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Quiz Osteopathic Part 4 of 4
Quiz Osteopathic Part 4 of 4
b) Flatulence
c) Ileus
d) Abdominal distension
e) Difficulty defecating
5) The pelvic diaphragm is innervated by what nerve or plexus?
a) Vagus
b) Celiac
c) Superior mesenteric
d) Inferior mesenteric
e) Pudendal
6) A thoracolumbar fracture would lead to which of the following?
a) Paralytic ileus
b) Severe diarrhea
c) Mild constipation
d) Nausea and vomiting
e) Abdominal cramps and flushing
7) Post-surgical patients should be treated how many times per day until bowel sounds
return?
a) Once
b) Twice
c) Three times
d) Four times
e) Five times
8) At what stage of post gastrointestinal surgery should one be most concerned about a
patient’s hemodynamics and electrolyte balance?
a) Stage I
b) Stage II
c) Stage III
d) Stage IV
e) None of the above
9) Rib raising bilaterally may be most useful to inhibit sympathetic flow at what stage of
post-gastrointestinal surgery?
a) Stage I
b) Stage II
c) Stage III
d) All of the above
10) Pectoral traction with lymphatic and pedal pumps may be most useful at what stage
of post-gastrointestinal surgery?
a) Stage I
b) Stage II
c) Stage III
d) All of the above
11) The CV4 cranial technique may be beneficial at what stage of post-gastrointestinal
surgery?
a) Stage I
b) Stage II
c) Stage III
d) All of the above
12) Where are the posterior Chapman points located for the colon?
a) Right distal iliotibial band
b) Left distal iliotibial band
c) Right proximal iliotibial band
d) Left proximal iliotibial band
e) Triangle between L2 and iliac crests
13) Treatment to which of the following areas would be most helpful for left-sided colon
dysfunction?
a) OA, AA
b) Condylar decompression
c) C3-C5
d) Sacrum
14) Treatment to which of the following areas would be helpful for a patient with an
upper GI complaint?
a) Vagus nerve
b) Celiac ganglion
c) Superior mesenteric ganglion
d) Inferior mesenteric ganglion
e) Pudendal nerve
d) Gastrosplenic ligament
4) Which of the following techniques may be the most beneficial for a patient, as many
structures are anatomically related to the treated area?
a) Fulford release
b) Diaphragmatic release
c) Celiac ganglion release
d) Superior mesenteric ganglion release
e) Mesenteric root release
5) Treatment for singultus should be focused on what levels?
a) OA, AA
b) C3-5
c) T5-9
d) T10-11
e) T12-L2
6) What type of radiation is sensed by the hand using manual thermal diagnosis?
a) Ultraviolet
b) Gamma
c) Infrared
d) Visible light
e) Microwave
7) When palpating just below the xiphoid process, what organ will you feel?
a) Stomach
b) Pancreas
c) Liver
d) Gallbladder
e) Spleen
8) When doing layer palpation of the abdomen, the clinician puts their hand softly on the
abdomen and presses until they reach what layer?
a) Skin
b) Camper fascia
c) Scarpa fascia
d) Transversalis fascia
e) Peritoneal organ
9) What technique would you do to release pressure at the mesenteric root?
a) Balanced ligamentous tension
b) Fulford release
c) Celiac ganglion release
d) LLQ mesentery lift
e) Muscle energy
2) A patient presents with low back pain after reaching over their head. They also
complain of shoulder pain. Which muscle may be to blame?
a) Gluteus maximus
b) Piriformis
c) Psoas
d) Quadratus lumborum
e) Latissimus dorsi
3) A patient presents with shooting low back pain and an externally rotated leg. Which
muscle may be to blame?
a) Gluteus maximus
b) Piriformis
c) Psoas
d) Quadratus lumborum
e) Latissimus dorsi
4) The Thomas test would be most useful for contracture of what muscle?
a) Gluteus medius
b) Piriformis
c) Psoas
d) Quadratus lumborum
e) Latissimus dorsi
5) What is the first ligament to become tender with lumbar posture changes?
a) Iliolumbar ligament
b) Sacroiliac ligament
c) Sacrospinous ligament
d) Sacrotuberous ligament
e) Ligamentum flavum
6) A patient presents with sharp low back pain with radiculopathy. The pain is worse with
valsalva maneuver. Testing reveals +1/4 Achilles reflex, loss of sensation on the lateral
foot, and difficulty toe walking. Heel walking and squat & rise are normal. What disc
may be herniated?
a) L2 (L2-L3)
b) L3 (L3-L4)
c) L4 (L4-L5)
d) L5 (L5-S1)
e) S1 (S1-S2)
7) An elderly patient presents with aching low back pain that goes to the lower legs.
