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Courtesy of Dr. Chris LaFontano, D.O. Denver, CO.
Over 60 sample questions for the COMLEX. Answers
are provided below.
1. Questions 1-4 are Case 1
A 47 year-old woman presents to your office reporting shortness of breath. During
the course of the physical examination, you note that there is an increased
thoracic kyphosis. As you auscultate the chest, you also note that the kyphosis
remains unchanged with inhalation. The normal motion of the thoracic spine with
inhalation is:
A. Increasing kyphosis
B. Decreasing kyphosis
C. Kyphosis remains unchanged
2. As you auscultate the heart, you note an irregularly
irregular rhythm consistent with atrial fibrillation. At what spinal levels
would you expect to find viscerosomatic reflex changes as a result of this cardiac
condition?
A. T1 to T4
B. T5 to
C. T10 to L2
D. L3 to S1
E. S2 to S4
3. As you palpate the paravertebral tissues at the involved
spinal levels, what changes would you expect to find if this cardiac dysrhythmia
were due to an acute myocardial infarction?
A. Skin warm, fascia tense immobile, muscle hard and
ropy, slight dull tenderness
B. Skin warm, increased muscle tension, superficial tenderness, edematous
feel
C. Tenderness elicited on deep palpation, skin cool to touch, fascias fibrotic
D. Joint ankylosis, warm skin, superficial tenderness, edema
E. Tenderness on deep palpation, muscles feel boggy or doughy, fascia fibrotic
4. On examining this patient's cervical region, you discover
segmental dysfunction at C3, C4, and C5. A somatosomatic reflex from these segments
could cause hyper tonicity and dysfunction o which of the following muscles:
A. Extensor carpi radialis longus and brevis mm.
B. Triceps m.
C. Flexor digitorum superficialis m.
D. Diaphragm
E. Rectus capitis obliquius m.
5. Case 2
A 75 year-old woman presents to your office with pain in the shoulder. On examining
the shoulder, you find no evidence of shoulder pathology. On auscultation of
the chest, you discover a pleural rub in the lung base. The innervation of the
pleura covering the central tendon of the diaphragm is:
A. The sixth intercostal nerve
B. The right vagus
C. The eighth intercostals nerve
D. The phrenic nerve
E. The tenth intercostals nerve
6. Questions 6-7 are Case 3
A 53 year-old man presents to your office with facial pain which follows the
maxillary division of the trigeminal nerve. The pain is sudden and lancinating
and makes the patient wince and on occasion cry out with sudden distress. It
is triggered by chewing, talking and even breezes blowing on the face. Lightly
touching the patient's cheek reproduces the pain. Diagnosis:
A. Trigeminal neuralgia
B. Facial neuralgia
C. Glossopharyngeal neuralgia
D. C2 radiculitis
E. Optic neuritis
7. The pain began following extraction of a lower molar
three months ago. This extraction commonly causes which of the following cranial
bone dysfunctions?
A. Zygoma
B. Palatines
C. Ethmoid
D. Frontal
E. Temporal
8. Dysfunction of the radial head most commonly causes
loss of which of the following motions:
A. Elbow flexion
B. Wrist flexion
C. Shoulder abduction
D. Forearm supination
E. Elbow extension
9. Case 4
A 36 year-old man presents to your office 24-hours after being involved in a
motor vehicle accident and sustaining a whiplash type injury to his neck. He
was driving a 1995 American vehicle. He was restrained by both seat belt and
shoulder harness. His car was struck behind by a fully loaded lumber truck.
The rear axle of his car was pushed forward until it was positioned just behind
his headrest. In addition to neck pain, he is also experiencing chest discomfort
and palpitations. Cardiac auscultation reveals a regular heart rate of 40 bpm.
Injury which irritates this structure during the whiplash mechanism could be
the source of his bradycardia?
