COMSAE Phase 1 Form 117 – The
Complete 176 Question Test Bank All
questions with correct verified answers &
detailed rationales verified based on
current NBOME standards and
COMLEX-USA Level 1 blueprint for the
2026 examination cycle
Question 1
A 45-year-old female presents with chronic low back pain. On
examination, you find that the L5 vertebra is restricted in flexion, rotates
more easily to the left, and sidebends more easily to the left. According
to Fryette's principles, how should this dysfunction be documented?
A) L5 Flexed RR SR
B) L5 Flexed LR SL
C) L5 Extended RR SR
D) L5 Neutral LR SR
,,,answer,,,: B) L5 Flexed LR SL
Rationale: Fryette's principles describe spinal motion mechanics. Type
II (non-neutral) dysfunctions occur in flexion or extension with rotation
and sidebending in the same direction. Since the segment is restricted in
flexion with rotation left (LR) and sidebending left (SL), the correct
,documentation is "L5 Flexed LR SL". Type I mechanics (neutral)
involve rotation and sidebending in opposite directions. The extended
dysfunction (C) would be documented if the restriction improved in
extension.
Question 2
A 32-year-old patient with a history of recurrent urinary tract infections
has a tender, nodular region at the tip of the 12th rib on the right. This
Chapman reflex point is associated with dysfunction of which organ?
A) Right kidney
B) Right ureter
C) Appendix
D) Right ovary
,,,answer,,,: A) Right kidney
Rationale: Chapman reflexes are small, tender nodules in the deep
fascia that correspond to visceral dysfunction. The kidney reflex points
are located at the tips of the 12th ribs bilaterally. The ureter reflex is
located medial to the anterior superior iliac spine. The appendix reflex is
in the right lower quadrant between the ASIS and the umbilicus. The
ovary reflex is on the pubic ramus.
Question 3
A patient presents with a right posterior innominate rotation. Which
muscle energy treatment is most appropriate?
,A) Treat the right hip flexors
B) Treat the right hamstrings
C) Treat the left hip flexors
D) Treat the left hamstrings
,,,answer,,,: B) Treat the right hamstrings
Rationale: In a posterior innominate rotation, the ilium rotates
posteriorly relative to the sacrum. The hamstrings on the affected side
are shortened and should be treated with muscle energy. The hip flexors
(iliopsoas) would be lengthened in a posterior rotation. The contralateral
side (C and D) would not be the primary focus.
Question 4
A 55-year-old male with chronic asthma has paraspinal tenderness and
restricted motion at T3-T5. This viscerosomatic reflex is most consistent
with dysfunction of which organ?
A) Heart
B) Lungs
C) Stomach
D) Liver
,,,answer,,,: B) Lungs
Rationale: Viscerosomatic reflexes occur when visceral disease causes
somatic dysfunction in corresponding spinal segments. The pulmonary
reflex corresponds to T1-T4, with T3-T5 more specifically associated
with bronchial and lung tissue. The heart reflex is T1-T5, stomach T6-
T9, and liver T7-T9.
, Question 5
Which cranial bone is assessed using the frontal lift technique in cranial
osteopathy?
A) Sphenoid
B) Occiput
C) Frontal
D) Temporal
,,,answer,,,: C) Frontal
Rationale: The frontal lift technique is used to assess and treat
dysfunction of the frontal bone in cranial osteopathy. The V-Spread
technique (A) assesses the sphenoid. Occipital decompression (B)
assesses the occiput. Temporal decompression (D) assesses the temporal
bones.
Question 6
A patient with a history of GERD has tenderness in the left upper
quadrant at the 5th and 6th intercostal spaces. This Chapman reflex is
associated with which organ?
A) Stomach
B) Liver
C) Gallbladder
D) Pancreas
,,,answer,,,: A) Stomach
Complete 176 Question Test Bank All
questions with correct verified answers &
detailed rationales verified based on
current NBOME standards and
COMLEX-USA Level 1 blueprint for the
2026 examination cycle
Question 1
A 45-year-old female presents with chronic low back pain. On
examination, you find that the L5 vertebra is restricted in flexion, rotates
more easily to the left, and sidebends more easily to the left. According
to Fryette's principles, how should this dysfunction be documented?
A) L5 Flexed RR SR
B) L5 Flexed LR SL
C) L5 Extended RR SR
D) L5 Neutral LR SR
,,,answer,,,: B) L5 Flexed LR SL
Rationale: Fryette's principles describe spinal motion mechanics. Type
II (non-neutral) dysfunctions occur in flexion or extension with rotation
and sidebending in the same direction. Since the segment is restricted in
flexion with rotation left (LR) and sidebending left (SL), the correct
,documentation is "L5 Flexed LR SL". Type I mechanics (neutral)
involve rotation and sidebending in opposite directions. The extended
dysfunction (C) would be documented if the restriction improved in
extension.
Question 2
A 32-year-old patient with a history of recurrent urinary tract infections
has a tender, nodular region at the tip of the 12th rib on the right. This
Chapman reflex point is associated with dysfunction of which organ?
A) Right kidney
B) Right ureter
C) Appendix
D) Right ovary
,,,answer,,,: A) Right kidney
Rationale: Chapman reflexes are small, tender nodules in the deep
fascia that correspond to visceral dysfunction. The kidney reflex points
are located at the tips of the 12th ribs bilaterally. The ureter reflex is
located medial to the anterior superior iliac spine. The appendix reflex is
in the right lower quadrant between the ASIS and the umbilicus. The
ovary reflex is on the pubic ramus.
Question 3
A patient presents with a right posterior innominate rotation. Which
muscle energy treatment is most appropriate?
,A) Treat the right hip flexors
B) Treat the right hamstrings
C) Treat the left hip flexors
D) Treat the left hamstrings
,,,answer,,,: B) Treat the right hamstrings
Rationale: In a posterior innominate rotation, the ilium rotates
posteriorly relative to the sacrum. The hamstrings on the affected side
are shortened and should be treated with muscle energy. The hip flexors
(iliopsoas) would be lengthened in a posterior rotation. The contralateral
side (C and D) would not be the primary focus.
Question 4
A 55-year-old male with chronic asthma has paraspinal tenderness and
restricted motion at T3-T5. This viscerosomatic reflex is most consistent
with dysfunction of which organ?
A) Heart
B) Lungs
C) Stomach
D) Liver
,,,answer,,,: B) Lungs
Rationale: Viscerosomatic reflexes occur when visceral disease causes
somatic dysfunction in corresponding spinal segments. The pulmonary
reflex corresponds to T1-T4, with T3-T5 more specifically associated
with bronchial and lung tissue. The heart reflex is T1-T5, stomach T6-
T9, and liver T7-T9.
, Question 5
Which cranial bone is assessed using the frontal lift technique in cranial
osteopathy?
A) Sphenoid
B) Occiput
C) Frontal
D) Temporal
,,,answer,,,: C) Frontal
Rationale: The frontal lift technique is used to assess and treat
dysfunction of the frontal bone in cranial osteopathy. The V-Spread
technique (A) assesses the sphenoid. Occipital decompression (B)
assesses the occiput. Temporal decompression (D) assesses the temporal
bones.
Question 6
A patient with a history of GERD has tenderness in the left upper
quadrant at the 5th and 6th intercostal spaces. This Chapman reflex is
associated with which organ?
A) Stomach
B) Liver
C) Gallbladder
D) Pancreas
,,,answer,,,: A) Stomach