History reveals the pain is worse with walking but relieved with sitting. Extending the
lumbar spine creates pain for the patient. Which of the following is most likely?
a) Herniated disk
b) Spinal stenosis
c) Paget disease
d) Spondylolysis
e) Epidural abscess
8) A wrestler presents with severe low back pain after a match. An oblique standing x-ray
shows a broken neck on the collar of the Scottie dog. Where is the defect?
a) Pedicle
b) Transverse process
c) Inferior articular process
d) Pars interarticularis
e) Lamina
9) Spondylolisthesis is most commonly found at what level?
a) L2 on L3
b) L3 on L4
c) L4 on L5
d) L5 on S1
e) S1 on S2
10) A patient presents with hypertonic hamstrings, backward tilting of the pelvis,
protruding abdomen, and neurologic defects. Radiograph shows a 55% spondylolisthesis
slippage. What classification is this?
a) Class I
b) Class II
c) Class III
d) Class IV
11) A patient presents with aching low back pain that radiates to the groin. Testing
reveals a positive Thomas test and positive pelvic shift test to the contralateral side.
Sacral dysfunction is found on an oblique axis and the contralateral piriformis is tight.
Extension somatic dysfunction is found at L1-L2. Which of the following is most likely?
a) Sciatica
b) Psoas syndrome
c) Spondylitis
d) Spondylolysis
12) Which of the following would be seen in a right psoas syndrome?
a) Positive Thomas Test on the left
b) L2 F RL SL
c) R on R sacral dysfunction
d) Right piriformis spasm
13) Which of the following should be ruled out with severe low back pain that has sudden
onset and no trauma?
a) Spinal stenosis
b) Malignancy
c) Aortic aneurysm
d) Epidural assess
e) Spondylolisthesis
14) A patient presents to the Emergency Room with severe low back pain. History
reveals they have chronic back pain relieved specifically with narcotics. Supine straight
leg raise is positive. Seated straight leg raise is negative. Hoover test is positive. Which of
the following is most likely?
a) Spinal stenosis
b) Sciatica
c) Spondylolysis
d) Herniated disc
e) Malingering
15) Which of the following lumbar somatic dysfunctions would be treated in the Sim
position (face down lateral recumbent)?
a) L2-L4 N RR SBL
b) L2-L4 N RL SBR
c) L4 F RR SBR
d) L2 F RL SBL
e) L4 E RR SRR
16) Which of the following tests for gluteus medius weakness?
a) Straight leg raise
b) Hoover test
c) Thomas test
d) Trendelenberg test
e) Ober test
17) In a lumbar type-one curve, which of the following is true of the patient’s legs?
a) Up above the table, patient pushing down
b) Up above the table, patient pushing up
c) Down below the table, patient pushing up
d) Down below the table, patient pushing down
e) One leg up above the table, patient pushing down
18) In a lumbar type-two flexed somatic dysfunction, which of the following is true of the
patient’s legs?
a) Up above the table, patient pushing down
b) Up above the table, patient pushing up
c) Down below the table, patient pushing up
d) Down below the table, patient pushing down
e) One leg up above the table, patient pushing down
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e) Tibial
19) What nerve levels correspond to ankle dorsiflexion and inversion?
a) L2-L3
b) L3-L4
c) L4-L5
d) L5-S1
e) S1-S2
20) What nerve root is most responsible for motor movement of the extensor hallicus
longus?
a) L1
b) L2
c) L3
d) L4
e) L5
f) S1
21) What is the most common cause of low back pain?
a) Ankylosing spondylitis
b) Reiter syndrome
c) Multiple myeloma
d) Mechanical
e) Infection
22) The straight leg raise tests for:
a) Disc herniation
b) Spondylolisthesis
c) Sciatic nerve compression
d) Weak gluteus medius
e) Tight iliopsoas
23) A middle-aged man presents with low back pain. X-ray shows a bamboo spine.
Which of the following is most likely?
a) Ankylosing spondylitis
b) Reiter syndrome
c) Multiple myeloma
d) Neoplasm
e) Coccygodynia
24) A young woman presents with complains of low back pain that worsens with sitting.
