OMT Qs Questions and Answers with Guaranteed Top Results, Reviewed and Certified

A patient presents with a neurological deficit resulting in an absent triceps tendon reflex and weakness in the extensors of the hand, wrist and elbow. Which nerve is most likely involved? A) Musculocutaneous B) Median C) Radial D) Ulnar E) Axillary - Answer C The radial nerve innervates the extensors of the upper extremity [elbow (triceps), wrist and hand]. An absent triceps (C7) reflex and wrist drop will indicate radial nerve pathology. The musculocutaneous nerve innervates the biceps, brachialis, and coracobrachialis. A patient with a musculocutaneous nerve injury presents with a loss of the biceps reflex (C5, C6). Answer A The median nerve innervates forearm pronators, wrist and finger flexors and thenar muscles. Answer B The ulnar nerve innervates flexor carpi ulnaris, hypothenar muscles and the adductor pollicis. Answer D The axillary nerve innervates the teres minor and deltoid muscles. Injury to the axillary nerve results in atrophy of the deltoid and weakness with shoulder abduction and flexion. Answer E 2 | P a g e A 45-year-old male with a history of diabetes comes to the emergency department with acute onset of low back pain. The pain started suddenly when he was sliding into home plate during a softball game earlier today. The pain is severe and radiates into his right lower extremity. He describes an electric type pain shooting into his right foot. What are some findings you would expect to see when examining him? A) Edematous, boggy tissue with palpation, and full active range of motion of the lumbar spine. Decreased sensation on the dorsum of the foot. B) Severe, sharp pain with palpation of lumbar tissues, guarded range of motion of the lumbar spine, and increased deep tendon reflexes of the right lower extremity. C) Warm tissue texture changes, hypertonic muscles, and decreased range of motion of the lumbar spine. D) Little to no edema or erythema, cool dry skin to palpation, ropy and fibrotic muscles, and decreased - Answer C The above patient has an acute somatic dysfunction of the lumbar spine. He also herniated one of his lumbar discs. Acute somatic dysfunctions are associated with severe sharp pain (especially with palpation). Acute tissue texture changes are usually described as edematous, erythematous, and boggy. There is increased moisture on the overlying skin and associated hypertonic muscles. The muscle contraction and guarding will cause a limited range of motion of the involved areas. Answer A did not contain the limited range of motion in the lumbar spine that is consistent with this type of injury. Answer A An acute herniated disc results in decreased reflexes of the effected lower extremity. Answer B 3 | P a g e This patient likely has a positive straight leg raising test and decreased sensation somewhere on the foot, secondary to a herniated disc. Answers D and E included these findings however, they were coupled incorrectly with descriptors of a chronic somatic dysfunction. Chronic tissue texture changes include cool dry skin; flaccid, doughy, or mushy muscles; and firm, ropy, thickened, fibrotic interstitial tissues. Decreased range of motion is secondary to fibrotic tissues or possibly contractures. Answers D and E A 56-year-old male is complaining of low back pain. On examination you notice transverse process of L5 is posterior on the right. Extending L5 worsens the asymmetry while flexion restores rotational symmetry. Which one of the following is the best statement regarding this patient's somatic dysfunction? A) Due to the non-neutral L5 somatic dysfunction, a group dysfunction of the high lumbar region will be present. B) This patient has a right-sided psoas syndrome. C) L5 will resist left rotation in the extended position. D) When employing a muscle energy (post-isometric relaxation) technique the patient would be asked to rotate his torso to the left against isometric contraction. E) Extending L5 will greatly limit its sidebending to the right - Answer C The patient in the above question has L5 flexed, rotated right, and sidebent right. If the spine is extended symmetry is worsened, and L5 will resist left rotation. 