happens when the intrinsic muscles of the larynx are not innervated correctly. The recurrent laryngeal nerve, a branch of the vagus, provides the motor supply to nearly all these intrinsic muscles and thus to the vocal cords. If this nerve is invaded or damaged, the affected vocal cord cannot adduct and tense normally, leading to a breathy, hoarse voice. The nerve’s course—looping under the aorta on the left and under the subclavian on the right—puts it at risk from mediastinal or thyroid tumors, explaining why invasion often presents with hoarseness. In contrast, the phrenic nerve affects the diaphragm and breathing, the hypoglossal nerve affects tongue movements, and while vagus nerve injury can cause multiple deficits, the characteristic hoarseness from vocal cord paralysis points to the recurrent laryngeal nerve.