A. Phrenic nerve
B. Esophagus
C. Cardiophrenic ligament
D. Brachial plexus
E. Vagus nerve
10. Case 5
A 40 year-old woman is seen in your office with chronic headaches as her primary
symptom. The headache is described as continuous and non-pulsatile. It is occipito-frontal
in location and creates a tightness or squeezing sensation in the head. It is
worst in the morning and again in the late afternoon. The headache is relieved
by rest, has no premonitory signs or symptoms and is unassociated with nausea,
photophobia or hyperacusis. Neurologic examination of this patient is normal.
Diagnosis:
A. Classic migraine
B. Muscle contraction headache
C. Common migraine
D. Cluster headache
E. Cephalgia fugax
11. Questions 11-13 are Case 6
A 60 year-old man presents to the emergency room with chest pain and shortness
of breath. ECG findings are suggestive of myocardial ischemia, but not definitive.
While waiting for coronary enzymes to come back you examine the patient structurally.
He is only 45 minutes from the onset of his pain. You would expect to find which
of the following if he has an acute cardiac ischemic event?
A. C5FSLRL
B. T3ESLRL
C. T7NSLRR
D. T2NSLRR
E. R2InR
12. Enzymes come back consistent with acute myocardial
infarction. Manipulative support of the patient who has suffered an acute MI
should consist of:
A. HVLA techniques directed only at levels of viscerosomatic
reflex activity.
B. Thoracic pump techniques to improve rib cage mobility, especially if CPR
has been previously necessary.
C. Indirect techniques to reduce the risk of hypersympathecotonia.
D. Muscle energy techniques directed to any costal dysfunctions.
E. Sphenobasilar decompression and synchronous rotation of the temporal bones.
13. Structural examination of this patient should also
pay special attention to which of the following areas because of the impact
of dysfunction on the parasympathetic nerve supply to the heart:
A. Thoracolumbar junction
B. Mid-thoracic region
C. Upper thoracic spine
D. Typical cervical segments (C3 to C7)
E. Suboccipital region
14. Questions 14-15 are Case 7
Your patient presents to you with symptoms of medial elbow pain and decreased
grip strength. Your only finding on the physical examination is flattening of
the palmar arches. Disease involving which of the following nerve roots would
result in this set of findings?
A. C6
B. C3
C. T1
D. C7
E. C5
15. On further systemic examination you note that the patient
has findings consistent with a Horner's syndrome on the same side as the elbow
pain. You now suspect which of the following diagnoses?
A. Paraneoplastic syndrome
B. Thoracic outlet syndrome due to the first rib held in an inhalation position
C. Pancoast tumor
D. Thoracic outlet syndrome due to caudad displacement of the distal clavicle
E. Pseudotumor cerebri
16. Which of the following diagnoses is consistent with
a Positive Lumbar Spring Test?
A. Anterior sacral torsion about a left oblique axis
B. Bilaterally extended sacrum
C. Unilaterally flexed sacrum
D. Sacral base anterior
E. Anterior rotation of the in nominate
17. Genu varum is associated with which of the following
conditions?
A. Pes planus
B. Fibular nerve compression
C. Slipped capital femoral epiphyses
D. Foot drop
E. Anterior displacement of the proximal fibula
18. Which of the following is NOT a diagnostic criterion
for osteoarthritis?
A. Age over 50 years
B. Joint stiffness after periods of inactivity lasting less than 30 minutes
C. Warm, fluctuant swelling
D. Crepitus with motion
E. Bony enlargement
19. Case 8
A 53 year-old man comes to your office complaining of vertex headaches. He was
struck in the head 6 months ago by a 40 pound pipe, which fell from an overhead
storage rack. The blow was struck to the left superior frontal area. When asked
to point to his areas of pain, he indicates a line extending from the lambda
to the bregma and then for an inch or so along the left coronal suture. On physical
examination he appears to be suffering from simple sutural compression. Which
of the following cranial techniques would NOT be appropriate for this case?
