Recurrent laryngeal nerve (right, anatomy)

The right recurrent laryngeal nerve originates from the descending right vagus nerve as it passes intermediate to the right subclavian vein anteriorly and the right subclavian artery posteriorly. It curves posteriorly around the inferior margin of the right subclavian artery. Then, it passes medially and ascends over the posterolateral surface of the trachea into the groove between oesophagus and trachea.

Ascending in the tracheo-oesophageal groove, consecutively the recurrent laryngeal nerve is related to:

• medially:
  • small branches it gives off to supply mucosa of the upper oesphagus
  • inferior thyroid artery
  • inferior thyroid veins
• laterally:
  • paratracheal lymph nodes
  • parathyroid glands
  • lateral lobe of thyroid gland

On route, it also gives off cardiac and tracheal branches.

At the level of the thyroid gland, it passes beneath the inferior border of the muscle cricopharyngeus to run deep to it and superiorly towards the pharynx and larynx. Within the latter areas, the recurrent laryngeal nerve supplies the:

• intrinsic laryngeal muscles except cricothyroid - special visceral motor fibres:
  • posterior cricoarytenoids
  • lateral cricoarytenoids
  • transverse arytenoids
  • oblique arytenoids
  • thyroarytenoids
  • vocalis
• mucosa of the larynx and pharynx below the vocal cords inferiorly to the top of the oesophagus and trachea