Which of the following clinical conditions is most likely to result in hoarseness during speech?: (A) Bronchogenic carcinoma of the apical segment of the right lung, (B) Mitral valve insufficiency, (C) Pulmonary thromboembolism, (D) Retroesophageal right subclan aery
Answer is A. A tumor of the apical segment of the upper lobe may impinge on the recurrent laryngeal nerve since it ascends from the superior mediastinum to the root of the neck in a groove between the trachea and esophagus. The recurrent laryngeal nerve supplies all intrinsic muscles of the larynx except the cricothyroid.