DO (True or False) 4 — Questions and Answers
Question 1: Preganglionic sympathetic fibers supplying the heart originate from spinal cord levels T1–T4.
- True (Correct answer)
- False — cardiac sympathetics arise from T5–T9
- True, and these same fibers also innervate the lungs
- Cardiac sympathetics originate solely from the cervical ganglia
Correct answer: True
Preganglionic cardiac sympathetic fibers arise from T1–T4, synapsing in the cervical and upper thoracic sympathetic ganglia before innervating the heart.
Question 2: According to Fryette's Law I, sidebending and rotation in a neutral spine occur to opposite sides.
- True (Correct answer)
- False — they occur to the same side in Law I
- True, but Law I only applies to the thoracic spine
- Fryette's Laws do not address neutral spine mechanics
Correct answer: True
Fryette's Law I states that in a neutral (non-flexed, non-extended) spine, sidebending and rotation couple to opposite sides and involve a group of vertebrae.
Question 3: Type II somatic dysfunction (Fryette's Law II) describes a single vertebral segment where sidebending and rotation occur to the same side.
- True (Correct answer)
- False — Type II involves rotation opposite to sidebending
- True, but this only applies in the cervical spine
- Type II dysfunction always involves multiple vertebrae
Correct answer: True
Fryette's Law II applies to a single non-neutral (flexed or extended) vertebral segment in which sidebending and rotation couple to the same side.
Question 4: The greater splanchnic nerve (T5–T9) carries preganglionic fibers to the celiac ganglion.
- True (Correct answer)
- False — the celiac ganglion is supplied by T10–T12
- True, but the celiac ganglion also receives parasympathetic fibers
- The greater splanchnic nerve supplies the inferior mesenteric ganglion
Correct answer: True
The greater splanchnic nerve (T5–T9) provides preganglionic sympathetic fibers to the celiac ganglion, which innervates the upper abdominal organs.
Question 5: Loss of cervical lordosis on lateral cervical X-ray always indicates serious pathology requiring immediate intervention.
- True
- False — it is a common finding with muscle spasm, positioning, or poor posture (Correct answer)
- True, but only in patients over 50 years old
- Cervical lordosis can only be accurately assessed by MRI, not plain X-ray
Correct answer: False — it is a common finding with muscle spasm, positioning, or poor posture
Loss of cervical lordosis is frequently a benign finding associated with muscle spasm, patient positioning during imaging, or habitual posture and does not mandate urgent intervention.
Question 6: The psoas major muscle can produce low back and flank pain that mimics renal colic due to its retroperitoneal location.
- True (Correct answer)
- False — the psoas does not refer pain to the flank
- True, but only when completely ruptured
- The psoas only refers pain to the anterior thigh and groin
Correct answer: True
The psoas major lies adjacent to the ureter and kidney; spasm or trigger points in this muscle can refer pain to the flank and low back, mimicking renal colic.
Question 7: The knee-chest position is used in osteopathic treatment to place the sacrum in a position of ease (extension/counternutation).
- True (Correct answer)
- False — knee-chest places the sacrum in flexion (nutation)
- True, but only for anterior sacral dysfunctions
- The knee-chest position is used for lumbar, not sacral somatic dysfunction
Correct answer: True
In the knee-chest position, gravity allows the sacrum to drop into extension (counternutation), providing an indirect position of ease for certain sacral somatic dysfunctions.
DO (True or False) 4
Preganglionic sympathetic fibers supplying the heart originate from spinal cord levels T1–T4.