OMM COMAT QUIZZES WITH
ACCURATE RIGHT ANSWERS.
A 22-year-old female presents with right forearm paresthesia. Structural examination reveals restricted
transverse carpal ligament and palmar fasciae. Which of the following represents the most appropriate
initial position when performing direct myofascial release? ANS - E. Forearm supinated with the wrist
neutral or extended
A 44-year-old male presents with debilitating left lower back pain and dark, tinted urine of one weeks'
duration. History reveals the back pain is sharp at a 8 out of 10 on the pain scale and localized to the
lower left paraspinal region. The urine is described as being "cola or tea colored." An abdominal CT scan
without contrast is obtained revealing a 4 mm stone within the proximal left ureter. Which of the
following spinal segments will most likely facilitate tissue texture changes in this patient? ANS - C. T10-
T11
A 24-year-old female presents with low back pain of three months' duration. History reveals she
fractured her femoral growth plate as a child and subsequently has an anatomically short right leg.
Which of the following additional findings will most likely be found upon structural examination? ANS -
A. Cephalad sacral sulcus on the left
A 39-year-old male presents to the office with the complaint of mid-back pain. Osteopathic structural
examination reveals the left transverse process immediately lateral to the T8 spinous process is more
difficult to push anteriorly than the right when performing intersegmental motion testing. This is more
apparent when you induce flexion but becomes more even when you induce extension. The most likely
diagnosis is ANS - D. T9 extended, rotated left, sidebend left
A 19-year-old football player presents after twisting his right knee during a game. Physical examination
reveals joint line tenderness and mild swelling in the area of injury. A clicking and popping sound is
appreciated during passive flexion and extension of the right knee. The initial modality most appropriate
for confirming the diagnosis is ANS - D. MRI
A 22-year-old female presents with anxiety and obsessive-compulsive disorder. Structural examination
with the vault hold reveals the sphenoid and occiput to be in extension. Under normal craniosacral
mechanics, you suspect the sacral base to be ANS - A. Anterior and inferior
,A 21-year-old female who is 1 week post-partum presents with pelvic pain. History reveals she had an
unremarkable vaginal delivery without complications. Structural examination reveals multiple pelvic
tender points with an anterior lumbar tender point corresponding to L4 on the right. Where and how is
this tender point located? ANS - A. inferior AIIS pressing cephalad
A 29-year-old male presents to the doctor's office with an occipital headache after he sustained a rear-
end collision in his car. His headache is intermittent, non-radiating, non-pulsatile, and without
photophobia. On palpation of his occipito-atlantal joint, there is restriction in translation to the left,
which improves with upper cervical flexion. Which of the following is the correct starting position to
begin treatment with muscle energy? ANS - B. Cervical extension with the occiput sidebent right,
rotated left
A 49-year-old male presents with low back pain. History reveals an acute onset of sharp, burning pain
radiating down the leg that started while he working on his car in the garage. An MRI of the lumbar
spine is obtained revealing a herniated disc between the L3 and L4 vertebrae. The most likely additional
finding upon physical examination is ANS - B. Absent patellar reflex
A 46-year-old male presents to the office with left-sided neck pain that began after he drove home from
visiting his parents in another state. His pain is non-radiating, and he denies numbness and tingling of
the upper extremities. His pain is worse when he turns his head to the right, and he rates it as a 7/10. On
examination, he has limited passive rotation to the left and sidebending to the right. When the neck is
flexed to 45 degrees, there is rotational restriction to the left. What is the initial starting position of the
neck for muscle energy treatment? ANS - A. Left rotation
A 16-year-old female presents to the office after being hit on the left side of the head with a softball 1
hour ago. The injury occurred during practice while she was throwing with a teammate; someone across
the field called her name, and she turned her head and was hit with the ball while not paying attention.
She did not lose consciousness. She localizes the pain to the left central portion of her head and slightly
posterior to her left ear. She describes the pain as throbbing and rates it as a 6/10. She took an
ibuprofen on the field which has helped with some of the pain. She also complains of point tenderness
and mild swelling but denies vision changes, dizziness, nausea, vomiting, or gait abnormalities. On
physical exam, CN2-12 are intact without focal neurologic deficits. There are no palpable cranial
fractures, but the tissues around the left central side of her head are red and boggy. On osteopathic
exam, th ANS - C. Left sidebending rotation
A 23-year-old G1P0 obese female is in active labor at 40 weeks' gestation. After many hours of difficult
labor she gives birth to a 9 pound baby boy. Which of the following structural abnormalities of the
mother is likely to be seen in the post-partum period? ANS - A. Bilateral sacral flexion
,A 35-year-old female presents with abdominal bloating and cramping in the left lower quadrant, bloody
and diarrhea more than ten times daily, a 15-pound weight loss, and hematochezia. Her symptoms
began one month ago, with no prior history. Vital signs are normal. Physical examination reveals left
lower quadrant abdominal tenderness without rebound, no masses, and normal bowel sounds. Stool is
positive for occult blood. The most likely location of a corresponding parasympathetic viscerosomatic
reflex would be: ANS - E. S2-S4
A 30-year-old female transcriptionist presents with neck pain of 7 days' duration. Osteopathic structural
exam is significant for a tender C3 that is extended, rotated left, sidebent left. What is the most
appropriate initial position for treatment with Still's technique of this lesion? ANS - A. Extension,
rotation to the left, sidebending to the left
A 55-year-old male presents to the office with the complaint of right shoulder pain. History reveals the
pain has been worsening over the last few weeks and is associated with any motion of the shoulder.
