COMSAE 115 FINAL EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with acute low back pain. Physical examination reveals L2 is
flexed, sidebent left, and rotated left. Which of the following describes the most likely
positional finding for the sacrum if L5 follows Fryette’s principles relative to the sacrum?
A. Left-on-right backward torsion
B. Right-on-right forward torsion
C. Left-on-left forward torsion
D. Right-on-left backward torsion
Answer: C
Conceptual Explanation: According to Fryette’s laws as applied to the lumbar-sacral
relationship, L5 and the sacrum rotate in opposite directions. If L5 is rotated left, the
sacrum must rotate right (on a right axis, creating a left-on-left forward torsion).
2. A patient presents with a Chapman point located on the lateral aspect of the middle to
lower femur (iliotibial band). This point is most indicative of dysfunction in which organ?
A. Colon
,B. Bladder
C. Ovary
D. Prostate
Answer: A
Conceptual Explanation: The Chapman point for the colon is located along the iliotibial
band. Specifically, the right IT band correlates to the ascending colon and the left IT band to
the descending colon.
3. When performing a vault hold, the physician’s fifth digits (little fingers) are placed on which
of the following structures?
A. Squamous portion of the occiput
B. Mastoid processes of the temporal bones
C. Greater wings of the sphenoid
D. Zygomatic arches
Answer: A
Conceptual Explanation: In the vault hold, the index fingers are on the greater wings of
the sphenoid, the middle fingers are on the zygomatic processes of the temporal bone, the
ring fingers are on the mastoid processes, and the little fingers are on the squamous
portion of the occiput.
, 4. During a cranial rhythm evaluation, the physician notes that the sphenoid and occiput
move superiorly at the SBS, with the bases of these bones moving in the same direction.
What is the diagnosis?
A. Torsion
B. Inferior vertical strain
C. Superior vertical strain
D. Lateral strain
Answer: C
Conceptual Explanation: A vertical strain occurs when the sphenoid base moves
superiorly (superior strain) or inferiorly (inferior strain) relative to the occiput. In a
superior vertical strain, the sphenoid base moves superiorly.
5. Which nerve is most likely at risk of injury during a mid-shaft fracture of the humerus?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Axillary nerve
Answer: C
Conceptual Explanation: The radial nerve runs in the spiral groove of the humerus and is
the nerve most commonly injured in mid-shaft humeral fractures.
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with acute low back pain. Physical examination reveals L2 is
flexed, sidebent left, and rotated left. Which of the following describes the most likely
positional finding for the sacrum if L5 follows Fryette’s principles relative to the sacrum?
A. Left-on-right backward torsion
B. Right-on-right forward torsion
C. Left-on-left forward torsion
D. Right-on-left backward torsion
Answer: C
Conceptual Explanation: According to Fryette’s laws as applied to the lumbar-sacral
relationship, L5 and the sacrum rotate in opposite directions. If L5 is rotated left, the
sacrum must rotate right (on a right axis, creating a left-on-left forward torsion).
2. A patient presents with a Chapman point located on the lateral aspect of the middle to
lower femur (iliotibial band). This point is most indicative of dysfunction in which organ?
A. Colon
,B. Bladder
C. Ovary
D. Prostate
Answer: A
Conceptual Explanation: The Chapman point for the colon is located along the iliotibial
band. Specifically, the right IT band correlates to the ascending colon and the left IT band to
the descending colon.
3. When performing a vault hold, the physician’s fifth digits (little fingers) are placed on which
of the following structures?
A. Squamous portion of the occiput
B. Mastoid processes of the temporal bones
C. Greater wings of the sphenoid
D. Zygomatic arches
Answer: A
Conceptual Explanation: In the vault hold, the index fingers are on the greater wings of
the sphenoid, the middle fingers are on the zygomatic processes of the temporal bone, the
ring fingers are on the mastoid processes, and the little fingers are on the squamous
portion of the occiput.
, 4. During a cranial rhythm evaluation, the physician notes that the sphenoid and occiput
move superiorly at the SBS, with the bases of these bones moving in the same direction.
What is the diagnosis?
A. Torsion
B. Inferior vertical strain
C. Superior vertical strain
D. Lateral strain
Answer: C
Conceptual Explanation: A vertical strain occurs when the sphenoid base moves
superiorly (superior strain) or inferiorly (inferior strain) relative to the occiput. In a
superior vertical strain, the sphenoid base moves superiorly.
5. Which nerve is most likely at risk of injury during a mid-shaft fracture of the humerus?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Axillary nerve
Answer: C
Conceptual Explanation: The radial nerve runs in the spiral groove of the humerus and is
the nerve most commonly injured in mid-shaft humeral fractures.
