AOA Osteopathic Principles & Practice 2 — Questions and Answers
Question 1: After locating a counterstrain tender point in the lumbar region and placing the patient in the position of maximal ease, how long is the position typically held?
- 30 seconds
- 60 seconds
- 90 seconds (Correct answer)
- 3-5 seconds
Correct answer: 90 seconds
Standard counterstrain holds the position of ease for 90 seconds (120 seconds for rib tender points) before slowly returning to neutral.
Question 2: T4 is found to be flexed, rotated right, and sidebent right as a single-segment dysfunction. Which Fryette principle does this describe?
- Type I mechanics
- Type II mechanics (Correct answer)
- Type III mechanics
- Neutral group mechanics
Correct answer: Type II mechanics
Type II mechanics involve a single segment in flexion or extension with rotation and sidebending to the same side.
Question 3: A patient with suspected appendicitis would most likely have an anterior Chapman reflex point at which location?
- Tip of the right 12th rib (Correct answer)
- Right 5th intercostal space near the sternum
- Left 10th intercostal space
- Just below the right ASIS
Correct answer: Tip of the right 12th rib
The Chapman point for the appendix is at the tip of the right 12th rib.
Question 4: In a post-isometric relaxation muscle energy technique, how long does the patient typically hold each contraction against physician counterforce?
- Less than 1 second
- 3-5 seconds (Correct answer)
- 30 seconds
- 90 seconds
Correct answer: 3-5 seconds
Muscle energy contractions are usually held 3-5 seconds and repeated 3-5 times, engaging a new barrier each time.
Question 5: Which of the following is an absolute contraindication to cervical HVLA treatment?
- Tension-type headache
- Mild cervical osteoarthritis
- Down syndrome with atlantoaxial instability (Correct answer)
- Chronic neck stiffness after desk work
Correct answer: Down syndrome with atlantoaxial instability
Ligamentous laxity and atlantoaxial instability, as seen in Down syndrome, make cervical HVLA absolutely contraindicated because of the risk of spinal cord injury.
Question 6: In a left-on-left sacral torsion, which finding is expected?
- Positive seated flexion test on the left
- Positive lumbar spring test
- Deep sacral sulcus on the left
- Positive seated flexion test on the right (Correct answer)
Correct answer: Positive seated flexion test on the right
In a left-on-left forward torsion the seated flexion test is positive on the side opposite the oblique axis (the right), and the spring test is negative.
Question 7: Parasympathetic innervation of the descending colon comes from which source?
- Vagus nerve
- Pelvic splanchnic nerves (S2-S4) (Correct answer)
- Greater splanchnic nerve (T5-T9)
- Lumbar splanchnic nerves (L1-L2)
Correct answer: Pelvic splanchnic nerves (S2-S4)
The vagus supplies the gut up to roughly the splenic flexure, and the pelvic splanchnics (S2-S4) supply the descending colon and beyond.
