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 sets correctly describes the key rib that treatment should be focused towards?

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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 the thoracic diaphragm during exhalation. Which of the following sets of nerves innervates this muscle?

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May 29, 2023 No Comments

A 56-year-old male presents to clinic with complaints of back pain that has been ongoing for about 3 weeks. The patient states that the pain started after moving around some equipment in his garage. He has tried ice and over-the-counter medications with only mild relief of his symptoms. Osteopathic structural examination reveals the left transverse process of T4 to be more anterior than the left. The rotational asymmetry does not change with positional changes. On physical examination, where is the spinous process of T4 located?

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May 29, 2023 No Comments

A 51-year-old female presents to clinic with complaints of back pain that has been ongoing for about 1 month. The patient states that the pain started after moving around some heavy boxes in her garage. She has tried ice and over-the-counter medications with only mild relief of her symptoms. Osteopathic structural examination reveals the right transverse process of T8 to be more anterior than the left. The rotational asymmetry does not change with positional changes. On physical examination, where is the vertebral body of T8 most likely found?

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May 29, 2023 No Comments

A 65-year-old female presents to clinic with complaints of low back pain ongoing for 1 week. She states the pain began after picking up her grandchildren. She says the pain does not radiate and rates the pain a 4/10. Osteopathic structural examination is significant for tightness and tenderness to palpation of the paraspinal musculature around L2. Palpation of the transverse processes of L2 reveals that the left transverse process is more anterior than the right. The asymmetry seems to become more exaggerated when asking the patient to lean forward. Which of the following diagnoses is most likely given the physical exam findings?

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May 29, 2023 No Comments

A 63-year-old male presents to clinic with complaints of low back pain going on for 2 weeks. He states the pain started after he went horse-back riding with his wife. He has tried over-the-counter pain medications without relief of his symptoms. Osteopathic structural examination finds segments L2-L4 rotated left. These segments are found to resist translation to the right. Which of the following most accurately describes the findings above?

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May 29, 2023 No Comments

A 30-year-old present to the office with complaints of upper back pain. Osteopathic structural examination of the patient’s thoracic region reveals a band of hypertonic muscles on the left side of the spine. Further examination reveals posterior transverse processes on the right from T3 to T6. Using Fryette’s principles, which of the following is true regarding the somatic dysfunction presented above?

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May 29, 2023 No Comments

A 48-year-old female presents to clinic with complaints of back pain that has been ongoing for about 3 months. The patient states that the pain started after moving around some heavy boxes in her garage. She has tried ice and over-the-counter medications with only mild relief of her symptoms. Osteopathic structural examination reveals the right transverse process of T9 to be more posterior than the left. The rotational asymmetry does not change with positional changes. Which of the following is the most likely diagnosis?

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May 29, 2023 No Comments

A 48-year-old female presents to clinic with complaints of back pain that has been ongoing for about 3 months. The patient states that the pain started after moving around some heavy boxes in her garage. She has tried ice and over-the-counter medications with only mild relief of her symptoms. Osteopathic structural examination reveals T11 to be rotated to the left with improvement of the rotational asymmetry in extension. Which of the following physical exam findings would be most consistent with the diagnosis of T11?

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May 29, 2023 No Comments

A 47-year-old female presents to the clinic with neck pain. She states the pain has been ongoing for almost a year. She has tried over-the-counter medications which only provided mild relief. She has also tried massage therapy which she says relieved her pain, however it returned soon after. Osteopathic structural examination of the cervical spine reveals that the transverse process of C7 is deeper on the right when compared to the left. The restriction seems to worsen upon flexion of the neck. Which of the following is the most likely diagnosis given the physical exam findings?

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May 29, 2023 No Comments