OMM Midterm Practice
Lecture Questions
Flashcard 1
Q: Student doctor Mark is performing a layer palpation on the posterior thoracic region of a 34-year-old man presenting with pain between the shoulders. He encounters taut fibers traveling in an oblique, superior, medial direction. What is he most likely palpating?
A: Rhomboid muscle.
Flashcard 2
Q: Student doctor Margaret is performing layer palpation on one of her classmates and notices increased motion as she moves her hand cephalad and caudad. This provides the most reliable information regarding which layers?
A: Skin and superficial fascia.
Green Book Questions
Flashcard 1: Q: A 50-year-old male presents with acute low back pain after gardening. What is most likely to be observed at this time? A: B. Hypertonicity
Flashcard 2: Q: A 60-year-old female has chronic somatic dysfunction of T1-T2 on the left, with fibrotic muscles and decreased tension. What is most associated with this dysfunction? A: A. Cool dry skin
Flashcard 3: Q: A 40-year-old presents with mid-thoracic pain. T6 is noted to be ERLSL. What is most associated with this segment’s restrictions? A: E. Flexion, rotation, and sidebending to the right in relation to T7
Flashcard 4: Q: A 25-year-old male has upper back pain. T2 is restricted with left rotation, and flexing causes it to rotate further to the right. What is the most appropriate nomenclature for this dysfunction? A: B. ERRSR
Flashcard 5: Q: A 75-year-old male with chronic low back pain due to metastatic prostate cancer. What is the most appropriate osteopathic manipulative therapy? A: A. Facilitated positional release to the lumbar spine
Flashcard 6: Q: A 40-year-old male presents with a thoracic curve and a large paraspinal hump on the left. What is the most likely diagnosis? A: D. T7-9 NRLSR
Flashcard 7: Q: A patient without cervical somatic dysfunction sidebends her cervical spine to 45 degrees. How is this limit best described? A: C. Physiologic barrier
Flashcard 8: Q: The orientation of the superior facets in the thoracic spine is best described as? A: B. Backward, upward, and lateral
Flashcard 9: Q: Normal motion of vertebral segments in a sagittal plane includes? A: A. Flexion and extension
Flashcard 10: Q: Motion of vertebral segments around a vertical axis includes? A: C. Rotation
Flashcard 11: Q: The activity of the biceps muscle during the elevation of a weight while performing a curling maneuver is indicative of? A: A. Concentric
Flashcard 12: Q: The activity of the biceps muscle while holding a weight steady with arms flexed at 90 degrees is? A: D. Isometric
Flashcard 13: Q: The activity of the biceps muscle while lowering a weight during a curling exercise is? A: B. Eccentric
Flashcard 14: Q: Muscle contraction against resistance while an external force causes the muscle to lengthen with the purpose of breaking adhesions is? A: C. Isolytic
Flashcard 1
Q: A middle-aged male had a sudden syncopal event, and a good Samaritan palpates the pulse on the distal portion of the lateral wrist. Which vessel is being palpated?
A: Radial artery, which eventually forms the deep palmar arch of the hand.
Flashcard 2
Q: The brachial artery originates at which anatomical landmark?
A: The inferior border of the teres minor.
Flashcard 3
Q: An 18-year-old has acute shoulder pain with a dislocated humerus. What is the most likely location of the shoulder dislocation?
A: Anterior.
Flashcard 4
Q: A 21-year-old pitcher has shoulder pain, tenderness at the acromion, and a positive drop arm test. What is the most likely diagnosis?
A: Supraspinatus tendinitis.
Flashcard 5
Q: A 30-year-old with forearm pain has increased pain with resisted wrist extension. Where is palpatory tenderness likely found?
A: Lateral epicondyle.
Flashcard 6
Q: An individual presents with wrist drop and mild sensory loss on the dorsum of the hand. Which nerve is most likely injured?
A: Radial nerve.
Flashcard 7
Q: A child has forearm pain and an abducted ulna somatic dysfunction. What is the most likely associated finding?
A: Decreased carrying angle.
Flashcard 8
Q: A 30-year-old has upper back pain and a prominent medial border of the scapula. Which nerve is most likely injured?
A: Long thoracic nerve.
Flashcard 9
Q: A 31-year-old female has neck pain radiating into her arm and diminished radial pulse with inspiration. What is the most likely diagnosis?
A: Thoracic outlet syndrome.
Flashcard 10
Q: Compression in thoracic outlet syndrome is most likely occurring between which structures?
A: Anterior scalene and clavicle.
Flashcard 11
Q: When palpating the carpal bones, which one is the most medial?
A: Hamate.
Flashcard 12
Q: Pronation of the forearm primarily involves which nerve?
A: Median nerve.
Flashcard 13
Q: A 12-year-old with C5 and C6 nerve root injury during childbirth most likely has which condition?