She says she recently slipped on ice and fell on her butt. She also complains of pain
during intercourse and bowel movements. Which of the following is most likely?
a) Ankylosing spondylitis
b) Reiter syndrome
c) Multiple myeloma
d) Cauda equina syndrome
e) Coccygodynia
25) Which of the following is most associated with saddle anesthesia, loss of
bowel/bladder function, and needs to be treated within 6 hours?
a) Ankylosing spondylitis
b) Reiter syndrome
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c) Multiple myeloma
d) Cauda equina syndrome
e) Coccygodynia
26) A patient is found to have a positive seated flexion test on the right, L5 N SBL RR,
shallow left ILA, deep right superior sulcus, and the lumbar spine is convex to the right.
What is the sacral diagnosis?
a) Right on Right
b) Left on Left
c) Right on Left
d) Left on Right
27) When performing the iliolumbar ligament treatment with ligamentous articular strain
(LAS), the physician places their hand superior and medial to the PSIS to contact the
iliolumbar ligament and uses this to monitor during treatment. The clinician then lifts the
ipsilateral leg and:
a) Abducts the leg then compresses toward the iliolumbar ligament
b) Flexes the leg then distracts away from the iliolumbar ligament
c) Adducts the leg then compresses toward the iliolumbar ligament
d) Flexes the leg then distracts away from the iliolumbar ligament
e) They do not lift the ipsilateral leg
28) Which of the following describes the location of the gluteus medius counterstrain
point and the position that the patient’s ipsilateral leg is placed during treatment?
a) Between L4-L5 on the iliac crest; leg is flexed
b) Between L4-L5 on the iliac crest; leg is extended
c) Between L3-L4 on the iliac crest; leg is flexed
d) Between L3-L4 on the iliac crest; leg is extended
29) Which of the following is NOT true of facilitated positional release (FPR) for the
sacrum?
a) Clinician stands on side opposite of restricted SI joint
b) Clinician places hand on contralateral sulcus
c) Clinician leg ipsilateral to SI joint
d) Clinician externally rotates leg
30) Which of the following is NOT true when treating a left on left forward sacral torsion
with muscle energy?
a) Patient lies on left side
b) Patient rotates so they are face down
c) Clinician monitors at superior pole
d) Patient’s legs are raised above the table
e) Clinician opposes patient’s leg force toward neutral
31) Which of the following is NOT true when treating a left on right forward sacral
torsion with muscle energy?
a) Patient lies on left side
b) Patient rotates so they are face up
c) Clinician monitors at superior pole
d) Patient’s lower leg is lowered below the table
e) Clinician opposes patient’s leg force toward neutral
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OPP #7 – Gait
1) Which of the following is NOT true?
a) The ileum is anterior during the swing phase and posterior during stance
b) A normal base is 2-4”
c) A normal step length is 12”
d) A normal cadence is 90-120 steps/minute
e) Stride length is measured from heel strike to heel strike
2) The center of gravity oscillates with an amplitude of 2” during gait, with ileum motion
moving 40 degrees with each step. Where is the center of gravity located?
a) 2” anterior to S2
b) 2” posterior to S2
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c) 1” superior to L4
d) 2” anterior to L4
e) 2” posterior to L4
3) Which of the following is an analysis of forces that produce motion?
a) Dynamic EMG
b) Kinesthetics
c) Kinematics
d) Kinetics
e) Momentum
4) 60% of the total gait cycle is spent in:
a) Stance phase
b) Double support
c) Swing phase
d) Heel strike
e) Push off
5) Which of the following is NOT existent during running?
a) Stance phase
b) Double support
c) Swing phase
d) Heel strike
e) Push off
6) Which of the following provides a loading response, waiting for the opposite foot to be
ready for swing?
a) Heel strike
b) Foot flat
c) Midstance
d) Push off
e) Acceleration
f) Midswing
g) Deceleration
7) During heel strike, how is the ipsilateral ileum positioned?
a) Rotates anteriorly and internally
b) Rotates anteriorly and externally
c) Rotates posteriorly and inferiorly
d) Rotates posteriorly and superiorly
e) Rotated maximally posteriorly
8) During flat foot, how is the ipsilateral ileum positioned?
a) Rotates anteriorly and internally
b) Rotates anteriorly and externally
c) Rotates posteriorly and inferiorly
d) Rotates posteriorly and superiorly
e) Rotated maximally posteriorly
9) During push off, how is the ipsilateral ileum positioned?
a) Rotates anteriorly and internally
b) Rotates anteriorly and externally
c) Rotates posteriorly and inferiorly
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affected side. The pelvis and trunk shift away from the affected side. Which of the
following is most likely?
a) Trendelenburg gait
b) Ataxic gait
c) Antalgic gait
d) Steppage gait
e) Equinovarus
17) A child with cerebral palsy walks with very stiff legs. You note very little knee
flexion during swing and nearly no ankle plantarflexion. There is a very wide base.
