COMLEX LEVEL 2-CE LATEST REVIEW GUIDE
2026–2027 Featuring Clinical Cases, Practice
Questions & Osteopathic Board Success Strategies
1. A 45-year-old male presents with low back pain and limited range of
motion. On examination, you note restriction of the L5 vertebral segment in
flexion and extension. Which somatic dysfunction is most likely?
A. L5 flexed, rotated right, sidebent right
B. L5 flexed, rotated left, sidebent left
C. L5 extended, rotated right, sidebent right
D. L5 extended, rotated left, sidebent left
E. L5 flexed, rotated left, sidebent left
2. A 32-year-old female presents with chronic headaches. Osteopathic
examination reveals a restricted C2 segment with the transverse process
palpated more prominent on the right. Which type of dysfunction is present?
A. C2 neutral, rotated right, sidebent left
B. C2 neutral, rotated left, sidebent right
C. C2 flexed, rotated right, sidebent left
D. C2 extended, rotated left, sidebent right
E. C2 neutral, rotated right, sidebent left
3. The Chapman reflex for the myocardium is located at:
A. 2nd intercostal space, right
B. 3rd intercostal space, left
C. 4th intercostal space, right
D. 5th intercostal space, left
E. 4th intercostal space, right
4. A patient presents with a tender point in the right iliac fossa. Which
viscerosomatic reflex is most likely involved?
A. Appendix
B. Gallbladder
C. Stomach
D. Colon
E. Appendix
,5. The primary respiratory motion of the sacrum is:
A. Flexion and extension around a transverse axis
B. Rotation around a vertical axis
C. Sidebending around an AP axis
D. Torsion around an oblique axis
E. Flexion and extension around a transverse axis
6. A 55-year-old male presents with right shoulder pain that is worse with
overhead activities. Which osteopathic manipulative treatment (OMT)
technique is most appropriate for the clavicle?
A. Direct myofascial release
B. Indirect myofascial release
C. Muscle energy
D. High-velocity low-amplitude (HVLA)
E. Muscle energy
7. The Chapman reflex for the kidney is located at:
A. 2nd rib, anterior
B. 4th rib, anterior
C. 6th rib, anterior
D. 8th rib, anterior
E. 6th rib, anterior
8. A patient with asthma would benefit from treatment of which Chapman
reflex?
A. 2nd intercostal space, left
B. 3rd intercostal space, right
C. 4th intercostal space, left
D. 5th intercostal space, right
E. 3rd intercostal space, right
9. The Still technique is characterized by:
A. Direct, high-velocity thrust
B. Indirect, low-velocity positioning
C. Direct, low-velocity articulation
D. Indirect, high-velocity thrust
E. Indirect, low-velocity positioning
10.A patient presents with acute low back pain following a lifting injury.
Examination reveals a left sacroiliac dysfunction. Which OMT technique is
, most appropriate?
A. Muscle energy for the sacrum
B. HVLA for the lumbar spine
C. Myofascial release for the thoracolumbar fascia
D. Counterstrain for the sacrum
E. Muscle energy for the sacrum
11.The primary function of the pelvic diaphragm is to:
A. Support the pelvic organs
B. Control urinary continence
C. Control fecal continence
D. All of the above
E. All of the above
12.A 40-year-old female presents with tension headaches and cervical spine
restriction. Which myofascial release technique is most appropriate for the
suboccipital muscles?
A. Direct myofascial release
B. Indirect myofascial release
C. Muscle energy
D. HVLA
E. Direct myofascial release
13.The ligamentum arteriosum is a remnant of which fetal structure?
A. Ductus arteriosus
B. Foramen ovale
C. Ductus venosus
D. Umbilical vein
E. Ductus arteriosus
14.A patient with chronic constipation would benefit from treatment of which
Chapman reflex?
A. 11th intercostal space, left
B. 12th intercostal space, right
C. 11th rib, anterior
D. 12th rib, anterior
E. 12th rib, anterior
15.The primary motion of the occiput on the atlas during flexion is:
A. Anterior glide
, B. Posterior glide
C. Superior glide
D. Inferior glide
E. Posterior glide
16.A 50-year-old male presents with acute torticollis. Which cervical somatic
dysfunction is most likely?
A. C1 neutral, rotated right
B. C2 flexed, rotated left
C. C3 extended, rotated right
D. C4 neutral, sidebent left
E. C2 flexed, rotated left
17.The Chapman reflex for the liver is located at:
A. 4th intercostal space, right
B. 5th intercostal space, right
C. 6th intercostal space, right
D. 7th intercostal space, right
E. 5th intercostal space, right
18.A patient with dysmenorrhea would benefit from treatment of which
Chapman reflex?
A. 10th intercostal space, anterior
B. 11th intercostal space, anterior
C. 12th intercostal space, anterior
D. Sacral base
E. 11th intercostal space, anterior
19.The myofascial release technique that involves following the tissue into its
restrictive barrier is:
A. Direct myofascial release
B. Indirect myofascial release
C. Muscle energy
D. Counterstrain
E. Indirect myofascial release
20.A patient presents with acute ankle sprain. Which OMT technique is most
appropriate for the fibula?