A: Erb-Duchenne palsy.
Flashcard 14
Q: With C5 and C6 nerve root injury, which neurological finding is most likely?
A: Decreased biceps reflex.
Flashcard 15
Q: Which nerve primarily carries fibers from the C5 nerve root?
A: Dorsal scapular nerve.
Flashcard 16
Q: A 35-year-old with numbness and tingling in the thumb and first two fingers is most likely suffering from which condition?
A: Carpal tunnel syndrome.
Flashcard 17
Q: In carpal tunnel syndrome, which structure is most likely contributing to the symptoms?
A: Median nerve.
Flashcard 18
Q: A 15-year-old with wrist and elbow pain and decreased carrying angle is most likely suffering from which condition?
A: Abducted ulna.
Flashcard 19
Q: After resolving an abducted ulna somatic dysfunction, which movement facilitates anterior gliding of the radial head?
A: Supination of the forearm.
Flashcard 20
Q: Which muscle is the primary abductor of the humerus?
A: Supraspinatus.
Flashcard 21
Q: A female presents with shoulder pain after playing tug-of-war, and MRI reveals unremarkable rotator cuff muscles. What is the most likely diagnosis?
A: Teres major injury (muscle not part of the rotator cuff).
Here are the flashcards based on the provided questions and answers:
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Flashcard 1
Q: A 65-year-old female presents with right low back and hip pain after gardening. Structural examination reveals hypertonicity and pain with passive motion testing of the primary flexor of the hip. The most likely muscle involved is the:
A: Iliopsoas.
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Flashcard 2
Q: A pro football player is hit by another player and develops acute knee pain. Physical examination reveals excessive anterior translation of the tibia. The most likely structure injured is the:
A: Anterior cruciate ligament (ACL).
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Flashcard 3
Q: An 18-year-old soccer player sustains an injury to multiple structures referred to as the “the terrible triad” or “O'Donaghue's triad.” Which of the following were most likely injured?
A: Anterior cruciate ligament (ACL), medial meniscus, and medial collateral ligament (MCL).
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Flashcard 4
Q: A high school football player presents with leg pain after a long practice. Structural examination reveals the fibular head resists anterior glide. Which of the following is most associated with this dysfunction?
A: It often occurs following a supination ankle sprain.
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Flashcard 5
Q: A 3-year-old presents for a well child examination and the parents are concerned about the way the child walks. Roentgenographic examination reveals a decrease in the angle between the neck and the shaft of the femur. The most likely diagnosis is:
A: Coxa vara.
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Flashcard 6
Q: A 4-year-old presents for a well child examination and the parents are concerned about the appearance of the child’s legs. Physical examination reveals a decreased Q angle. Which of the following is most associated with this abnormal finding?
A: Bow-legged appearance.
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Flashcard 7
Q: A female nursing home patient rolls her ankle on a curb and develops acute pain and swelling. Examination reveals the associated ligament to likely have at least a portion of the fibers disrupted. The most likely diagnosis is a:
A: Second degree sprain.
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Flashcard 8
Q: A tennis player sustains an inversion injury to the anterior talo-fibular and calcaneo-fibular ligaments. Which of the following somatic dysfunctions is most associated with this type of injury?
A: Anterior lateral malleolus.
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Flashcard 9
Q: An anatomist is researching the stability of the ankle mortise. The ankle is most stable in which one of the following positions?
A: Dorsiflexion.
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Flashcard 10
Q: A track runner trips and sustains a type II supination ankle sprain. Which of the following structures is most likely injured?
A: Anterior talofibular and calcaneofibular ligaments.
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Flashcard 11
Q: A little league player is struck in the lateral knee with a bat and is subsequently having difficulty ambulating. Plain film radiography reveals a fracture of the fibular head. This type of injury will most likely affect the:
A: Common peroneal nerve.
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Flashcard 12
Q: A middle-aged male presents with knee discomfort on the medial side. Structural examination reveals an ipsilateral posterior innominate rotation. The most likely muscle responsible for his knee pain is the:
A: Sartorius.
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Flashcard 13
Q: A patient presents concerned about the appearance of her flat feet. Structural examination of the lateral longitudinal arch is unremarkable. The most likely bone involved is the:
A: Navicular.
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Flashcard 14
Q: A middle-aged female presents for consultation of chronic anterior knee pain. History reveals her primary care physician diagnosed her with impaired lateral femoral patella tracking. Which of the following additional features will most likely be discovered upon obtaining further history and examination?
A: Crepitation of the posterior patella.
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Flashcard 15
Q: Treatment involves focused strengthening of the:
A: Vastus medialis.
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Flashcard 16
Q: For the deltoid ligament, which of the following features is most often injured in supination ankle sprains?
A: Tibio-navicular fibers.
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Flashcard 17
Q: For the anterior talofibular ligament, which of the following features is most often injured in supination ankle sprains?