During heel strike, it appears the child lands with such force that the knee hyperextends.
Which of the following is most likely?
a) Trendelenburg gait
b) Ataxic gait
c) Antalgic gait
d) Steppage gait
e) Equinovarus
f) Quadriceps avoidance
18) A man presents with an abnormal gait. You note an out-toeing and a lack of heel
strike. Leg lengths are equal. Which of the following is most likely?
a) Equinovalgus
b) Femoral anteversion
c) Vaulting gait
d) Femoral retroversion
e) Equinovarus
OPP #8 – Outpatient
1) Which of the following is NOT part of the definition of somatic dysfunction?
a) Arthroidal
b) Skeletal
c) Myofascial
d) Cranial
e) Neural
f) Lymphatic
g) Vascular
2) When sequencing techniques, which of the following is NOT true?
a) Treat axial skeleton before extremities
b) Treat proximal before distal dysfunction
c) Treat subacute changes before acute changes
d) Treat primary dysfunction before facilitating dysfunction
e) Any somatic dysfunction is significant until determined otherwise
3) With regard to dosage and treatment, which of the following is NOT true?
a) Treat key areas first
b) Allow time for the patient to respond to treatment
c) Chronic disease requires chronic treatment
d) Acute cases have a shorter interval between treatments
e) Sicker patients require increased doses
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4) Which of the following statements may be the most helpful for a patient who has never
received osteopathic care?
a) “I am an Osteopathic Physician, in addition to the types of treatment you have
had in the past, I use my hands evaluate your muscles and bones and can use
manipulation as part of your treatment plan”
b) “I am an Osteopathic Physician, which is basically a bone doctor”
c) “I am an Osteopathic Physician, instead of treatments you have had in the past,
I use my hands to provide Physical Therapy, Massage, and Chiropractic
manipulation”
d) “I am an Osteopathic Physician, so my treatment plan will be far different from
that of an M.D.”
e) “I am an Osteopathic Physician trained in the fine arts first enunciated by
Andrew Taylor Still”
5) Where are the counterstrain points located for the knee?
a) Anterior on the patella
b) Medial and lateral patella
c) Superior and inferior patella
d) Mid-popliteal fossa
e) No points exist
6) Where is the Chapman reflex point for the pharynx?
a) Inferior to 1st rib, lateral to sternum
b) Inferior to 1st rib, mid-clavicular
c) Inferior to 2nd rib, lateral to sternum
d) Inferior to 2nd rib, mid-clavicular
e) Mid-sternal
7) Still technique aimed at what rib may be helpful for a patient with carpal tunnel
syndrome?
a) 1st rib, ipsilateral
b) 1st rib, contralateral
c) 2nd rib, ipsilateral
d) 2nd rib, contralateral
e) 12th ribs, bilateral
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2) Inability to move the flexor digitorum superficialis and profundus would indicate a
nerve lesion at what root?
a) C3-5
b) C5
c) C5-6
d) C6-7
e) C7-8
f) C8
g) C8-T1
3) Inability to extend the great toe would indicate a nerve lesion at what root?
a) L2-3
b) L3-4
c) L4-5
d) L5-S1
e) S1-S2
f) S2-4
4) Which of the following is NOT associated with parasympathetic stimulation?
a) Vagus nerve (CN X)
b) Carotid body (CN IX, X)
c) Thickening of mucous
d) Contraction of bronchiolar smooth muscle
e) OA, AA, C1, C2
5) Which of the following has sympathetic innervation from T7-T11 as well as T1-T6?
a) Parietal pleura
b) Visceral pleura
c) Lung
d) Trachea
e) Bronchi
6) Which of the following Chapman points is incorrect?
a) Upper lung is anterior T3
b) Lower lung is anterior T4
c) Upper lung is posterior T2
d) Lower lung is posterior T3
e) Heart is posterior T1
7) Pelvic splanchnics (S2-4) supply parasympathetics to all of the following EXCEPT:
a) Prostate
b) Genitals and rectum
c) Upper ureter
d) Descending colon
e) Uterus
8) Innervation to the midgut (jejunum, ileum) would involve which of the following?