A. Direct sutural disengagement
B. Molding technique
C. Combined technique, starting indirect exaggeration and finishing with direct
disengagement
D. Direction of fluid technique
E. Oppose physiologic motion
20. Case 9
A 72 year-old man presents to your office with lower back pain localized to
the sacral region. He was walking down the street window shopping. When he reached
the end of the block, there was a large puddle in the street that he leapt over.
As soon as his right heel struck the pavement, he experienced acute sharp lower
back pain. He has had pain and a limp ever since. On physical examination there
is a moderate increase in the lumbar lordosis. Standing flexion test is negative.
Seated flexion test is positive on the right. Lumbar spring test is negative.
The sacral sulcus is deeper on the right. The inferior lateral angle is caudad
and posterior on the left. Transverse process of L5 is posterior on the right.
Diagnosis:
A. Anterior sacral torsion about a left oblique axis
B. Right on right sacral torsion
C. Posterior sacral torsion about a right oblique axis
D. Left on right sacral torsion
E. Anterior sacral torsion about a right oblique axis
21. Case 10
A four year-old child is brought to you with an acute pharyngitis. In addition
to appropriate medical management, you treat him with osteopathic techniques
to enhance his immune responses to the infection. Shortly after they arrive
home, the child spikes a fever to 102 degrees F. The parents call you wanting
to know what this sudden fever means. You reply:
A. It is normal following osteopathic treatment of an
acute infection in a child and will subside and return to normal very soon.
B. It means the infection has spread and the child should be re-examined immediately.
C. It means there has been spread of the infection to the meninges and the
child should be taken to the nearest emergency room immediately.
D. It means the antibiotic is not working and you need to switch to another
ant infective agent.
E. It means the child is allergic to the antibiotic and a change in drug should
be made.
22. Questions 22-25 are Case 11
A 72 year-old man presents to your office following a fall at home three days
age. He has injured his shoulder. X-rays obtained in the emergency room revealed
no evidence of fracture and the orthopedic surgeon told him it was a simple
muscle strain. He was given acetaminophen 325 mg with codeine 30 mg to be used
as needed for pain. This morning he woke to discover an erythematous, multiracial
rash on both anterior shin regions. You feel the patient is having an allergic
reaction, most likely to codeine. At what spinal levels might you expect to
find somatic dysfunction which could have contributed to reflex trophic influences
that resulted in the rash "choosing" this location?
A. L4 & L5
B. Sacroiliac joint
C. L1, L2 &L3
D. T6 to T9
E. T1 to T5
23. Many patients in this age group have impaired circulation
in the lower extremities. Segmental dysfunction at what spinal levels would
cause increased vasoconstriction in the legs?
A. T11 to L2
B. L3 to S1
C. S2 to S4
D. S5 & Coccygeal nn.
E. Occiput, C1 & C2
24. To promote improved lymphatic drainage of the lower
extremities, attention should first be directed to the site of terminal lymphatic
drainage at the:
A. Cisterna chili
B. Inguinal lymph nodes
C. Thoracic inlet
D. Diaphragm
E. Pelvic diaphragm
25. One commonly used technique which promotes venous and
lymphatic drainage of the lower extremities, is the pedal pump (Dalrymple technique).
Which of the following is a contraindication to use of this technique?
A. Psoriasis
B. Venous insufficiency of the lower extremities
C. Deep vein thrombophlebitis of the calf
D. Compensated congestive heart failure
E. Tearing of the medial meniscus
26. Questions 26-27 are Case 12
A 51 year-old man presents to your office following a minor motor vehicle accident
in which his car was tapped from behind while he was stopped at a toll booth.
There was no damage to either vehicle. He felt no pain immediately after the
accident, but awoke the next morning with some neck stiffness. The following
day his neck was quite stiff and painful. You diagnose a "Jolt Syndrome"
in which the force of the impact was low, but the driver's seat back acted as
a spring catapult, magnifying the effect of the impact. Physical examination
reveals a somatic dysfunction at the occipitoatlantal level. While positioning
this patient to correct the dysfunction using a thrust technique, the patient
develops a diplopia and sees flashing lights. Vertigo follows along with dysarthria.