A: Anterior talofibular ligament.
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Flashcard 1
Q: A young male presents for a routine physical. Structural examination reveals he has the most common fascial pattern noted in the population. The most likely compensatory pattern is:
A: L/R/L/R.
Flashcard 2
Q: When performing indirect myofascial release, which barrier is engaged?
A: Elastic.
Flashcard 3
Q: Which of the following is an indication for treatment utilizing myofascial release?
A: Peripheral edema.
Flashcard 4
Q: A young adult with chronic headaches undergoes osteopathic manipulative treatment. With the patient supine, the physician holds cephalad traction to the suboccipital tissues until the regional musculature relaxes. This technique is a type of:
A: Myofascial release.
Flashcard 5
Q: A 38-year-old professional bowler presents with a chief complaint of intermittent numbness in the thumb and index finger. Physical examination reveals a positive Phalen test. Radiographs of the wrist are normal. The appropriate direct myofascial release treatment for this patient’s condition includes:
A: Stretching the flexor retinaculum.
Flashcard 6
Q: You are consulted to see a severely debilitated 87-year-old male with complaints of mid thoracic pain. He was in the intensive care unit for 3 weeks and was transferred to a medical/surgical bed yesterday. He has a history of coronary artery disease, congestive heart failure, and prostate cancer with vertebral metastasis. His back pain is localized to the mid thoracic region and seems to be musculoskeletal in nature. Which osteopathic manipulative technique would be best suited to relieve this patient’s symptoms?
A: Direct myofascial release.
Flashcard 7
Q: A patient complains of neck pain that is worse at the end of the work day. Structural examination reveals somatic dysfunction in the upper cervical segments. The physician slowly turns the patient’s neck in the direction of limited movement, loads the soft tissues with a gentle constant force, then waits a few seconds until the tissues release and more motion is possible. This technique is an example of:
A: Direct myofascial release.
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Flashcard 1
Q: An elderly male status post lumbar laminectomy 6 weeks ago complains of low back pain and is observed ambulating in a forward flexed position. Standing examination reveals a positive side shift to the right. X-rays demonstrate no fracture but notable facet arthropathy at the level of the L4/L5 surgical side. The patient elects to undergo a low velocity/moderate amplitude technique. What clinical considerations are important when choosing this technique in this scenario?
A: Low velocity/moderate amplitude techniques tend to be generally well tolerated on post-operative patients.
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Flashcard 2
Q: An elderly female just had open reduction, internal fixation of her hip after a fracture and is now stabilizing on post-operative day 2. Multiple somatic dysfunctions of the thoracic region and ribs are discovered, and the provider elects to use rib raising to encourage recovery. Which is most associated with this technique?
A: It is a useful technique in patients with viral pneumonia.
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Flashcard 3
Q: In the Spencer technique for a chronic shoulder pain patient, Stage 1 involves glenohumeral:
A: Extension with the elbow flexed.
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Flashcard 4
Q: In the Spencer technique for a chronic shoulder pain patient, Stage 2 involves glenohumeral:
A: Flexion with the elbow extended.
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Flashcard 5
Q: In the Spencer technique for a chronic shoulder pain patient, Stage 3 primarily tests the:
A: Articular surface.
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Flashcard 6
Q: In the Spencer technique for a chronic shoulder pain patient, Stage 4 primarily tests the:
A: Joint capsule.
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Flashcard 7
Q: In the Spencer technique for a chronic shoulder pain patient, Stage 5 involves glenohumeral:
A: Abduction with internal rotation and elbow flexed.
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Flashcard 8
Q: In the Spencer technique for a chronic shoulder pain patient, Stage 6 places the forearm behind the patient’s back with the hand and wrist over the “hip pocket” area. This is engaging glenohumeral:
A: Internal rotation.
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Flashcard 1
Q: A patient presents with left shoulder pain and an overuse injury is suspected. In order to evaluate shoulder range of motion, you would perform the:
A: Apley scratch test.
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Flashcard 2
Q: A typist presents with chronic thumb pain on the radial side. History reveals the pain worsens when holding objects. Examination shows tenderness in the first dorsal compartment. Plain film radiography is unremarkable. Which of the following is most associated with the likely diagnosis?
A: It results from inflammation of the abductor pollicis longus and/or extensor pollicis brevis tendons.
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Flashcard 3
Q: A middle-aged female presents with nocturnal bilateral hand paresthesias and has a positive Phalen test. The most likely diagnosis is:
A: Carpal tunnel syndrome.
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Flashcard 4
Q: A patient with low back pain presents for evaluation. A hip drop test reveals that the left iliac crest drops 15 degrees with weightbearing on the right leg and the right iliac crest drops 25 degrees when weightbearing on the left leg. This test indicates that there is a:
A: Sidebending dysfunction of the lumbar spine.
