{"id":1583,"date":"2022-04-20T14:16:00","date_gmt":"2022-04-20T14:16:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=1583"},"modified":"2025-10-01T11:42:38","modified_gmt":"2025-10-01T19:42:38","slug":"omm-question-of-the-day-oa-joint-motion-testing","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing","title":{"rendered":"OMM Question of the Day: OA Joint Motion Testing"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#The_correct_answer_to_todays_OMM_Question_is%E2%80%A6\" >The correct answer to today&#8217;s OMM Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#B_OA_Flexed_Sidebent_Right_Rotated_Left\" >B. OA Flexed, Sidebent Right, Rotated Left<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#A_OA_Neutral_Sidebent_Right_Rotated_Left\" >A. OA Neutral, Sidebent Right, Rotated Left<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#C_OA_Flexed_Sidebent_Right_Rotated_Right\" >C. OA Flexed, Sidebent Right, Rotated Right<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#D_OA_Extended_Sidebent_Left_Rotated_Right\" >D. OA Extended, Sidebent Left, Rotated Right<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#E_OA_Extended_Sidebent_Right_Rotated_Left\" >E. OA Extended, Sidebent Right, Rotated Left<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\">A 27-year-old woman presents to the clinic for neck pain. She has experienced several episodes of this neck pain since it started two weeks ago. She describes it as a dull ache at the upper part of the back of her neck, extending into the bottom of her scalp. It goes away with gentle stretching and hot showers, but often returns the next day. She has no medical problems and takes no medications. She does not have any photophobia. Her&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Introduction_to_vital_signs:_Clinical_skills_notes\" target=\"_blank\" rel=\"noreferrer noopener\">vital signs&nbsp;<\/a>are within normal limits. Physical examination of the occipitoatlantal joint shows a deep left sulcus, the occiput translates more easily to the left. On flexion of the neck, the sulci seem to even out. Which of the following is the most likely somatic dysfunction of the patient\u2019s occipitoatlantal joint?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. OA Neutral, Sidebent Right, Rotated Left<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. OA Flexed, Sidebent Right, Rotated Left<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. OA Flexed, Sidebent Right, Rotated Right<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. OA Extended, Sidebent Left, Rotated Right<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. OA Extended, Sidebent Right, Rotated Left<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Scroll down for the correct answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Osmosis Around the World: Sudan!\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/Cp5CuS2_oTw?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_OMM_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s OMM Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_OA_Flexed_Sidebent_Right_Rotated_Left\"><\/span>B. OA Flexed, Sidebent Right, Rotated Left<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s OMM Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_OA_Neutral_Sidebent_Right_Rotated_Left\"><\/span>A. OA Neutral, Sidebent Right, Rotated Left<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The sidebending and rotation are correct, but the patient\u2019s findings improved with flexion, indicating it is a flexion somatic dysfunction. While neutral dysfunctions exist, most patients will be either flexed or extended.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_OA_Flexed_Sidebent_Right_Rotated_Right\"><\/span>C. OA Flexed, Sidebent Right, Rotated Right<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The patient does have a flexed somatic dysfunction, but her OA joint is rotated left, as indicated by the deep sulcus on the left. In addition, sidebending and rotation are always in opposite directions at the OA joint.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_OA_Extended_Sidebent_Left_Rotated_Right\"><\/span>D. OA Extended, Sidebent Left, Rotated Right<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Since the patient\u2019s sulci even out on flexion, we know it is a flexion somatic dysfunction. This would be the correct answer if the patient had the opposite findings (deep right sulcus, easier translation to the right, sulci even out on extension).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_OA_Extended_Sidebent_Right_Rotated_Left\"><\/span>E. OA Extended, Sidebent Right, Rotated Left<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Since the patient\u2019s sulci even out on flexion, we know the ease of motion is flexion, so it is a flexion somatic dysfunction. The sidebending and rotation in this question are correct.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Remember that rotation and sidebending always go in&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Diagnosing_cervical_somatic_dysfunction?from=\/do\/foundational-sciences\/osteopathic-manipulative-medicine-(omm)\/cervical-spine\/diagnosis\/diagnosing-somatic-dysfunction\" target=\"_blank\" rel=\"noreferrer noopener\">opposite directions at the OA joint<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">1. On palpation of the suboccipital sulci, the side with the deeper sulcus indicates the side of<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomical_terminology\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;rotation<\/a>&nbsp;of the OA joint. As the occiput rotates on its OA joint, your hand and fingers will be in contact with more of the occiput on that side, causing the sulci to feel deeper on palpation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">2. On translation of the OA joint to one side, you are assessing its sidebending motion to the opposite side. If the OA joint translates more easily to the left, it means the OA joint sidebends more easily to the right. Think of the occiput sidebending down to touch your finger as you translate it toward the opposite side.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">3. On either flexion or extension, the sulci will usually even out while you are palpating them. If they feel more even on flexion, then that is the ease of motion and the type of somatic dysfunction. If the sulci feel more even on extension (or the difference is even more pronounced on flexion), then it is an extension somatic dysfunction.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Remember the three components of&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Diagnosing_cervical_somatic_dysfunction?from=\/do\/foundational-sciences\/osteopathic-manipulative-medicine-(omm)\/cervical-spine\/diagnosis\/diagnosing-somatic-dysfunction\" target=\"_blank\" rel=\"noreferrer noopener\">the occipitoatlantal (OA) examination<\/a>&nbsp;\u2013 rotation, sidebending and flexion\/extension. Somatic dysfunctions are named for the ease of motion. In this patient, the sulci even out on flexion (flexed), translation is easier to the left (sidebent right), and the left sulcus is deep (rotated left).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><strong>_________________________<\/strong><\/em><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><strong>Want more OMM Questions as well as practice questions for USMLE\u00ae Step 1 and Step 2 CK?&nbsp;Try Osmosis today! Access your&nbsp;<a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\/do?source_cta=navbar\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-09T190357.132.png?w=700\" alt=\"\" class=\"wp-image-1514\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-09T190357.132.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-09T190357.132.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><br><a href=\"https:\/\/www.osmosis.org\/plans\/do?source_cta=navbar\" target=\"_blank\" rel=\"noreferrer noopener\"><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 27-year-old woman presents to the clinic for neck pain. She has experienced several episodes of this neck pain since it started two weeks ago. She describes it as a dull ache at the upper part of the back of her neck, extending into the bottom of her scalp. It goes away with gentle stretching [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":1584,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,34,16],"tags":[],"class_list":["post-1583","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-omm","category-do"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>OMM Question of the Day: OA Joint Motion Testing - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-oa-joint-motion-testing\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"OMM Question of the Day: OA Joint Motion Testing - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"A 27-year-old woman presents to the clinic for neck pain. She has experienced several episodes of this neck pain since it started two weeks ago. She describes it as a dull ache at the upper part of the back of her neck, extending into the bottom of her scalp. 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