COMLEX LEVEL 3 LATEST BOARD PREP 2026–2027
Complete Review Featuring Practice Questions,
OMM Concepts & Exam Success Guide
Question 1
A 45-year-old patient presents with chronic low back pain. On structural
examination, you find that the lumbar spine has restricted left side-bending
and restricted right rotation in the neutral position. According to Fryette's
laws, which type of somatic dysfunction is this?
A. Type I somatic dysfunction
B. Type II somatic dysfunction
C. Type III somatic dysfunction
D. A non-neutral dysfunction
Correct Answer: A
Rationale: Fryette's Type I (Group I) somatic dysfunction occurs when the
vertebrae are in a neutral position and side-bending and rotation occur to
opposite sides (e.g., side-bending left, rotation right; or side-bending right,
rotation left). This typically involves a group of vertebrae (3–5
segments). Option B — Type II occurs in non-neutral positions with side-
bending and rotation to the same side. Option C — Type III does not exist in
Fryette's classification. Option D — Non-neutral dysfunction describes Type
II.
Question 2
A 32-year-old woman presents with tension-type headaches. On cranial
examination, you find that the sphenobasilar synchondrosis (SBS) is restricted
in extension. Which of the following best describes the somatic dysfunction?
,A. SBS flexion dysfunction
B. SBS extension dysfunction
C. SBS torsion dysfunction
D. SBS side-bending dysfunction
Correct Answer: B
Rationale: SBS extension dysfunction occurs when the sphenoid and occiput
move away from each other anteriorly. This is characterized by
a narrowing of the skull and a lengthening of the anteroposterior
diameter. Option A — SBS flexion is the opposite motion (widening of the
skull). Option C — SBS torsion involves rotation around an anteroposterior
axis. Option D — SBS side-bending involves lateral flexion.
Question 3
During a structural examination, you palpate a Chapman's reflex point at the
intercostal space between the 2nd and 3rd ribs on the left side, approximately
2 inches from the sternum. This reflex point is associated with dysfunction of
which organ?
A. Stomach
B. Liver
C. Gallbladder
D. Heart
Correct Answer: D
Rationale: Chapman's reflex points are neurolymphatic reflexes that
correspond to specific viscera. The reflex point for the heart is located at
the 2nd and 3rd intercostal spaces on the left side, approximately 2 inches
from the sternum. Option A — The stomach reflex is at the 5th–6th
intercostal spaces on the left. Option B — The liver reflex is at the 6th–7th
intercostal spaces on the right. Option C — The gallbladder reflex is at the 5th
intercostal space on the right.
,Question 4
A 55-year-old patient presents with right upper quadrant abdominal pain. On
examination, you find a Chapman's reflex point at the 5th intercostal space on
the right side, 2 inches from the sternum. Which organ is most likely involved?
A. Liver
B. Gallbladder
C. Stomach
D. Pancreas
Correct Answer: B
Rationale: The Chapman's reflex point for the gallbladder is located at
the 5th intercostal space on the right side, approximately 2 inches from the
sternum. Option A — The liver reflex is at the 6th–7th intercostal spaces on
the right. Option C — The stomach reflex is at the 5th–6th intercostal spaces
on the left. Option D — The pancreas reflex is at the 7th intercostal space on
the left.
Question 5
A patient presents with chronic constipation. On examination, you find a
Chapman's reflex point at the inferior angle of the scapula on the left side. This
finding is most consistent with dysfunction of which organ?
A. Kidney
B. Spleen
C. Colon
D. Bladder
Correct Answer: C
Rationale: The Chapman's reflex point for the colon is located at the inferior
angle of the scapula (both sides, with the left side more commonly
associated with the descending colon). Option A — The kidney reflex is at the
1st–2nd lumbar vertebrae. Option B — The spleen reflex is at the 8th–9th
ribs on the left. Option D — The bladder reflex is at the 1st sacral segment.
, Question 6
A 40-year-old patient presents with acute low back pain after lifting a heavy
object. On examination, you note a pelvic tilt with the left ilium rotated
anteriorly and the right ilium rotated posteriorly. Which somatic dysfunction
is most likely?
A. Left anterior innominate
B. Right anterior innominate
C. Left posterior innominate
D. Bilateral innominate dysfunction
Correct Answer: A
Rationale: An anterior innominate dysfunction occurs when the ilium
rotates anteriorly on the sacrum. The patient presents with a left anterior
innominate because the left ilium is rotated anteriorly. Option B — Right
anterior innominate would involve the right ilium. Option C — Left posterior
innominate would involve the left ilium rotating posteriorly. Option D —
Bilateral dysfunction would involve both sides.
Question 7
According to Fryette's laws, which of the following is true regarding Type I
somatic dysfunction?
A. The vertebrae are in a non-neutral position (flexion or extension).
B. Side-bending and rotation occur to the same side.
C. Side-bending and rotation occur to opposite sides.
D. The dysfunction involves only a single vertebra.
Correct Answer: C
Rationale: Fryette's Type I (Group I) somatic dysfunction states that when
the spine is in a neutral position, side-bending and rotation occur to
opposite sides. This typically involves a group of vertebrae (3–5
Complete Review Featuring Practice Questions,
OMM Concepts & Exam Success Guide
Question 1
A 45-year-old patient presents with chronic low back pain. On structural
examination, you find that the lumbar spine has restricted left side-bending
and restricted right rotation in the neutral position. According to Fryette's
laws, which type of somatic dysfunction is this?
