59-year-old male presents to the emergency room with complaints of severe abdominal pain for the last day. The patient states he had stabbing abdominal pain after a long night of drinking with his friends and rates his pain a 9/10. Vitals show the patient is tachycardic at 109 bpm. Patient refuses abdominal examination due to pain. Which of the following physical exam findings would one expect to find?

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May 29, 2023 No Comments

31-year-old female presents to clinic with complaints of frequent urination. She states that she notices she goes to the bathroom more frequently the last 5 days. She also notices an odor to her urine which she had not noticed previously. Her vitals are all within normal limits. On physical examination she has suprapubic tenderness on palpation, otherwise within normal limits. Urinalysis conducted in the office 25 WBCs with positive leukocyte esterase and nitrites. Given the findings above, which of the following would likely be found on osteopathic structural examination?

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May 29, 2023 No Comments

A 58-year-old male presents to clinic with complaints of lower back pain. He states the pain has been going on for about 3 weeks without radiation down either leg. He is unsure of any inciting events and describes the pain as sharp and rates about a 5/10. Physical exam reveals point tenderness at the right sacroiliac joint. Straight leg raise test is negative and patient has full strength with sensation intact bilaterally. Osteopathic structural examination reveals a positive standing flexion test on the right, a superior ASIS on the left, and a superior PSIS on the right. Given the exam findings, which of the following is the most likely diagnosis of this patient’s somatic dysfunction?

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May 29, 2023 No Comments

A 39-year-old male presents to clinic with complaints of low back pain after falling during a game of recreational basketball. He states that most of his pain is located around his “tail bone”. He rates the pain a 4/10 at worst and denies any radiation of his pain. Osteopathic structural examination reveals a positive seated flexion test on the right. The right sacral sulcus is more posterior than the left and the left ILA is more anterior than the right. Which of the following correctly describes all the somatic dysfunctions that can be associated with the results of this patient’s seated flexion test?

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May 29, 2023 No Comments

A 17-year-old male presents to the Emergency Department by ambulance after suffering trauma in a high school football game. The patient states he is in severe pain and is holding his right lower extremity. Physical examination reveals 2+ peripheral pulses bilaterally and decreased sensation to light touch of the right upper extremity. Xray imaging shows a fracture of the patient’s right femur. Which of the following physical exam findings would be concerning for an upper motor neuron lesion?

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May 29, 2023 No Comments

A 17-year-old male presents to the Emergency Department by ambulance after suffering trauma in a high school football game. The patient is in a cervical collar and Emergency Medical Services personnel states that the patient was unconscious on initial presentation. The patient is currently alert and oriented and states he is in severe pain and is holding his right upper extremity. Physical examination reveals 2+ peripheral pulses bilaterally and decreased sensation to light touch of the right upper extremity. Which of the following physical exam findings would be concerning for a lower motor neuron lesion?

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May 29, 2023 No Comments

A 24-year-old male presents to clinic with complaints of left upper extremity and shoulder pain and swelling for 2 days. He states he was trying to achieve personal records various exercises at the gym. He has no significant past medical or surgical history. Physical examination reveals tenderness to palpation on the superior aspect of the scapular spine. Sensation to light touch is intact bilaterally. Peripheral pulses are 2+ bilaterally. The patient exhibits weakness upon internal and external rotation of the shoulder secondary to the pain. Which of the following muscles of the “rotator cuff” does NOT exhibit the action of internal/external rotation?

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May 29, 2023 No Comments

A 24-year-old male presents to clinic with complaints of left upper extremity and shoulder pain and swelling for 2 days. He states he was trying to achieve personal records various exercises at the gym. He has no significant past medical or surgical history. Physical examination reveals tenderness to palpation on the superior aspect of the scapular spine. Sensation to light touch is intact bilaterally. Peripheral pulses are 2+ bilaterally. The patient exhibits weakness upon internal and external rotation of the shoulder secondary to the pain. Which of the following sets of muscles make up the “rotator cuff”?

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May 29, 2023 No Comments

A 71-year-old male presents to clinic with complaints of numbness and tingling in his right hand ongoing for 2 weeks duration. The patient does not recall any inciting events, nor has he observed any aggravating or alleviating factors. Further questioning reveals that the patient has had chronic neck pain. Vitals are within normal limits. Physical examination reveals decreased sensation of the first and second digits as well as 4/5 strength in flexion at the elbow of the right upper extremity. Which nerve innervates the muscle primarily responsible for elbow flexion?

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May 29, 2023 No Comments

A 58-year-old female presents to clinic for follow-up after recent hospitalization for COPD exacerbation. The patient is currently stable and without acute complaints. She has a 52-pack year smoking history and refuses to be counseled on tobacco cessation. Vital signs are within normal limits. Physical examination reveals a thin female with decreased breath sounds bilaterally and a raspy voice. Osteopathic structural examination reveals decreased movement of ribs 9 and 12 during inhalation. Which of the following nerves innervates the muscle that osteopathic treatment should be focused towards?

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May 29, 2023 No Comments