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A 47 year old man presents with low back pain and right buttock pain. His weight-
bearing ferguson angle is 54 degrees. Kemp's upon right lateral bending and extension
is positive. Goldthwait test is negative. Which is the most likely diagnosis for this
patient?
a. posteromedial disc on the left
b. posteromedial disc on the right
c. posterolateral disc on the left
d. lumbar facet syndrome - CORRECT ANSWER: d. lumbar facet syndrome
A chronic scalene muscle spasm may be found with:
a. decreased cervical lordosis
b. increased cervical lordosis
c. upper cervical subluxation
d. thoracic subluxation - CORRECT ANSWER: a. decreased cervical lordosis
A flexion type injury following a pushing movement is most likely the result in which type
of sacroiliac dysfunction?
a. anterior subluxation sprain
b. posterior subluxation sprain
c. anterior subluxation
,d. posterior subluxation - CORRECT ANSWER: b. posterior subluxation sprain
A measurement differing by more than 3 mm from anterior to posterior using Van
Akkerveeken's lines suggests:
a. instability
b. scoliosis
c. extension malposition
d. stenosis - CORRECT ANSWER: a. instability
A patient assessed as having a right positive Derefield (R+D) would have the equivalent
static and dynamic sacroiliac listings of a right:
a. posterior-inferior ilium or flexion restriction
b. posterior-inferior ilium or extension restriction
c. anterior-superior ilium or flexion restriction
d. anterior-superior ilium or extension restriction - CORRECT ANSWER: b. posterior-
inferior ilium or extension restriction
A patient presents with inability to laterally flex the lumbar spine to the right or rotate to
the left. This restriction may represent a malposition of L5 on sacrum. There is a right
convexity of the lumbar spine above L5. The preferred segmental contact point is:
a. right spinous process
b. right mammillary process
c. left spinous process
d. left mammillary process - CORRECT ANSWER: b. right mammillary process
, A patient with a right anterior talus subluxation and a right interosseous sacroiliac
ligament sprain will show what posture on plumb line analysis?
a. antalgia
b. high right shoulder
c. left head tilt
d. left pelvic translation - CORRECT ANSWER: d. left pelvic translation
A patient with lumbar pain on extension, a positive McNab's line, and facet arthrosis
probably suggests:
a. spinal stenosis
b. vertical sacroiliac slippage
c. facet syndrome
d. Otto's pelvis - CORRECT ANSWER: c. facet syndrome
A patient with some acetabular degeneration suffers a pelvic trauma by falling on the
buttocks during ice-skating. The sacrum is pushed into a frontal plane distortion. Which
of these muscles may test weak?
a. psoas major
b. piriformis
c. sartorius
d. quadratus lumborum - CORRECT ANSWER: b. piriformis
Accessory joint motions can best be described as:
a. involuntary movements necessary for normal joint function