4 | P a g e A non-neutral L5 dysfunction does not always cause a high lumbar group dysfunction or a right- sided psoas syndrome. Answers A and B Post-isometric relaxation muscle energy technique is an example of a direct technique in which the patient is positioned toward the barrier and is asked to turn away from the barrier. In this case the patient would be positioned with his torso rotated to the left and he would be asked to rotate his torso to the right. Answer D Extending L5 will limit its sidebending to the left, not right. Answer E A 35-year-old male is in the intensive care unit after a recent motorcycle accident. He fractured C6, C7 and his left tibia. As a result, he has a spinal cord injury. He underwent surgical spine stabilization, but is awaiting surgical stabilization for his tibia fracture. Which one of the following osteopathic treatments is contraindicated in this individual? A) Thoraco-abdominal diaphragm release B) Thoracic rib raising and paraspinal inhibition C) Pedal lymphatic pump D) Myofascial release E) Counterstrain - Answer C The above patient has a lower extremity that is awaiting surgical stabilization. The rhythmic motion of the pedal pump will exert forces at the still unstable fracture site. 5 | P a g e There are several different techniques to release the thoraco-abdominal diaphragm. Some are very gentle and can be performed on individuals with several concurrent medical or surgical conditions. Answer A Thoracic rib raising and paraspinal inhibition will not harm the recent surgical site in the cervical spine or the lower extremity fracture. Answer B Although myofascial release and counterstrain would be contraindicated in some areas for the above individual, the modalities are not specifically contraindicated and thus not the best answers. Answers D and E In a patient with low back pain, the dysfunctional T12 segment is found to have restriction in a transverse plane and around a transverse axis. Which of the following dysfunctions best describes the position of T12? A) T12 is flexed B) T12 is sidebent right C) T12 is rotated left D) T12 is neutral sidebent right, rotated left E) T12 is extended rotated right, sidebent right - Answer E Vertebral motion around a transverse axis is flexion or extension. So therefore T12 must be either flexed or extended. Vertebral motion in a transverse plane is rotation. So therefore T12 must also be rotated. Understanding Fryette's principles one must conclude if a vertebrae is flexed or extended and rotated it must be sidebent toward the same side. T12 has restricted motion around a transverse axis, therefore it is flexed or extended, not neutral. Answer D 6 | P a g e Answers A, B and C only comment on one plane of motion. In a patient with neck pain, the atlas is rotated to the left. Given this information what else would you expect to find on this patient? A) The OA joint will resist translation to the left. B) C2 will resist anterior glide on the right C) C2 will resist right sidebending D) The lower cervical segments will be rotated to the right to compensate for the somatic dysfunction of this upper segment E) With the patient's neck flexed to 45 degrees, he will be able to turn his head further left than right. - Answer E Rotation of the atlas (on the axis) is the AA joint. Flexing the patient's head will lock out rotation of C2 - C7 and will isolate rotation to the AA joint. Since the AA joint is rotated to the left, the patient should be able to turn his head further left than right. The AA joint will not necessarily affect motion of the occiput on the atlas (OA joint) or C2 on C3. Answers A, Band C Motion at the AA joint will not necessarily cause compensation or somatic dysfunction of the lower cervical units. Answer D 20-year-old male presents with low back pain following a fall onto a concrete floor. The patient 7 | P a g e gives a history of episodic aching of the lumbar region prior to the fall. Examination of the patient in the prone position reveals a deep sacral sulcus on the left, a posterior/inferior ILA on the right when compared to the opposite side, and a lumbosacral junction that springs freely upon compression. The most likely diagnosis is? A) A forward sacral torsion on a right oblique axis B) A forward sacral torsion on a left oblique axis C) A backward sacral torsion on a left oblique axis D) A left unilateral sacral flexion E) Bilateral sacral extension - Answer A In a patient with a deep left sulcus and a negative lumbosacral spring test the left portion of the sacrum has moved anterior. Since the above patient has a posterior/inferior ILA on the right this indicates that this portion of the sacrum has moved posteriorly. A forward sacral torsion on a right oblique axis (Le. a right rotation on a right oblique axis) is the only answer that would be consistent with the above findings. In a forward sacral torsion on a left oblique axis (left on left) the right sulcus would be deeper and the left ILA would be posterior/inferior. Answer B In a backward sacral torsion or a bilateral sacral extension, the lumbosacral spring test would be positive (Le. the lumbosacral junction would not spring). Answers C and E In a unilateral sacral flexion on the left, the left ILA would be posterior and significantly inferior. Answer D 4-year-old child with asthma is brought to the ED by his father. The child developed an upper.....