This indicates which of the following?
A. Normal response to a severe OA dysfunction
B. Strong emotional overlay complicating the minor injuries
C. Positional vertebral basilar insufficiency, abort the technique
D. OA dysfunction creating secondary cranial dysfunction with neurologic symptomatology
E. None of the above
27. Your patient is not a dwarf, but x-rays of the
cervical spine reveal a grade 1 spondylolisthesis of C4 on C5. The most common
etiology of spondylolisthesis in this location is:
A. Pars interarticularis defect
B. Degenerative disc disease
C. Fracture subluxation
D. Facet dislocation with overriding
E. Congenital elongation of the pedicles
28. Questions 28-31 are Case 13
A 23 year-old man presents to your office six months after being struck in the
head by a line drive while playing baseball. He was facing away from the batter
for a moment and was struck squarely in the back of the head just above the
inion. He was knocked unconscious for about 15 minutes and taken to the local
hospital for evaluation. Neurologic exam was normal and he was discharged with
a diagnosis of cerebral concussion. He is now experiencing profound depression,
distractibility, increased sensitivity to lack of sleep, fatigue, noise, stress
and the effects of medications or alcohol. He finds he has no drive and lacks
initiative. He is frequently impatient with others, which is not like he used
to be. He has experienced a distressing loss of his libido. He has frequent
episodes of double vision. He has constant headaches which wax and wane in intensity.
His coordination is off; he would not even attempt to play baseball now. Diagnosis:
A. Suspicion of epidural hematoma
B. Chronic subdural hematoma
C. Subdural hygroma
D. Post-concussion syndrome
E. Traumatic frontal lobe infarction
29. In this case cranial manipulation is:
A. Not indicated
B. Indicated to treat the headache, but of no help for the other symptoms
C. Dangerous and may cause neurologic deterioration or death
D. Somewhat helpful
E. Curative
30. Evaluation of the cranial base reveals a fixed extension
pattern. The cranial rhythmic impulse has a rate of 5 cpm with a very poor amplitude.
This is consistent with sphenobasilar:
A. Torsion
B. Sidebending
C. Compression
D. Lateral strain
E. Vertical strain
31. This patient has also been experiencing gastrointestinal
upset since the head trauma. At first he was told it was due to the concussion
and headache, but it has persisted. Cranial dysfunction impinging on which of
the following foramina could be responsible for these symptoms?
A. Optic foramen
B. Foramen rotundum
C. Foramen ovale
D. Stylomastoid foramen
E. Jugular foramen
32. Case 14
A 24 year-old woman presents to your office reporting inability to achieve orgasm.
She has been thoroughly evaluated for physical disease and none has been found.
A series of sessions with a psychologist likewise failed to reveal any psychological
reason for this condition. She is now inquiring as to whether manipulation of
some sort might be helpful for this problem. On physical examination you discover
the following:
Standing flexion test Negative
Seated flexion test Positive on the right
Sacral sulcus Deep on the left
Inferior lateral angle Posterior & inferior on the right
Lumbar spring test Positive
Palpation of the sacral sulci in the Sphinx position exaggerates the asymmetry
of the sacral sulci
Transverse process of L5 Posterior on the left
Diagnosis:
A. Anterior sacral torsion on a right oblique axis
B. Left on right sacral torsion
C. Posterior sacral torsion on a left oblique axis
D. Unilateral flexed sacrum on the right
E. Unilateral extended sacrum on the right
33. Questions 33-34 are Case 15
Should a patient develop complications from the use of NSAID's to treat a disease,
which of the following dysfunctions would be the result of a viscerosomatic
reflex emanating from gastric mucosal erosion or ulceration?
A. T6FSLRR
B. T7NSLRR
C. T8NSLRL
D. T7ESLRL
E. T6FSRRL
34. A somatic dysfunction designated T11ESRRR should indicate
NSAID induced toxicity of which of the following organs?