A. Type I somatic dysfunction
B. Type II somatic dysfunction
C. Type III somatic dysfunction
D. A non-neutral dysfunction
Correct Answer: A
Rationale: Fryette's Type I (Group I) somatic dysfunction occurs when the
vertebrae are in a neutral position and side-bending and rotation occur to
opposite sides (e.g., side-bending left, rotation right; or side-bending right,
rotation left). This typically involves a group of vertebrae (3–5
segments). Option B — Type II occurs in non-neutral positions with side-
bending and rotation to the same side. Option C — Type III does not exist in
Fryette's classification. Option D — Non-neutral dysfunction describes Type
II.
Question 2
A 32-year-old woman presents with tension-type headaches. On cranial
examination, you find that the sphenobasilar synchondrosis (SBS) is restricted
in extension. Which of the following best describes the somatic dysfunction?
,A. SBS flexion dysfunction
B. SBS extension dysfunction
C. SBS torsion dysfunction
D. SBS side-bending dysfunction
Correct Answer: B
Rationale: SBS extension dysfunction occurs when the sphenoid and occiput
move away from each other anteriorly. This is characterized by
a narrowing of the skull and a lengthening of the anteroposterior
diameter. Option A — SBS flexion is the opposite motion (widening of the
skull). Option C — SBS torsion involves rotation around an anteroposterior
axis. Option D — SBS side-bending involves lateral flexion.
Question 3
During a structural examination, you palpate a Chapman's reflex point at the
intercostal space between the 2nd and 3rd ribs on the left side, approximately
2 inches from the sternum. This reflex point is associated with dysfunction of
which organ?
A. Stomach
B. Liver
C. Gallbladder
D. Heart
Correct Answer: D
Rationale: Chapman's reflex points are neurolymphatic reflexes that
correspond to specific viscera. The reflex point for the heart is located at
the 2nd and 3rd intercostal spaces on the left side, approximately 2 inches
from the sternum. Option A — The stomach reflex is at the 5th–6th
intercostal spaces on the left. Option B — The liver reflex is at the 6th–7th
intercostal spaces on the right. Option C — The gallbladder reflex is at the 5th
intercostal space on the right.
,Question 4
A 55-year-old patient presents with right upper quadrant abdominal pain. On
examination, you find a Chapman's reflex point at the 5th intercostal space on
the right side, 2 inches from the sternum. Which organ is most likely involved?
A. Liver
B. Gallbladder
C. Stomach
D. Pancreas
Correct Answer: B
Rationale: The Chapman's reflex point for the gallbladder is located at
the 5th intercostal space on the right side, approximately 2 inches from the
sternum. Option A — The liver reflex is at the 6th–7th intercostal spaces on
the right. Option C — The stomach reflex is at the 5th–6th intercostal spaces
on the left. Option D — The pancreas reflex is at the 7th intercostal space on
the left.
Question 5
A patient presents with chronic constipation. On examination, you find a
Chapman's reflex point at the inferior angle of the scapula on the left side. This
finding is most consistent with dysfunction of which organ?
A. Kidney
B. Spleen
C. Colon
D. Bladder
Correct Answer: C
Rationale: The Chapman's reflex point for the colon is located at the inferior
angle of the scapula (both sides, with the left side more commonly
associated with the descending colon). Option A — The kidney reflex is at the
1st–2nd lumbar vertebrae. Option B — The spleen reflex is at the 8th–9th
ribs on the left. Option D — The bladder reflex is at the 1st sacral segment.
, Question 6
A 40-year-old patient presents with acute low back pain after lifting a heavy
object. On examination, you note a pelvic tilt with the left ilium rotated
anteriorly and the right ilium rotated posteriorly. Which somatic dysfunction
is most likely?
A. Left anterior innominate
B. Right anterior innominate
C. Left posterior innominate
D. Bilateral innominate dysfunction
Correct Answer: A
Rationale: An anterior innominate dysfunction occurs when the ilium
rotates anteriorly on the sacrum. The patient presents with a left anterior
innominate because the left ilium is rotated anteriorly. Option B — Right
anterior innominate would involve the right ilium. Option C — Left posterior
innominate would involve the left ilium rotating posteriorly. Option D —
Bilateral dysfunction would involve both sides.
Question 7
According to Fryette's laws, which of the following is true regarding Type I
somatic dysfunction?
A. The vertebrae are in a non-neutral position (flexion or extension).
B. Side-bending and rotation occur to the same side.
C. Side-bending and rotation occur to opposite sides.
D. The dysfunction involves only a single vertebra.
Correct Answer: C
Rationale: Fryette's Type I (Group I) somatic dysfunction states that when
the spine is in a neutral position, side-bending and rotation occur to
opposite sides. This typically involves a group of vertebrae (3–5