Physical examination reveals a negative drop arm test and apprehension test, however, active and
passive range of motion is severely restricted in each plane of motion of the right shoulder. Deep tendon
reflexes are 2+ at biceps, triceps, and brachioradialis bilaterally. The correct sequence of motion using
the most appropriate technique is ANS - C. Extension, flexion, circumduction with compression,
circumduction with traction, abduction, internal rotation, pump
A 54-year-old male presents to his family physician's office with 2 weeks of slowly worsening right
shoulder pain. The pain is described as sharp, 6/10, and worse when he tries to lift his arm away from
his side. He does not recall any specific injury, but he plays baseball for a recreational league after work.
On palpation, there is a tender point in the right supraspinatus fossa. Pain is also elicited when the
physician moves the patient's arm to 90° of abduction, 30° of flexion, and internal rotation until the
thumb points down, and pushes down on the arm against resistance. After discussing treatment
options, the patient consents to osteopathic treatment, and the physician decides to use counterstrain
to treat the affected tender point. Which of the following is the correct initial positioning to treat the
patient with counterstrain? ANS - B. Patient supine, arm flexed and abducted with humerus externally
rotated
A 54-year-old male presents to the office with the complaint of right hip pain and trouble walking.
History reveals the patient is a construction worker and the pain began after falling from a ladder.
Structural examination reveals the following:
Seated flexion test: positive on the leftSacral base: anterior on the leftInferolateral angle: posterior on
the rightLumbosacral spring test: negative
, Based on the physical examination finding the most likely intersegmental somatic dysfunction at L5 is
ANS - D. Neutral, rotated left, sidebent right
A 32-year-old male presents to the physician's office after a brick fell on his head while working at a
construction site. He states that he did not lose consciousness but has some mild swelling and 5/10
nonradiating pain. He denies vomiting, blurry vision, dizziness, and speech or gait changes. Physical
examination reveals mild soft tissue swelling along the apex of the head without ecchymosis or
hematoma. Cranial nerves II-XII are intact without focal neurologic deficits. On osteopathic examination,
the physician palpates the cranial rhythm impulse and finds that it is 7 cycles/min. After explaining the
risks and benefits of osteopathic manipulation and cranial treatment techniques, the physician places
the patient's head in the vault hold. While appreciating the cranial rhythm, the physician's index fingers
move superior while the little fingers move inferior. Which of the following is the axis/axes of motion for
ANS - D. 2 parallel transverse axes
A 21-year-old female who is three weeks post-partum presents with pelvic and buttock pain. History
reveals she had an unremarkable vaginal delivery without complications. Structural examination reveals
tissue texture abnormalities and tender points along the right iliacus muscle. Which of the following is
the most appropriate patient position for treating these tender points with strain-counterstrain? ANS -
B. Patient supine with bilateral flexion of the hips and knees with external rotation of the thighs
A 76-year-old female presents to your office stating that she is "walking funny." She first noticed this
abnormality eight months ago when her left hip began hurting. She had been diagnosed with mild to
moderate degenerative joint disease of her left hip. Physical examination reveals her right hip to drop
when standing on her left leg. This is most likely due to weakened ANS - A. Hip abductor
A 52-year-old male presents to the emergency department with perineal pain of several days duration.
He has had intermittent fevers with chills, fatigue, and dysuria, but denies dyspnea, gross hematuria,
hematochezia, and melena. Vital signs reveal:
Temperature 39.5°C (103.0°F) Blood pressure 140/90 mmHg Heart rate 120/min
Urinalysis reveals 10 white blood cells per high-power field (WBC/HPF) (reference: < 5 WBC/HPF) and
laboratory studies reveal a leukocyte count of 14.0 x 103/µL (reference range: 4.8-10.8 x 103/µL).
Physical examination reveals bowel sounds are present and normoactive in all 4 quadrants. There is no
abdominal tenderness or rebound tenderness. Rectal examination reveals a boggy prostate that is
tender to palpation. Based on the most likely diagnosis, where would a corresponding Chapman's reflex
point be found? ANS - C. Posterior superior illiac spine
ACCURATE RIGHT ANSWERS.
