COMLEX-USA Osteopathic Manipulative Medicine 3 — Questions and Answers
Question 1: Which type of somatic dysfunction is described as Type I (group) mechanics in the thoracic spine?
- Single segment, flexed or extended, with rotation and side-bending opposite
- Multiple segments in neutral with side-bending and rotation opposite (Correct answer)
- Single segment with side-bending and rotation same side
- Multiple segments in flexion with same-side coupling
Correct answer: Multiple segments in neutral with side-bending and rotation opposite
Type I (Fryette's first law) involves neutral, multiple vertebral segments where side-bending and rotation occur in opposite directions.
Question 2: Strain-counterstrain tender points for lumbar flexion dysfunction are typically found:
- On the spinous processes posteriorly
- On the anterior abdominal wall or ASIS region (Correct answer)
- At the iliac crest posteriorly
- At the posterior superior iliac spine
Correct answer: On the anterior abdominal wall or ASIS region
Anterior lumbar strain-counterstrain tender points (L1–L5) are located anteriorly on the lower abdominal wall or near the ASIS.
Question 3: What is the end result of successfully treating a somatic dysfunction using indirect OMT techniques?
- Joint cavitation
- Resolution of all four TART criteria (Correct answer)
- Increased joint laxity
- Muscle hypertrophy
Correct answer: Resolution of all four TART criteria
Successful OMT resolves somatic dysfunction, eliminating the TART findings: tissue texture changes, asymmetry, restriction, and tenderness.
Question 4: The Galbreath technique is a mandibular drainage technique primarily used to treat dysfunction of which structure?
- Sinuses
- Eustachian tube / middle ear (Correct answer)
- Temporomandibular joint
- Cervical lymph nodes
Correct answer: Eustachian tube / middle ear
The Galbreath technique uses rhythmic mandibular traction to open the Eustachian tube and facilitate middle ear drainage.
Question 5: Which nerve root level is primarily responsible for the knee jerk reflex and can be assessed via segmental facilitation at T12–L1?
- L1–L2
- L2–L3
- L3–L4 (Correct answer)
- L4–L5
Correct answer: L3–L4
The patellar (knee jerk) reflex is mediated by L3–L4 nerve roots; somatic dysfunction at L3–L4 may affect this reflex.
Question 6: Contraindications to HVLA technique include all of the following EXCEPT:
- Osteoporosis
- Cervical myelopathy
- Muscle tension headache (Correct answer)
- Fracture at the treatment site
Correct answer: Muscle tension headache
Muscle tension headache is not a contraindication to HVLA and may actually benefit from careful cervical or suboccipital treatment.
COMLEX-USA Osteopathic Manipulative Medicine 3
Which type of somatic dysfunction is described as Type I (group) mechanics in the thoracic spine?