A. Lower lungs
B. Kidneys
C. Duodenum
D. Liver
E. Heart
35. Questions 35-36 are Case 16
A four week old infant is brought to you with difficulty feeding. The child
has a weak suck response and spits up after every feeding. Forceps were used
in the delivery of the child. What common cranial dysfunction would adversely
affect the function of the hypoglossal nerve?
A. Sphenobasilar compression
B. Condylar compression
C. Superior vertical strain
D. External rotation of the frontal bones
E. Sagittal compression
36. The glossopharyngeal nerve may be responsible for the
symptoms described via entrapment in which of the following foramina due to
fixed internal rotation of the temporal bone?
A. Foramen rotundum
B. Styloid foramen
C. Foramen spinosum
D. Jugular foramen
E. Foramen ovale
37. Questions 37-41 are Case 17
A 19 year-old runner turns her ankle on uneven ground. She sustains a fairly
typical, but severe, lateral ankle sprain. There is exquisite pain just proximal
to the ankle joint on the anterior surface of the leg. This pain is relieved
by compressing the medical and lateral malleoli together. This is diagnostic
of an injury to the:
A. Inferior extensor retinaculum
B. Extensor digit rum longus tendon
C. Tibiocalcaneal ligament
D. Tibiofibular syndosmosis
E. Calcaneofibular ligament
38. You discover a fairly typical dysfunction which
commonly accompanies the lateral ankle sprain:
A. Posterior displacement of the proximal fibula
B. Anterior displacement of the tibia on the talus
C. Anterior displacement of the proximal fibula
D. Posterior displacement of the tibia on the talus
E. Plantar displacement of the third cuneiform
39. Four weeks after the injury, this patient is still
experiencing pain beyond what would be expected for this time in her recovery.
Her pain is localized to the area just beneath the anterior talofibular ligament.
This is the location of the:
A. Mortise and tenon joint of the ankle
B. Upward extension of the calcaneal bursa
C. Sinus tarsi
D. Anterior enthesopathy from ulcerative colitis
E. Tibiofibular nerve
40. Pain in this location may be due to a trigger point
located in the:
A. Soleus m.
B. Extensor digit rum brevis m.
C. Fibularis (Peroneus) longus m.
D. Fibular is (Peroneus) brevis m.
E. Abductor digiti minimi m.
41. The Fibularis (Peroneus) longus tendon may be put under
increased tension by which of the following dysfunctions commonly associated
with lateral ankle sprain?
A. Posterior displacement of the proximal fibula
B. Plantar displacement of the styloid end of the fifth metatarsal
C. Plantar rotation of the cuboids
D. Plantar rotation of the navicular
E. Plantar displacement of the proximal end of the third metatarsal
42. Questions 42-45 are case 18
A 78 year-old patient presents with coronary insufficiency and chronic congestive
heart failure. Today he is experiencing increased dyspnea due to pulmonary edema.
The pulmonary lymphatic tree empties into the systemic venous circulation:
A. Through the right lymphatic duct
B. Through the left lymphatic duct
C. At the hilum
D. Through the aortic hiatus of the diaphragm, emptying into the cisterna
chili
E. Directly into the superior vena cava
43. Pulmonary edema may be the result of obstruction to
lymphatic drainage by dysfunction in which of the following areas?
A. T5 to T9 left
B. First rib right
C. Left sternocleidomastoid m.
D. Diaphragmatic flattening
E. Sacrum
44. The pulmonary edema may be reduced by techniques
which enhance lymphatic flow. This includes:
A. Pectoral traction
B. Treatment of any dysfunction at the C2 level
C. CV-4
D. Paraspinal inhibition applied to T1 to T6
E. Indirect techniques applied to any cervical segmental dysfunction
45. Many elderly, especially women, suffer from an increasing
thoracic kyphosis as part of the aging process and accompanying osteoporosis.
At what Cobb angle does venous return to the heart become significantly impaired
by the structural deformity?