A. HVLA for the fibular head
B. Muscle energy for the ankle
2026–2027 Featuring Clinical Cases, Practice
Questions & Osteopathic Board Success Strategies
1. A 45-year-old male presents with low back pain and limited range of
motion. On examination, you note restriction of the L5 vertebral segment in
flexion and extension. Which somatic dysfunction is most likely?
A. L5 flexed, rotated right, sidebent right
B. L5 flexed, rotated left, sidebent left
C. L5 extended, rotated right, sidebent right
D. L5 extended, rotated left, sidebent left
E. L5 flexed, rotated left, sidebent left
2. A 32-year-old female presents with chronic headaches. Osteopathic
examination reveals a restricted C2 segment with the transverse process
palpated more prominent on the right. Which type of dysfunction is present?
A. C2 neutral, rotated right, sidebent left
B. C2 neutral, rotated left, sidebent right
C. C2 flexed, rotated right, sidebent left
D. C2 extended, rotated left, sidebent right
E. C2 neutral, rotated right, sidebent left
3. The Chapman reflex for the myocardium is located at:
A. 2nd intercostal space, right
B. 3rd intercostal space, left
C. 4th intercostal space, right
D. 5th intercostal space, left
E. 4th intercostal space, right
4. A patient presents with a tender point in the right iliac fossa. Which
viscerosomatic reflex is most likely involved?
A. Appendix
B. Gallbladder
C. Stomach
D. Colon
E. Appendix
,5. The primary respiratory motion of the sacrum is:
A. Flexion and extension around a transverse axis
B. Rotation around a vertical axis
C. Sidebending around an AP axis
D. Torsion around an oblique axis
E. Flexion and extension around a transverse axis
6. A 55-year-old male presents with right shoulder pain that is worse with
overhead activities. Which osteopathic manipulative treatment (OMT)
technique is most appropriate for the clavicle?
A. Direct myofascial release
B. Indirect myofascial release
C. Muscle energy
D. High-velocity low-amplitude (HVLA)
E. Muscle energy
7. The Chapman reflex for the kidney is located at:
A. 2nd rib, anterior
B. 4th rib, anterior
C. 6th rib, anterior
D. 8th rib, anterior
E. 6th rib, anterior
8. A patient with asthma would benefit from treatment of which Chapman
reflex?
A. 2nd intercostal space, left
B. 3rd intercostal space, right
C. 4th intercostal space, left
D. 5th intercostal space, right
E. 3rd intercostal space, right
9. The Still technique is characterized by:
A. Direct, high-velocity thrust
B. Indirect, low-velocity positioning
C. Direct, low-velocity articulation
D. Indirect, high-velocity thrust
E. Indirect, low-velocity positioning
10.A patient presents with acute low back pain following a lifting injury.
Examination reveals a left sacroiliac dysfunction. Which OMT technique is
, most appropriate?
A. Muscle energy for the sacrum
B. HVLA for the lumbar spine
C. Myofascial release for the thoracolumbar fascia
D. Counterstrain for the sacrum
E. Muscle energy for the sacrum
11.The primary function of the pelvic diaphragm is to:
A. Support the pelvic organs
B. Control urinary continence
C. Control fecal continence
D. All of the above
E. All of the above
12.A 40-year-old female presents with tension headaches and cervical spine
restriction. Which myofascial release technique is most appropriate for the
suboccipital muscles?
A. Direct myofascial release
B. Indirect myofascial release
C. Muscle energy
D. HVLA
E. Direct myofascial release
13.The ligamentum arteriosum is a remnant of which fetal structure?
A. Ductus arteriosus
B. Foramen ovale
C. Ductus venosus
D. Umbilical vein
E. Ductus arteriosus
14.A patient with chronic constipation would benefit from treatment of which
Chapman reflex?
A. 11th intercostal space, left
B. 12th intercostal space, right
C. 11th rib, anterior
D. 12th rib, anterior
E. 12th rib, anterior
15.The primary motion of the occiput on the atlas during flexion is:
A. Anterior glide
, B. Posterior glide
C. Superior glide
D. Inferior glide
E. Posterior glide
16.A 50-year-old male presents with acute torticollis. Which cervical somatic
dysfunction is most likely?
A. C1 neutral, rotated right
B. C2 flexed, rotated left
C. C3 extended, rotated right
D. C4 neutral, sidebent left
E. C2 flexed, rotated left
17.The Chapman reflex for the liver is located at:
A. 4th intercostal space, right
B. 5th intercostal space, right
C. 6th intercostal space, right
D. 7th intercostal space, right
E. 5th intercostal space, right
18.A patient with dysmenorrhea would benefit from treatment of which
Chapman reflex?
A. 10th intercostal space, anterior
B. 11th intercostal space, anterior
C. 12th intercostal space, anterior
D. Sacral base
E. 11th intercostal space, anterior
19.The myofascial release technique that involves following the tissue into its
restrictive barrier is:
A. Direct myofascial release
B. Indirect myofascial release
C. Muscle energy
D. Counterstrain
E. Indirect myofascial release
20.A patient presents with acute ankle sprain. Which OMT technique is most
appropriate for the fibula?
A. HVLA for the fibular head
B. Muscle energy for the ankle
