Osteopathic Medicine Recall

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OSTEOPATHIC MEDICINE RECALL

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OSTEOPRTHIC

MEDICINE RECR Editors

Andrew D. Mosier University College of Osteopathic Medicine (OUCOM) Doctors Hospital at Stork County Beachwood, Ohio

Dai Kohara University College of Osteopathic Medicine (OUCOM) Cuyahoga Falls General Hospital Medina, Ohio

@. Wolters Kluwer I Lippincott Williams & Wilkins Health

Philadelphia

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Buenos Air!!'s

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is not responsible (as a matter of product liability. negligenc'€. or othenvise) fo r any injury re sultin g from any material contained herein. This pu blica tio n contains information relating to ge ne ral principles of medical care that should no t be constnlcd as specific i ns truc tions for inruvid­

The p ublis her

ual patients. Manufacturers' product information and package inselis should be reviewed for current in fo rma tion. Printed in

inc l u ding c ontraindi cations .

d osages. and precaut.ions.

the United States oj Americo

Library of Congress Cataloging-in-Publication

Data

M OS ier,

Andrew D. Osteop athic medicine recall/Andrew D. Mosier, Dai

Kohan,.

p. ; cm.-(Recall series)

Includes bibliographical re fe r en c es and index. ISBN-13: 978-0-7817-6621-0 ISBN-10: 0-7817-662 1-4 1.

Osteopat.hic Inedicine-Miscellanea.

I.

Koh ar.,

Dai.

II. Title.

III.

Ser ies. [DNLM: 1. Ma nipu lat ion. Osteopathic-Ex:lmination Qu es t io ns .

Osteo pathic Medicine-Examination Questions.

WB 18.2 M91lo 2007)

R2.343.M672007 615.5'3

c22 2 006037 180

The publishers

haGe made eveT1J effort to trace the copylight Iwlders Jo,. borrowed IlUltelia!.

iflndr;( rtetl.tly overlooked any. fil>! oppartu nit'!' hm.::e

they

tL'ill be pleased to

make th.e

Car-ejlJ.1 thn.e and attention has been taken to make certain th.at

necessary

the

OMT Osteopathic Me dicine Recoil is correct and col1l7Jalibie with I.he

if they

nrnillgelllclits at the

il fon1Ult;on

siallihm/s

(;{mtliiIUX/ within

oj wee accepted al

aulh",,', cdUol>. 011 15°

at the elbow and the

significant for abduction of the

forearm?

ulna if somatic dysfunction is

10.770

6.421

pres('nt. What is the significance of

A carrying angle less than 3° is

having a carrying angle '"

the patient to abduct

performed?

to 900 and then test results if the patient cannot lower the arm.

Copyrighted Material

6.416

6.41&417

Chapter 3 I Upper and Lower Extremities Wbat is Yerguson test?

Yerguson test is used to

45

6.416

determine the stability of the bicep tendon in the bicipital groove and is positive if pain is elicited in the tendon of the long head of the biceps when the patient internally rotates the shoulder of a flexed arm against resistance; a positive test indicates possible bicep tendon dislocation or tendonitis. For boards: You may also encounter the Speed test. which is also used to assess the bicep tendon in the biCipital groove. W'hat is the purpose of the

The Finkelstein test is used to

Finkelstein test'?

test the abductor pollicis longus

6.465

and extensor pollicis brevis tendons at the wrist and is positive if ulnar deviation of the wrist is not possible due to pain; a positive test indicates possible de Quervain tenosynovitis. W'hat is the purpose of the

Thl' Adson test is used to diagnose

Adson test?

thoracic outlet syndrome and is

1.701

positive if the radial pulse is diminished or lost; symptoms may be fUlther exacerbated by dt'ep inspiration if the diagnosis is difficult to make. What is the cause of

Pelfonning the Adson test causes

a positive Adson test?

the anterior scalene muscle to raise the first rib. which narrows the thoracic outlet. compressing the subclavian artery. which gives rise to the axillary artery. the brachial mtery. and then further divides into the ulnar and radial arteries.