A. 60 degrees
B. 50 degrees
C. 40 degrees
D. 30 degrees
E. 20 degrees
46. Questions 46-48 are Case 19
What should be the daily intake of an osteoporitic woman?
A. 1000 mg of elemental calcium daily
B. 1500 mg of elemental calcium daily
C. 2000 mg of elemental calcium daily
D. 2000 mg of calcium carbonate daily
E. 3000 mg of calcium carbonate daily
47. In the presence of normal laboratory values, the best
form of exercise for a patient of this age and in this condition is:
A. Aquatic exercise
B. Use of an exercycle
C. Use of a cross country ski machine
D. Williams flexion exercises
E. Walking ½ mile daily to every other day
48. Which of the following coexisting conditions could
have contributed to her current osteopenic condition?
A. Hypergonadism
B. Hypoadrenocorticism
C. Hypoparathyroidism
D. Hyperthyroidism
E. Chronic coumarin administration
49. Questions 49-52 are Case 20
A 47 year-old woman presents to your office with painful paresthesias of her
right hand. She is a golf professional on the women's PGA tour and plays at
least one round of golf almost daily. She is currently under treatment for hypothyroidism.
Physical examination reveals atrophy of the radial side of the thenar eminence,
and sensory changes I the first 3 ½ digits of the right hand. Phalen's
test is positive. Prayer sign or reverse Phalen test is also positive. Tinel's
sign at the median nerve is negative. Diagnosis:
A. Cubital tunnel syndrome
B. Dupuytren's contracture
C. Thoracic outlet syndrome
D. Volkmann's ischemic contracture
E. Carpal tunnel syndrome
50. Severity of this condition can be determines using:
A. Electromyography
B. MRI of the region
C. Nerve Conduction Velocities
D. CT of the region
E. Plain film x-rays
51. Osteopathic manipulative treatment to help this
condition would include:
A. Treatment of somatic dysfunction at Occiput
to C2 to remove potential vagal influences
B. Treatment of somatic dysfunction at C3 to C5 to reduce spinal cord facilitation
of the sensory nucleus of the trigeminal nerve
C. Treatment of somatic dysfunction at C5 to T1 to remove somatosomatic reflex
neurotrophic effects
D. Treatment of somatic dysfunction at T1 to T4 to eliminate viscerosomatic
reflex
effects on the condition
E. Treatment of somatic dysfunction at T5 to T9 to reduce gastric acidity
and enhance absorption of the medications needed for this condition
52. Another local form of osteopathic manipulative treatment
can also be used:
A. Articulatory technique for radial head dysfunction
B. Correction of first rib dysfunction
C. Spencer techniques
D. Bougie type dilation of the carpal tunnel
E. Transverse tarsal ligament release
53. Questions 53-57 are Case 21
A 42 year-old man presents to your office for evaluation of a rash on his thigh.
It began as a red macule and expanded to form an annular lesion with a bright
red outer border and partial central clearing. There is local lymphadenopathy
of the inguinal lymph nodes. On further questioning he admits to migratory joint
pain without joint swelling. The knee on the affected leg is particularly sore.
He had also had an intense headache with a stiff neck and a sore throat. He
lives in an urban townhouse and has not traveled extensively in the past eighteen
months. Diagnosis:
A. Syphilitic arthritis
B. Mycoplasma arthritis
C. Tuberculous arthritis
D. Lyme disease
E. Eastern Equine Encephalitis
54. The name of the rash is:
A. Rash of secondary syphilis
B. Pityriasis rosea
C. Nummular eczema
D. Contact dermatitis
E. Erythema chronicum migrans
55. Since this is an infectious condition, what manipulative
technique may be used to create a generalized enhancement of the immune response?
A. Thoracic pump
B. CV-4
C. Mesenteric release
D. Sacral rock
E. Hepatic pump
56. Normalization of which of the following regions is
essential for normal lymphatic drainage of the affected skin region?
