A 25-year-old male presents to the emergency department after motor vehicle accident and complains of headache. Vitals are within normal limits and imaging studies reveal no intracranial hemorrhage. Physical examination without neurologic deficits. Osteopathic structural examination reveals significantly reduced cranial rhythmic impulse (CRI). Which of the following ranges characterizes a normal cranial rhythmic impulse?

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May 29, 2023 No Comments

A 25-year-old male presents to the emergency department after motor vehicle accident and complains of headache. Vitals are within normal limits and imaging studies reveal no intracranial hemorrhage. Physical examination without neurologic deficits. Osteopathic structural examination reveals significantly reduced cranial rhythmic impulse. Vault hold with minimal movement of sphenobasilar synchondrosis (SBS). Given history and exam findings, which of the following is the most likely cranial strain pattern?

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May 29, 2023 No Comments

A 55-year-old female presents to clinic with complaints of migraines. She states that she gets a migraine headache about once a week with associated symptoms of nausea, photophobia, and phonophobia. Vitals are within normal limits. Physical exam without neurologic deficits. Osteopathic structural examination reveals a normal cranial rhythmic impulse. Vault hold reveals a somatic dysfunction of the sphenobasilar synchondrosis (SBS). Which of the following occurs during flexion of the SBS?

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May 29, 2023 No Comments

A 55-year-old female presents to clinic with complaints of migraines. She states that she gets a migraine headache about once a week with associated symptoms of nausea, photophobia, and phonophobia. She is currently on topiramate which she states has helped improve her migraines. Vitals are within normal limits. Physical exam without neurologic deficits. Osteopathic structural examination reveals a normal cranial rhythmic impulse. Where is the index finger placed on a standard vault hold?

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May 29, 2023 No Comments

A 47-year-old male presents to clinic with complaints of low back for the last 3 months. The patient states he got injured during a pick-up soccer match and has tried warm and cold compress as well as over the counter pain medications with only mild improvement in symptoms. Vitals are within normal limits. Osteopathic structural examination reveals a standing flexion test on the right. The right ASIS is inferior when compared to the left and the right PSIS is superior when compared to the left. Given the examination findings above, which of the following muscles would be targeted if utilizing muscle energy?

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May 29, 2023 No Comments

A 65-year-old male presents to clinic with chronic low back pain ongoing for years. Patient has a history of moderate degenerative disc disease from L2-S1. The patient states that over-the-counter medication have only provided mild relief. Vitals are within normal limits. Patient’s strength is 5/5 in bilateral lower extremities with normal sensation to light touch and pinprick. Osteopathic structural examination reveals chronic tissue texture changes of lumbar paraspinal musculature and negative straight leg test bilaterally. While standing, you ask the patient to lift their left leg and balance on their right leg. Which of the following findings would be consistent with a positive Trendelenburg sign?

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May 29, 2023 No Comments

A 65-year-old male presents to clinic with chronic low back pain ongoing for years. The patient has a history of moderate degenerative disc disease from L2-S1. The patient states that over-the-counter medication has only provided mild relief. Vitals are within normal limits. Patient’s strength is 5/5 in bilateral lower extremities with normal sensation to light touch and pinprick. Osteopathic structural examination reveals chronic tissue texture changes of lumbar paraspinal musculature and negative straight leg test bilaterally. Gait examination reveals patient with Trendelenburg gait. Which of the following nerves supplies the muscle causing this gait pattern?

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May 29, 2023 No Comments

A 46-year-old female presents to clinic with complaints of back pain for about 3 weeks. She states she has tried heat compresses and over-the-counter medications which only mildly alleviate her pain. Vital signs are within normal limits. Osteopathic structural examination reveals a posteriorly rotated innominate on the left. Which of the following exam findings is consistent with the somatic dysfunction

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May 29, 2023 No Comments

A 46-year-old female presents to clinic with complaints of back pain for about 3 weeks. She states she has tried heat compresses and over-the-counter medications which only mildly alleviate her pain. Vital signs are within normal limits. Osteopathic structural examination reveals Left unilateral sacral flexion. Which of the following exam findings is consistent with the somatic dysfunction?

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May 29, 2023 No Comments

A 46-year-old female presents to clinic with complaints of back pain for about 3 weeks. She states she has tried heat compresses and over-the-counter medications which only mildly alleviate her pain. Osteopathic structural examination reveals a Left on Right sacral torsion. Which of the following exam findings is consistent with the somatic dysfunction?

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May 29, 2023 No Comments