Copyrighted Material

1.701

46

Osteopathic Medicine Recall

What is the Allen test

The Allen test is used to ass('ss

used for?

the adequacy of the blood supply

7.576

to the hand by the radial and ulnar mteries and is positive if capillary refill does not take place in under two seconds; a positive test indicates diminished pprfllsion and possible occlusion of the radial or ulnar arteries, depending on which artery was compressed. What is the purpose of the

The hip drop test is used to

hip drop test?

assess the sidebending ability

1.741

of the lumbar spine and the thoracolumbar junction. What does a positive hip

A positive hip drop test is

drop test indicate?

indicative of a somatic

1.741

dysfunction in thl' lumbar or thoracolumbar spine. What is the purpose of the

The straight-leg raiSing test is

straight-leg raising test?

used to evaluate for sciatic nerve

6482

compression and is positive if pain radiates past the knee; a positive test indicates possible lumbar disc herniation or sciatic nerve impingement. What is the use of the

The Trendelenberg test is used

Trendelenberg test?

to assess gluteus medius muscle

6480

stren)!;th and is positive if the patient's hip drops to the contralateral side of the leg the patient is standing on. What condition often results

Psoas syndrome often results

in pelvic shift from midline?

in a flexion contracture leading to a pelvic shift in the opposite direction of the dysfunctional psoas.

Copyrighted Material

6.539

Chapter 3 / Upper and Lower Extremities What is the purpose of the

The Ober test is used to assess for

Ober test?

a tight tensor fascia lata and

47

6.479

iliotibial band and is positive if the abducted leg does not freely return to midline; a positive test indicates possible IT Lliotibial

band contracture. What is the significance of

The Thomas test evaluates for

the Thomas test?

the possibility of a flexion

6.479

contracture of the hip, usually of iliopsoas origin, and the test is positive if the affected hip is unable to be fully extended.

When the hip glides

When the hip glides anteriorly,

anteriody, in what direction

the head of the femur glides

does the femoral head

anteliorly with external rotation

move?

of the hip.

When the hip glides

When the hip glides posteriorly,

posteriorly, in what direction

the head of the femur glides

6,479483

6,479483

does the femoral head

posteriorly with internal rotation

move?

of the hip.

What types of somatic

Piriformis and iliopsoas spasms

6479

Tibiofemoral joint

6.484

The ACL prevents excessive

6484485

dysfunctions are most likely to cause hip restriction with intemall"otation? Which joint is the largest joint in the body? What is the function of the anterior cruciate ligament

anterior translation of the tibia

(ACL)?

on the femur.

What is the function of the

The PCL prevents excessive

posterior cruciate ligament

posterior translation of the tibia

(PCL)?

on the femur.

What is the function of

The medial collateral ligament

medial collateral ligament?

helps to stabilize the knee.

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6.485

6.484

48

Osteopathic Medicine Recall

In what direction does the

The fibular bead

fibular head move when the

when the foot is

6,486

foot is In what direction does the

The fibular head glides

fibular head move when the

n()<tprif'lriv when the foot

6486

foot is supinated? What ankle motions occur

Dorsiflexion, eversion, and

when the foot is pronated?

abduction of the ankle occur

6498

when the foot is pronated, What ankle motions occur

Plantar flexion, inversion, ::md

when the foot is supinated?

adduction of the

6498

when the foot is Coxa

'Vhat is coxa vara?

occurs when the

6.488

between the neck and shaft the femur is less than 120°, occurs when the

\\!hat is coxa valga?

neck and the of the femur is greater than 135°, What nerve lies directly

The common

nndpMor to the

nerve

nr ..v'rn!>1

10.631

head? What is the cause of

Patellofernoral

pateHofemoral syndrome?

imbalance of the musculature of the

an

nt

5I

6.486

L543544

a type 1 the ankle? Type 2

1.543-

in a

the anterior

544

of the ankle?

and the calcaneofibular

'''''hat lig2lmt�nts

1.543,,44

in a type 3 of the ankle?

What ligllnl.ent or.,,,pnt.'

Deltoid

1.544

excessive ankle? True

01'

False: Excessive

False; excessive

pronation of ankle will

ankle will rnore

result in a pure

a fracture of the

6.498502

injury, What is the function of the

The function

spring (CaIC!l:neon:aVlCI ligament?

6.499

is to support the arch.

What structures make up

6.499

the plantar

Which muscle is considered

The

muscle

6473

the primary flexor of the hip? What muscle is the

Gluteus maximus

6473

hip edensor? What muscles al'e considered

6.485

the major knee extensors?

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52

Osteopathic Medicine Recall

What muscles are considered

Tlle semimembranosus and semi-

the maior knee flexors?

tendinosus

hold

How many

the femoroacetabular joint

Name the

that

hold the femoroacefabular in

muscles

Four ligaments hold the

5A71

femoroacetabular loint in

1. 2.