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Flashcard 5
Q: A 15-year-old presents for a sports physical during which the Trendelenburg test is performed. This will assess the hip:
A: Abductors.
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Flashcard 6
Q: A 45-year-old male presents with left-sided low back pain. He states the pain worsens by standing after prolonged sitting and radiates to his groin. On examination, L1 is FRLSL with an associated tenderpoint medial to the left ASIS. You suspect the problem lies within the left hip flexor. Which test may aid in confirming your diagnosis?
A: Thomas test.
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Flashcard 7
Q: A 32-year-old female presents to the emergency department with acute knee pain after a basketball injury. Examination reveals effusion of the joint with a positive McMurray's test and a positive Apley compression test. Apley distraction, anterior drawer, and valgus and varus tests are all negative. The most likely diagnosis is:
A: Medial meniscal tear.
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Flashcard 8
Q: A 72-year-old female presents with low back pain after gardening. Observation reveals a hunched posture. Physical exam shows restriction of right thigh extension and a positive Thomas test on the right. Which of the following additional findings is most associated with this condition?
A: Pelvic side shift to the left.
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Flashcard 9
Q: A 28-year-old male presents with acute low back pain. In the supine position, lifting his right leg to 40 degrees with the knee extended causes right-sided lumbar pain and right leg pain radiating below the knee. Lifting his left leg in the same manner causes right-sided lumbar pain and right buttock pain. The patient is most likely experiencing:
A: Sciatic nerve irritation.
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Flashcard 10
Q: A patient has a positive standing flexion test on the right. This evaluates for:
A: Iliosacral dysfunction.
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Flashcard 11
Q: A football player limps off the field reporting knee pain after an aggressive tackle. The athletic trainer discovers excessive posterior movement of the tibia on the femur. This is indicative of injury to the:
A: PCL.
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Flashcard 12
Q: The patient then lies supine with the knee flexed at 90 degrees. The examiner compresses the knee into the table while internally and externally rotating the leg. Which statement is true concerning the Apley compression test? A pain response would indicate:
A: A meniscal injury.
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Flashcard 13
Q: A 45-year-old male laborer presents with shoulder pain and has a positive Adson test. This is most closely associated with:
A: Thoracic outlet syndrome.
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Flashcard 14
Q: A 45-year-old female carpenter presents with upper extremity soreness and has a positive Yergason test. This is most closely associated with:
A: Instability of the biceps tendon in the bicipital groove.
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Flashcard 15
Q: Stenosis of the intervertebral foramen causing radiculopathy into the upper extremity can be most effectively assessed with:
A: Spurling test.
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Flashcard 16
Q: Which of the following tests will be positive in vertebral artery insufficiency?
A: Wallenberg test.
Lecture Questions
Q: When does a stiff muscle exhibit pain?
A: At the end of range of motion
Q: Characteristics of a painful muscle?
A: increased temperature and doughy texture
Q: Which muscles when hypertonic inhibits arm abduction?
A: lat dorsi.
Which muscle is tight that would pull against the deltoid to prevent abduction?
A: lat dorsi.
Q: Which muscles can cause pain with arm abduction
A: deltoid, supraspinatus, serratus anterior, trap
bicipital tendonitis causes? overuse
Q: a 76 yr old female presents with shoulder pain, and she cannot localize the pain to any one part of the shoulder. active and passive flexion is to 140 degrees and is totally pain-free. she has active and passive abduction to 100 degrees, at which point she feels a sharp pain in the shoulder.
A: elevate the elbow to shoulder height and internally rotate the humerus
Q: lateral knee pain, walking and running were major precipitators, tenderness over left lat femoral epicondyle, mod pain when abducting, flexing, and medially rotating her left hip
A: tensor fascia lata
Q: left hip, thigh, and buttocks pain, externally rotated left leg, point tenderness over greater trochanter on the left, paresthesia on left post thigh/leg, antalgic gait and pain
A: hip external rotators—piriformis, glut max, glut med, glut min, greater trochanter—insertion site for lat rotators, post thigh & buttocks pain/paresthesia—cluneal, sciatic impingement, post fem cut nerve
Q: football player falls and grabs right thigh, post right thigh in spasm, decreased ROM in both flex and extension
A: post thigh: hammy, knee flex: hammy, knee extend: quads
Q: a 49-yr old presents w left pos thigh pain and unsteady gait. The pain is a burning pain that runs from the buttock to the knee, no history of trauma, PROM shows straight leg abd and add normal and decreased internal rotation of left compared to right. hip ext and knee flex are weaker on left than right
A: sciatic
Q: ant thigh pain, burning pain and difficulty w knee extension, hip flexion and knee extension. palpation of ant thigh doesn’t reproduce pain.
A: femoral
Q: right medial thigh pain.
A: adductor magnus