a) Celiac ganglion (post-ganglionic)
b) Greater splanchnic (pre-ganglionic, T5-T9)
c) Superior mesenteric ganglion (post-ganglionic)
d) Least splanchnic (pre-ganglionic, T12-L2)
e) Inferior mesenteric ganglion (post-ganglionic)
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110, R 16/min. However, she is quite drowsy and falls asleep in mid sentence. Physical
exam reveals Elevated 1st rib left and T1 RR SR. Bilateral basilar crackles on
auscultation. Which of the following is most likely?
a) Pneumonia
b) Atelectasis
c) Pneumothorax
d) Ascites
e) Ileus
10) A 45-year-old white male, right hand dominant, complains bitterly of low back pain
following an 11-hour operation to re-attach and repair 4 fingers, to his right hand
following a lawnmower mishap. He has TART changes in his lumbar spine bilaterally
and his sacrum moves better during inhalation than exhalation. He cannot do a Spring test
in bed. He says his pain is constant, achy, non-radiating and 8/10. Sacral motion is not
noticeable during respiration. Sulcus is tender, shallow bilat, ILA’s symmetrical, and
seated flexion test +/-. Which of the following is most likely?
a) Bladder distension
b) Atelectasis
c) Pneumothorax
d) Ascites
e) Ileus
11) Where is the anterior Chapman point for the kidneys?
a) 2cm lateral and 2cm cephalad of umbilicus
b) 4cm lateral and 4cm cephalad of umbilicus
c) 2cm superior to umbilicus
d) 4cm superior to umbilicus
e) Peri-umbilical
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e) Typhoid fever
4) A. T. Still broke with orthodox medicine and “flung the banner of osteopathy to the
breeze.” He developed a form of manipulation to help keep the body fit with
unobstructed circulation and innervation. He did this on the 22nd of June in which year?
a) 1874
b) 1875
c) 1876
d) 1877
e) 1878
5) In which of the following years did Dr. Still open the American School of Osteopathy
in Kirksville, MO?
a) 1828
b) 1850
c) 1874
d) 1892
e) 1917
6) Medical Education in the United States and Canada was a scathing exposé of medical
schools in North America. A few medical schools were closed but medical education was
improved. Who was the author of this report?
a) Flexner
b) Jones
c) Mitchell
d) Palmer
e) U.S. Public Health Service
7) Due to AMA antagonism, Osteopathic Physicians were not allowed to practice in the
armed forces during several wars. This situation subsequently strengthened their practices
within the United States. The involved wars included which of the following?
a) Civil and Spanish American Wars
b) World War II and Korean War
c) World War I and War of 1912
d) World Wars I and II
e) Korean and Vietnam Wars
8) Presently (2009), excluding branch campuses, how many schools of Osteopathic
Medicine exist?
a) 21
b) 23
c) 25
d) 27
e) 28
9) Dr. Still died at the age of 89 in what year?
a) 1817
b) 1850
c) 1874
d) 1892
e) 1917
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10) Licensing of osteopathic physicians in California was halted and M.D. degrees were
granted by the former Osteopathic College to nearly 2,500 D.O.s for a fee. The Los
Angeles College of Osteopathic Physicians and Surgeons becomes an allopathic medical
school, later affiliated with the University of California system. This all happened in what
years?
a) 1960-61
b) 1961-62
c) 1962-63
d) 1963-64
e) 1964-65
11) When the Osteopathic profession suffered a major setback in California, D.O.s could
purchase an M.D. degree for how much?
a) $55
b) $65
c) $75
d) $85
e) $1,000
12) Osteopathic medicine is first and foremost:
a) Osteopathic manipulation
b) Allopathic medicine and manipulation
c) A system based on using minute dosages of medication
d) A medical philosophy
e) A system based solely on the fact that the body is a unit
13) Cellular structures stabilize themselves by balancing counteracting forces of
compression and tension via microtubules, microfilaments, cell membranes, and fascial
collagen. This phenomenon is known as:
a) Bioelectricity
b) Elasticity
c) Plasticity
d) Viscosity
e) Tensegrity
14) When is the best time to treat a newborn, according to Fulford?
a) Within 6 hours
b) After 6 hours, but no longer than 24-hours
c) After a 24-hour waiting period
d) Between days 1 and 3
e) Between days 3 and 5
15) Although all of the following can be treated with occipital condylar decompression,
which of the following is specific to CN IX (glossopharyngeal)?
a) Torticollis
b) Reflux
c) Colic
d) Pyloric stenosis
e) Sucking
16) When treating the thoracic inlet in the prone position, how should the patient’s head
be positioned with respect to the dysfunctional side?
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James Lamberg
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