OMM Exam 1 Block 3 Questions and Answers updated For Excellence A+ Graded 100%

OMM Exam 1 Block 3 Questions and Answers updated For Excellence A+ Graded 100% what should be on your differential if a patient comes in with thoracic pain? (what is the acronym that is used?) - CORRECT ANSWER-*VINDICATE* Vascular, Infectious, Neoplastic, Drugs, Inflammatory/Idiopathic, Congenital, Autoimmune, Trauma, Endocrine/Metabolic *what are the main 3 must not miss diagnoses of thoracic back pain?* - CORRECT ANSWER-Infection (Osteomyelitis) seen in immunocompromised and diabetic patients Fractures seen in elderly who use steroids Primary tumor or metastasis which is commonly spread from breast and lung, worse pain at night what motions are seen in the thoracic spine? - CORRECT ANSWER-Sidebending is seen throughout the thoracic spine, but highest degree of sidebending is in the lower thoracic. *90% of Rotation is seen in the lower thoracic.* (T9-T12) *what are the differences between symptoms of Neoplastic thoracic back pain versus Degenerative thoracic back pain?* - CORRECT ANSWER-Neoplastic thoracic pain: Pain does not improve with rest or conservative therapy. Pain is worse at night. (history of cancer and abnormal labs) Degenerative thoracic pain: Pain increases with activity. Achy, but subsides with rest and NSAID use. An 70 year old woman comes in with thoracic back pain. She has recently lost weight and NSAIDs do not help. It is worse at night and she has a history of breast cancer. You highly suspect metastatic cancer to the thoracic spine. What test should you order to confirm? - CORRECT ANSWER-MRI is best test for diagnosis of cancer A patient presents with back pain, urinary retention, numbness on their inner thigh and groin, leg weakness, and decreased anal sphincter tone. Is this serious? What condition/syndrome does this patient have? - CORRECT ANSWER-This is *Cauda Equina Syndrome*. This is a must not miss diagnosis for back pain. Cauda equina is associated with lower lumbar disc herniation. A patient presents with acute mechanical thoracic back pain. How should this patient be treated? what do you recommend? - CORRECT ANSWER-•75-90 % of nonspecific mechanical back pain improve within 4-6 weeks. •Bed rest does not help acute pain and may prolong the duration. Activity modifications should be implemented. Mr. J is a 55 year old man that works as a bank teller and sits for 12 hours a day. Recently he has been experiencing radiating back pain that is worsened by sitting. What is at the top of your differential? - CORRECT ANSWER-*Discogenic pain* should be at the top of your differential. •Discogenic pain is usually worsened by sitting and may radiate. Increased prevalence in age group 45-65. •70% recover in 6 weeks; strengthening back muscles help For appropriate thoracic cage motion, thoracic spine/sternum/ribs all need to be able to move freely. How do you treat a patient with issues in the thoracic cage? - CORRECT ANSWER-•Treat thoracics first and ribs second ---> correcting the thoracic dysfunction may improve the rib dysfunction What are the 3 Fryette's Principles? - CORRECT ANSWER-I.When the spine is in neutral position and sidebending is induced, rotation and sidebending will be in opposite directions. (thoracic and lumbar segments) II.When the spine is flexed or extended and sidebending is induced, rotation and sidebending will be to the same side. (thoracic and lumbar single segment) III.Initiation of motion in any one plane will modify motion in the other two planes. (entire spine) *how do you name scoliosis?* - CORRECT ANSWER-For the side of the CONVEXITY (also the side of the rib hump) Image shows right thoracic scoliosis what is Adam's Test used for? - CORRECT ANSWER-Screening test for Scoliosis. •Ask patient to bend forward at waist •Monitor for symmetry of thoracic area and rib hump *What are acute and chronic changes seen in soft tissues?* - CORRECT ANSWER-Acute changes: Vasodilation, Warm skin, Boggy/Increased muscle tone Chronic changes: Vasoconstriction, Cool skin, Ropy/Decreased muscle tone