A 71-year-old female presents to clinic with complaints of right sided hip pain for 2 weeks. She denies trauma and says the pain began after playing with her grandchildren. She has tried over-the-counter medications without relief of her symptoms. Osteopathic structural examination reveals a positive seated flexion test on the right. Palpation of the sacral sulci is more anterior on the right than the left and the right ILA is more posterior than the left. Which of the following diagnoses correctly describes the patient’s sacral somatic dysfunction?

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May 29, 2023 No Comments

A 70-year-old male presents to clinic with complaints of chronic low back pain. He states that he is having difficulty completing his activities of daily living due to the pain. He describes the pain as dull and rates it a 4/10 at worst. He has tried over-the-counter medications without significant relief of his symptoms. Osteopathic structural examination reveals a sacral sulcus that is deeper on the left as well as a positive sphinx test. Which of the following somatic dysfunctions does this patient exhibit?

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May 29, 2023 No Comments

A 70-year-old male presents to clinic with complaints of chronic low back pain. He states that he is having difficulty completing his activities of daily living due to the pain. He describes the pain as dull and rates it a 5/10 at worst. He says that occasionally he experiences sharp, shocks of pain that go down his left leg. Vital signs are within normal limits. Physical examination reveals mild tenderness to palpation along the lumbar paraspinal musculature bilaterally. A straight leg raise reproduces the patient’s radiating leg pain. Which of the following vertebral disc spaces is the likely origination of this patient’s symptoms?

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May 29, 2023 No Comments

A 67-year-old female presents to clinic with complaints of numbness and tingling in her left foot ongoing for 1 week. The patient does not recall any inciting events nor has she observed any aggravating or alleviating factors. Further questioning reveals that the patient has had chronic low back pain. Vitals are within normal limits. Physical examination reveals decreased sensation at the lateral malleolus. Which of the following nerve roots is mostly responsible for the Achilles reflex?

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May 29, 2023 No Comments

A 67-year-old female presents to clinic with complaints of numbness and tingling in her left foot ongoing for 1 week. The patient does not recall any inciting events nor has she observed any aggravating or alleviating factors. Further questioning reveals that the patient has had chronic low back pain. Vitals are within normal limits. Physical examination reveals decreased sensation at the medial malleolus as well as 4/5 strength in dorsiflexion of the right foot. Which of the following nerve roots is mostly responsible for the patellar reflex?

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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 the right triceps. Which of the following nerve roots is mostly responsible for the triceps’ reflex?

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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 the right biceps. Which of the following nerve roots is mostly responsible for the biceps’ reflex?

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May 29, 2023 No Comments

A 22-year-old male presents to clinic with complaints of right shoulder pain ongoing for about 3 weeks. He states he has been going to the gym more frequently to become more fit. He says the pain is intermittent and is worse with deep breaths. He describes the pain as sharp and rates the pain a 5/10 at worst. No alleviating nor aggravating factors are identified on further questioning. Osteopathic structural examination reveals decreased range of motion of ribs 6-8 on the right. Manipulative treatments are initiated with focus towards a false rib that exhibits primarily a bucket-handle motion. Which of the following sets correctly describes the key rib and somatic dysfunction exhibited by this patient?

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May 29, 2023 No Comments

A 19-year-old female presents to clinic with complaints of right sided neck pain ongoing for 2 weeks. She states that the neck pain has gotten worse since she has started more to keep up with the demands of her college classes. She has tried icing her neck; however, it has only provided mild relief. She prefers to stay away from medications if possible. Osteopathic structural examination reveals a restriction in the range of motion of ribs 2-5 on the right. Osteopathic manipulative treatments are focused on an atypical rib with a pump-handle motion. Which of the following sets correctly describes the key rib and somatic dysfunction exhibited by this patient?

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May 29, 2023 No Comments

A 19-year-old female presents to clinic with complaints of right sided neck pain ongoing for 2 weeks. She states that the neck pain has gotten worse since she has started to keep up with the demands of her college classes. She has tried icing her neck; however, it has only provided mild relief. She prefers to stay away from medications if possible. Osteopathic structural examination reveals a restriction in the range of motion of ribs 1-3 on the right. If osteopathic manipulative treatments were to be focused towards the middle scalene, which of the following would describe the key rib and the associated somatic dysfunction?

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May 29, 2023 No Comments