DO Doctor of Osteopathic Medicine MCQ 2 — Questions and Answers
Question 1: A patient presents with a tender point in the anterior thigh. Using counterstrain, the physician should position the patient to achieve maximum:
- Extension of the hip
- Flexion of the hip with slight abduction (Correct answer)
- Adduction and internal rotation only
- Neutral position with traction
Correct answer: Flexion of the hip with slight abduction
Counterstrain for anterior thigh tender points typically involves flexion of the hip with slight abduction and external rotation to shorten the involved muscle and reduce afferent nociceptive activity.
Question 2: Which of the following best describes the 'ease-bind' concept in osteopathic diagnosis?
- The direction of maximum restriction is the bind; ease is the opposite direction (Correct answer)
- Ease and bind refer to respiratory phases during OMT
- Bind describes fascial planes; ease describes joint motion
- Ease is the direction of maximum restriction; bind is the barrier
Correct answer: The direction of maximum restriction is the bind; ease is the opposite direction
In osteopathic palpation, 'bind' is the direction of motion restriction or resistance, while 'ease' is the direction of least resistance — somatic dysfunction is named for the ease (freedom) direction.
Question 3: A 45-year-old male presents with acute low back pain after lifting. Palpation reveals L3 NSLRL. What does this notation indicate?
- L3 is neutral, sidebent left, rotated left (Correct answer)
- L3 is non-neutral, sidebent left, rotated left
- L3 is neutral, sidebent right, rotated left
- L3 is non-neutral, sidebent right, rotated left
Correct answer: L3 is neutral, sidebent left, rotated left
NSLRL stands for Neutral, Sidebent Left, Rotated Left — a Type I (Fryette's) neutral group curve dysfunction following the rule that rotation and sidebending occur to opposite sides in extension.
Question 4: Which cranial nerve is most closely associated with the parasympathetic supply to the parotid gland?
- CN VII (facial nerve)
- CN IX (glossopharyngeal nerve) (Correct answer)
- CN V3 (mandibular branch)
- CN X (vagus nerve)
Correct answer: CN IX (glossopharyngeal nerve)
CN IX (glossopharyngeal nerve) carries preganglionic parasympathetic fibers via the lesser petrosal nerve to the otic ganglion, which then sends postganglionic fibers to the parotid gland.
Question 5: During osteopathic structural exam, a patient is found to have a right-on-right sacral torsion. Which combination of findings is expected?
- Left sacral sulcus deep, right ILA posterior, positive left seated flexion test
- Right sacral sulcus deep, right ILA posterior, positive right seated flexion test (Correct answer)
- Left sacral sulcus shallow, left ILA posterior, negative seated flexion test
- Right sacral sulcus deep, left ILA posterior, positive right seated flexion test
Correct answer: Right sacral sulcus deep, right ILA posterior, positive right seated flexion test
A right-on-right sacral torsion has the right sacral sulcus deep (sacrum rotating right around a right oblique axis), right ILA posterior/inferior, and a positive right seated flexion test (right ilium restricted).
Question 6: A 30-year-old woman with asthma is treated with osteopathic manipulative treatment targeting the upper thoracic region. The primary goal of treating T1-T4 is to:
- Reduce afferent pain signals from the lung parenchyma
- Normalize sympathetic outflow to the bronchopulmonary tree (Correct answer)
- Increase parasympathetic tone via the recurrent laryngeal nerve
- Improve lymphatic drainage through the thoracic duct
Correct answer: Normalize sympathetic outflow to the bronchopulmonary tree
The sympathetic innervation to the lungs originates from T1-T4 spinal levels; somatic dysfunction here can cause facilitated segments that increase bronchial smooth muscle tone, and OMT aims to normalize this sympathetic outflow.
Question 7: A physician applies a muscle energy technique to the cervical spine. The patient actively contracts against the physician's unyielding resistance for 3-5 seconds. This technique relies primarily on which physiological mechanism?
- Gate control theory of pain modulation
- Post-isometric relaxation and reciprocal inhibition (Correct answer)
- Golgi tendon organ activation causing stretch reflex
- Joint mechanoreceptor stimulation reducing gamma motor neuron firing
Correct answer: Post-isometric relaxation and reciprocal inhibition
Muscle energy technique uses post-isometric relaxation (the muscle relaxes after isometric contraction) and reciprocal inhibition (antagonist relaxes when agonist contracts) to improve range of motion.
DO Doctor of Osteopathic Medicine MCQ 2
A patient presents with a tender point in the anterior thigh.
Using counterstrain, the physician should position the patient to achieve maximum: