A 23-year-old male presents to clinic with 2 days of left sided low back pain. The patient states the pain began after he got tackled during a recreational football game with his friends. He has tried over-the-counter pain medications with moderate relief but is worried that he might have broken his ribs. Physical examination reveals tenderness to palpation on the right flank around ribs 7-12. Osteopathic structural examination reveals decreased range of motion of ribs 7-12. Xray imaging completed in the office shows all ribs to be intact. Osteopathic treatments begin with focus on the serratus anterior muscle. Which of the following is the key rib and the somatic dysfunction the patient is exhibiting?

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May 29, 2023 No Comments

A 23-year-old male presents to clinic with 2 days of left sided low back pain. The patient states the pain began after he got tackled during a recreational football game with his friends. He has tried over-the-counter pain medications with moderate relief but is worried that he might have broken his ribs. Physical examination reveals tenderness to palpation on the right flank around rib 12. The patient also exhibits restriction of motion of rib 12 upon deep inhalation. Xray imaging completed in the office shows all ribs to be intact. Given the physical exam findings, which muscle should osteopathic treatment be focused towards to correct the patient’s somatic dysfunction?

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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 restriction of movement on inhalation of ribs 7-10 on the right. Which of the following muscle groups should osteopathic treatment be focused towards?

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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 restriction of movement on exhalation of ribs 7-10 on the right. Which of the following muscle groups should osteopathic treatment be focused towards?

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May 29, 2023 No Comments

A 26-year-old male presents to clinic with complaints of worsening asthma. He has a long history of asthma and has now begun to use his rescue inhaler more frequently. He also states that he wakes up at night due to his asthma. Physical examination reveals mild wheezes bilaterally. In addition to starting the patient on a low-dose inhaled glucocorticoid, osteopathic manipulative treatments are initiated. Osteopathic structural examination reveals restriction of motion in rib 2 on the left during inhalation. Which of the following muscles should initial treatment be focused towards?

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May 29, 2023 No Comments

A 26-year-old male presents to clinic with complaints of worsening asthma. He has a long history of asthma and has now begun to use his rescue inhaler more frequently. He also states that he wakes up at night due to his asthma. Physical examination reveals mild wheezes bilaterally. In addition to starting the patient on a low-dose inhaled glucocorticoid, osteopathic manipulative treatments are initiated. Osteopathic structural examination reveals restriction of motion in ribs 4-6 on the left during inhalation. Which of the following muscles should initial treatment be focused towards?

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May 29, 2023 No Comments

A 26-year-old male presents to clinic with complaints of worsening asthma. He has a long history of asthma and has now begun to use his rescue inhaler more frequently. He also states that he wakes up at night due to his asthma. Physical examination reveals mild wheezes bilaterally. In addition to starting the patient on a low-dose inhaled glucocorticoid, osteopathic manipulative treatments are initiated. Osteopathic structural examination reveals restriction of motion in ribs 3-5 on the left during exhalation. In addition, thoracic segment, T5, is found to be rotated left and the rotational asymmetry improves in flexion. Which of the following diagnoses is the most appropriate to treat initially?

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May 29, 2023 No Comments

A 52-year-old male presents to clinic with complaints of neck pain. He says the pain has been ongoing for about 3 months ever since he has been sleeping on his new mattress. Osteopathic structural examination reveals the patient has tightness and tenderness to palpation on the left cervical paraspinal musculature. Further examination exhibits the patient’s 1st and 2nd rib on the left have decreased movement during exhalation when compared to the right. Which of the following correctly describes the diagnosis and the muscle that treatment should be focused towards?

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May 29, 2023 No Comments

A 52-year-old male presents to clinic with complaints of neck pain. He says the pain has been ongoing for about 3 months ever since he has been sleeping on his new mattress. Osteopathic structural examination reveals the patient has tightness and tenderness to palpation on the left cervical paraspinal musculature. Further examination exhibits the patient’s 1st and 2nd rib on the left have decreased movement during exhalation when compared to the right. Which of the following sets correctly describes the key rib?

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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 is the key rib that treatment should be focused towards?

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May 29, 2023 No Comments