A 22-year-old female presents with right forearm paresthesia. Structural examination reveals restricted
transverse carpal ligament and palmar fasciae. Which of the following represents the most appropriate
initial position when performing direct myofascial release? ANS - E. Forearm supinated with the wrist
neutral or extended
A 44-year-old male presents with debilitating left lower back pain and dark, tinted urine of one weeks'
duration. History reveals the back pain is sharp at a 8 out of 10 on the pain scale and localized to the
lower left paraspinal region. The urine is described as being "cola or tea colored." An abdominal CT scan
without contrast is obtained revealing a 4 mm stone within the proximal left ureter. Which of the
following spinal segments will most likely facilitate tissue texture changes in this patient? ANS - C. T10-
T11
A 24-year-old female presents with low back pain of three months' duration. History reveals she
fractured her femoral growth plate as a child and subsequently has an anatomically short right leg.
Which of the following additional findings will most likely be found upon structural examination? ANS -
A. Cephalad sacral sulcus on the left
A 39-year-old male presents to the office with the complaint of mid-back pain. Osteopathic structural
examination reveals the left transverse process immediately lateral to the T8 spinous process is more
difficult to push anteriorly than the right when performing intersegmental motion testing. This is more
apparent when you induce flexion but becomes more even when you induce extension. The most likely
diagnosis is ANS - D. T9 extended, rotated left, sidebend left
A 19-year-old football player presents after twisting his right knee during a game. Physical examination
reveals joint line tenderness and mild swelling in the area of injury. A clicking and popping sound is
appreciated during passive flexion and extension of the right knee. The initial modality most appropriate
for confirming the diagnosis is ANS - D. MRI
A 22-year-old female presents with anxiety and obsessive-compulsive disorder. Structural examination
with the vault hold reveals the sphenoid and occiput to be in extension. Under normal craniosacral
mechanics, you suspect the sacral base to be ANS - A. Anterior and inferior
,A 21-year-old female who is 1 week post-partum presents with pelvic pain. History reveals she had an
unremarkable vaginal delivery without complications. Structural examination reveals multiple pelvic
tender points with an anterior lumbar tender point corresponding to L4 on the right. Where and how is
this tender point located? ANS - A. inferior AIIS pressing cephalad
A 29-year-old male presents to the doctor's office with an occipital headache after he sustained a rear-
end collision in his car. His headache is intermittent, non-radiating, non-pulsatile, and without
photophobia. On palpation of his occipito-atlantal joint, there is restriction in translation to the left,
which improves with upper cervical flexion. Which of the following is the correct starting position to
begin treatment with muscle energy? ANS - B. Cervical extension with the occiput sidebent right,
rotated left
A 49-year-old male presents with low back pain. History reveals an acute onset of sharp, burning pain
radiating down the leg that started while he working on his car in the garage. An MRI of the lumbar
spine is obtained revealing a herniated disc between the L3 and L4 vertebrae. The most likely additional
finding upon physical examination is ANS - B. Absent patellar reflex
A 46-year-old male presents to the office with left-sided neck pain that began after he drove home from
visiting his parents in another state. His pain is non-radiating, and he denies numbness and tingling of
the upper extremities. His pain is worse when he turns his head to the right, and he rates it as a 7/10. On
examination, he has limited passive rotation to the left and sidebending to the right. When the neck is
flexed to 45 degrees, there is rotational restriction to the left. What is the initial starting position of the
neck for muscle energy treatment? ANS - A. Left rotation
A 16-year-old female presents to the office after being hit on the left side of the head with a softball 1
hour ago. The injury occurred during practice while she was throwing with a teammate; someone across
the field called her name, and she turned her head and was hit with the ball while not paying attention.
She did not lose consciousness. She localizes the pain to the left central portion of her head and slightly
posterior to her left ear. She describes the pain as throbbing and rates it as a 6/10. She took an
ibuprofen on the field which has helped with some of the pain. She also complains of point tenderness
and mild swelling but denies vision changes, dizziness, nausea, vomiting, or gait abnormalities. On
physical exam, CN2-12 are intact without focal neurologic deficits. There are no palpable cranial
fractures, but the tissues around the left central side of her head are red and boggy. On osteopathic
exam, th ANS - C. Left sidebending rotation
A 23-year-old G1P0 obese female is in active labor at 40 weeks' gestation. After many hours of difficult
labor she gives birth to a 9 pound baby boy. Which of the following structural abnormalities of the
mother is likely to be seen in the post-partum period? ANS - A. Bilateral sacral flexion
,A 35-year-old female presents with abdominal bloating and cramping in the left lower quadrant, bloody
and diarrhea more than ten times daily, a 15-pound weight loss, and hematochezia. Her symptoms
began one month ago, with no prior history. Vital signs are normal. Physical examination reveals left
lower quadrant abdominal tenderness without rebound, no masses, and normal bowel sounds. Stool is
positive for occult blood. The most likely location of a corresponding parasympathetic viscerosomatic
reflex would be: ANS - E. S2-S4
A 30-year-old female transcriptionist presents with neck pain of 7 days' duration. Osteopathic structural
exam is significant for a tender C3 that is extended, rotated left, sidebent left. What is the most
appropriate initial position for treatment with Still's technique of this lesion? ANS - A. Extension,
rotation to the left, sidebending to the left
A 55-year-old male presents to the office with the complaint of right shoulder pain. History reveals the
pain has been worsening over the last few weeks and is associated with any motion of the shoulder.
