OCC OCC Neurological Assessment & Neuromuscular Medicine 2

Question 1

Carpal tunnel syndrome produces paresthesias in which sensory distribution?

Accepted Answer

Thumb, index, middle, and radial half of ring finger

Answer

Compression of the median nerve in the carpal tunnel causes sensory symptoms in the lateral 3.5 fingers: thumb, index, middle, and radial half of the ring finger.

Question 2

The Romberg test primarily evaluates the integrity of which sensory pathway?

Accepted Answer

Posterior (dorsal) columns (proprioception/vibration)

Answer

The Romberg test assesses proprioception carried by the posterior columns; removing visual input unmasks deficits in sensory ataxia due to dorsal column dysfunction.

Question 3

Which combination of neurological signs is characteristic of amyotrophic lateral sclerosis (ALS)?

Accepted Answer

Both upper and lower motor neuron signs with no sensory deficits

Answer

ALS simultaneously involves upper motor neurons (spasticity, hyperreflexia, Babinski) and lower motor neurons (atrophy, fasciculations) while characteristically sparing sensory pathways.

Question 4

A patient describes the sudden onset of 'the worst headache of my life.' Which diagnosis must be emergently excluded?

Accepted Answer

Subarachnoid hemorrhage

Answer

A thunderclap headache reaching maximal intensity within seconds is the classic presentation of subarachnoid hemorrhage and requires immediate CT and lumbar puncture if CT is negative.

Question 5

When applying OMT for cervicogenic or tension-type headache, which region is most commonly the primary treatment target?

Accepted Answer

Suboccipital and upper cervical region

Answer

Somatic dysfunction in the suboccipital and upper cervical region contributes to headache via muscular tension, neurovascular compression, and neurological facilitation, making it the primary OMT target.

OCC - Osteopathic Continuous Certification Practice Test

OCC - Osteopathic Continuous Certification Practice Test

OCC OCC Neurological Assessment & Neuromuscular Medicine 2