A. Hip joint
B. Upper lumbar spine
C. Lower rib cage diaphragmatic attachments
D. Left thoracic inlet
E. Cranial base
57. Questions 57-60 are Case 22
A 19 year-old woman presents with severe dysmenorrhea which she finds incapacitating
for two to three days each cycle. This began five months ago after returning
from a summer trip with a church group during which they were refurbishing homes
for the poor. Since she was taller than many other teens there, she ended up
doing a lot of ceiling painting, standing working over her head with a long
handled roller.
Pelvic examination is normal. The lumbar lordosis is increased.
There is tenderness over the superior pole of the sacroiliac joints bilaterally.
There is increased tension and tenderness in the sacrotuberous ligaments. There
is symmetrically increased tension in the pelvic floor musculature. Standing
flexion test is negative. Seated flexion test is negative. Direct motion induction
of the sacrum indicates that it moves easily into flexion and resists extension.
The sacral sulci are deeper than average bilaterally. Lumbar spring test is
negative. Diagnosis:
A. Bilaterally extended sacrum
B. Anteriorly translated sacrum
C. Bilaterally flexed sacrum
D. Posteriorly translated sacrum
E. Normal sacrum with increased lumbar lordosis
58. Further examination reveals a "step off"
between the spinous processes of L4 and L5. Pressure on the spinous process
of L4 produces lower back pain. There is deep tenderness on palpation over the
iliolumbar ligaments. Which of the following conditions do you suspect?
A. Transitional lumbosacral segment with pseudoarthrosis
B. Lumbosacral facet tropism
C. Occult spina bifida
D. Spondylolisthesis
E. Herniated lumbar disc
59. Correction of the sacral dysfunction resulted in near
total relief of the dysmenorrhea. The probable mechanism by which sacral somatic
dysfunction produces dysmenorrhea is:
A. Somatosomatic reflex
B. Viscerosomatic reflex
C. Somatosensory reflex
D. Somatovisceral reflex
E. Somatopsychic reflexes
60. Restriction of motion of the pelvic floor would be
expected to produce a similar restriction in which of the following structures?
A. Psoas muscles
B. Floor of the femoral triangle
C. Respiratory diaphragm
D. Floor of the orbit
E. Cervical spine
61. Questions 61-63 are Case 23
A 53 year-old man presents to your office with right lower back pain and sciatica.
The pelvis is sideshifted to the right. L2FSLRL. In the supine position, left
leg appears shorter and is externally rotated. There are characteristic tender
points in the right piriformis muscle. The sciatica is relieved by passive flexion
and external rotation of the right leg. Diagnosis:
A. Piriformis syndrome
B. Lumbosacral syndrome
C. Syndrome of persistent sciatic artery
D. Psoas syndrome
E. Hamstring syndrome
62. The most common sacral dysfunction found in this condition
is:
A. Unilateral flexed sacrum right
B. Anterior torsion about a left oblique axis
C. Unilateral extended sacrum left
D. Sacral base posterior
E. Posterior torsion about a right oblique axis
63. If there were a counterstrain tenderpoint associated
with the muscle responsible for this condition, it would be located:
A. One inch lateral to the anterior superior iliac spine
B. Deep to the paravertebral muscles posteriorly at the L3 level
C. In the iliac fossa about two inches medial to the anterior superior iliac
spine
D. One inch caudad to the anterior inferior iliac spine
E. In the adductor attachments to the pubic bone
Answers
1. B
2. A
3. B
4. D
5. D
6. A
7. E
8. D
9. E
10. B
11. B
12. C
13. E
14. C
15. C
16. B
17. A
18. C
19. B
20. A
21. A
22. A
23. A
24. C
25. C
26. C
27. B
28. D
29. A
30. C
31. E
32. C
33. E
34. B
35. B
36. D
37. D
38. A
39. C
40. B
41. C
42. A
43. D
44. A
45. A
46. B
47. E
48. D
49. E
50. C
51. C
52. D
53. D
54. E
55. A
56. D
57. C
58. D
59. D
60. C
61. D
62. E
63. C
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