""emUlel

3. 4.

femoris

Capitis femoris

6.471

Sacrospinous

6.473

What is the purpose of the

The anterior drawer test is

6.488

anterior drawer test?

used to assess ACL function

\Vhich

is attached

to the head of the femur? divides the

and is positive for

a

possible

tear of the ACL if excessive anterior motion is observed during the test. What is the purpose of the

The posterior drawer test is used to assess PCL function and

posterior drawer test?

is positive for a

kar

of the peL if excessive n()<rpdnr motion is observed the test. ouroose of the Lachman is if excessive anterior

of the

tibia is observed What is the

of the

The

McMurray meniscaJ during the test

Copyrighted Material

test is used to

Chapter 3 / Upper and Lower Extremities

What is the purpose of the

The patellar-gli nd test is used

patellar-grind test?

to assess the posterior articular

53

6.492

surfaces of the patella and is positive for possible chondromalacia patellae if crepitus of the joint is noted during the test. What does a valgus stress

Valgus stress tests for medial

placed on the knee test?

collateral ligament tears.

What does a varus stress

Varus stress tests for lateral

placed on the knee test?

collateral ligament tears.

What is the purpose of the

The anterior draw test of the

anterior draw test of the

ankle is used to assess the medial

ankle?

6.488

6.488

6.488

and lateral ligaments of the ankle and is positive for possible ligamentous damage or tears if excessive anterior glide at the ankle is observed during the test.

What ligaments are assessed

The talofibular ligament,

using the anterior draw test

superficial ligament, and deltoid

of the ankle?

ligament

What is the cause of hallux

Hallux valgus is a structural

valgus?

deformity of the big toe resulting

6.488

1.800

from contracture of various periarticular structures of the first metatarsophalangeal joint. What is the cause of

A bunion is caused by varus

a bunion?

deviation of the first metatarsal.

What are hammer toes often

Hammer toes are often

associated with?

associated with myofascial trigger

1.800

1.801

points in the dorsal interossei of the foot. What is sciatica?

Sciatica describes the condition in which patients have pain along the sensory distribution of the sciatic nerve down the back of the leg.

Copyrighted Material

7.711

54

Osteopathic Medicine Recall

Name the two nerves that

The common peroneal and tibial

branch from the sciatic

nerves

7.711

nerve.

A bow-legged appearance

1791

What ligament is damaged

Annular ligament; this condition

10.801

when a child is lifted by the

is known as "nursemaid's elbow."

A decreased

Q angle is

associated with which one of the following conditions: bow-legged or knock-knee appearance?

upper limb while the forearm is pronated? What is plantar fasciitis?

Plantar fasciitis is an inflammation

6.542

of the plantar fascia on the plantar aspect of the foot. At what location does the

The inHammation usually occurs

inflammation usually occur?

at the insertion of the plantar

6.542

fascia near the calcaneus. What OMT approach is

OMT is directed at freeing

used when treating plantar

motion of the bones of the foot

6.543

and stretching hypertonic

fasciitis?

muscles of the calf and fascia. What is a march fracture?

A stress fracture found at the

6.542

shaft of the second or third metatarsal bones What causes pes planus?

Pes planus (Hat feet) is a condition

6.543

in which there is dropping of the medial longitudinal arch. How is pes planus treated?

Pes planus is treated by prescribing

6.543

heel wedges or exercises to strengthen the muscles involved. What is Morton neuroma?

Morton neuroma is a fibrotendinous reaction occurring between the heads of the third and fourth metatarsals.

Copyrighted Material

6.542

Chapter 3 I Upper and Lower Extremities

True or False: In Morton

True; pain is neuritic in type and

neuroma, pain radiates to

radiates to the toes,

55

6542

the toes. What castles pes anserine

Pes anserine bursitis is caused

bursitis?

trauma to the knee

Contraction of what muscles makes the pain of a pes

6,541

6,541

sart0l1ns, and

anserine bursitis worse? Whet'e is OMT directed to

OMT is directed to the

treat pes anserine bursitis?

and

What is the most common

Acute

injury to the ankJe?

ankle

\"''hat is the most common

Inversion stress

6.541

is the most common

6541

6,541

cause of acute ankle sprain? What ligament is stretched

Lateral collateral

by inversion of the foot? What is the common cause

Calcaneal

stress

6,541

of chronic ankle sprains'? What is meralgia paresthetica?

Meralgia

is an

intlarnmation of the lateral cutaneous nerve of the also known

What physical

"gun-belt

are

found in patients """, ...."Imi"

paresthetica? a distribution, to

How is the te