Physical examination reveals a negative drop arm test and apprehension test, however, active and
passive range of motion is severely restricted in each plane of motion of the right shoulder. Deep tendon
reflexes are 2+ at biceps, triceps, and brachioradialis bilaterally. The correct sequence of motion using
the most appropriate technique is ANS - C. Extension, flexion, circumduction with compression,
circumduction with traction, abduction, internal rotation, pump
A 54-year-old male presents to his family physician's office with 2 weeks of slowly worsening right
shoulder pain. The pain is described as sharp, 6/10, and worse when he tries to lift his arm away from
his side. He does not recall any specific injury, but he plays baseball for a recreational league after work.
On palpation, there is a tender point in the right supraspinatus fossa. Pain is also elicited when the
physician moves the patient's arm to 90° of abduction, 30° of flexion, and internal rotation until the
thumb points down, and pushes down on the arm against resistance. After discussing treatment
options, the patient consents to osteopathic treatment, and the physician decides to use counterstrain
to treat the affected tender point. Which of the following is the correct initial positioning to treat the
patient with counterstrain? ANS - B. Patient supine, arm flexed and abducted with humerus externally
rotated
A 54-year-old male presents to the office with the complaint of right hip pain and trouble walking.
History reveals the patient is a construction worker and the pain began after falling from a ladder.
Structural examination reveals the following:
Seated flexion test: positive on the leftSacral base: anterior on the leftInferolateral angle: posterior on
the rightLumbosacral spring test: negative
, Based on the physical examination finding the most likely intersegmental somatic dysfunction at L5 is
ANS - D. Neutral, rotated left, sidebent right
A 32-year-old male presents to the physician's office after a brick fell on his head while working at a
construction site. He states that he did not lose consciousness but has some mild swelling and 5/10
nonradiating pain. He denies vomiting, blurry vision, dizziness, and speech or gait changes. Physical
examination reveals mild soft tissue swelling along the apex of the head without ecchymosis or
hematoma. Cranial nerves II-XII are intact without focal neurologic deficits. On osteopathic examination,
the physician palpates the cranial rhythm impulse and finds that it is 7 cycles/min. After explaining the
risks and benefits of osteopathic manipulation and cranial treatment techniques, the physician places
the patient's head in the vault hold. While appreciating the cranial rhythm, the physician's index fingers
move superior while the little fingers move inferior. Which of the following is the axis/axes of motion for
ANS - D. 2 parallel transverse axes
A 21-year-old female who is three weeks post-partum presents with pelvic and buttock pain. History
reveals she had an unremarkable vaginal delivery without complications. Structural examination reveals
tissue texture abnormalities and tender points along the right iliacus muscle. Which of the following is
the most appropriate patient position for treating these tender points with strain-counterstrain? ANS -
B. Patient supine with bilateral flexion of the hips and knees with external rotation of the thighs
A 76-year-old female presents to your office stating that she is "walking funny." She first noticed this
abnormality eight months ago when her left hip began hurting. She had been diagnosed with mild to
moderate degenerative joint disease of her left hip. Physical examination reveals her right hip to drop
when standing on her left leg. This is most likely due to weakened ANS - A. Hip abductor
A 52-year-old male presents to the emergency department with perineal pain of several days duration.
He has had intermittent fevers with chills, fatigue, and dysuria, but denies dyspnea, gross hematuria,
hematochezia, and melena. Vital signs reveal:
Temperature 39.5°C (103.0°F) Blood pressure 140/90 mmHg Heart rate 120/min
Urinalysis reveals 10 white blood cells per high-power field (WBC/HPF) (reference: < 5 WBC/HPF) and
laboratory studies reveal a leukocyte count of 14.0 x 103/µL (reference range: 4.8-10.8 x 103/µL).
Physical examination reveals bowel sounds are present and normoactive in all 4 quadrants. There is no
abdominal tenderness or rebound tenderness. Rectal examination reveals a boggy prostate that is
tender to palpation. Based on the most likely diagnosis, where would a corresponding Chapman's reflex
point be found? ANS - C. Posterior superior illiac spine
