COMSAE PHASE 1 FORM 116
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with acute chest pain. An EKG shows ST-segment elevation in
leads II, III, and aVF. Which spinal levels would most likely show viscerosomatic reflexes
associated with this condition?
A. T1-T4 on the right
B. T1-T5 on the left
C. T5-T9 on the left
D. T10-T11 on the right
Answer: B
Conceptual Explanation: The patient is experiencing an inferior myocardial infarction.
The viscerosomatic reflex for the heart is located at T1-T5, typically more pronounced on
the left side.
,2. A 45-year-old female presents with recurrent episodes of vertigo, tinnitus, and hearing
loss. During a cranial exam, the physician notes that the sphenoid and occiput rotate in
opposite directions about an anteroposterior axis. Which strain pattern is this?
A. Torsion
B. Lateral strain
C. Vertical strain
D. Sidebending rotation
Answer: A
Conceptual Explanation: In a cranial torsion, the sphenoid and occiput rotate in opposite
directions about an AP axis. Vertigo and hearing loss can sometimes be associated with
temporal bone dysfunction related to these strains.
3. A 24-year-old male presents with a cough and fever. A chest X-ray shows a right lower lobe
infiltrate. Physical exam reveals a Chapman point at the intercostal space between the 4th
and 5th ribs on the right. What is the most likely diagnosis?
A. Upper lung pathology
B. Lower lung pathology
C. Liver pathology
D. Gallbladder pathology
Answer: B
, Conceptual Explanation: The anterior Chapman point for the lower lung is the 4th
intercostal space. The 3rd intercostal space corresponds to the upper lung.
4. A patient is diagnosed with a sacral torsion. L5 is found to be Sidebent Left and Rotated
Right. Which sacral torsion is most likely present?
A. Right on Left
B. Left on Left
C. Right on Right
D. Left on Right
Answer: A
Conceptual Explanation: According to Fryette’s laws applied to the L5-sacrum
relationship, the sacrum rotates in the opposite direction of L5 rotation, and the seated
flexion test is positive on the side opposite the axis. L5 rotated right implies a left sacral
rotation. L5 sidebent left implies a left sacral axis. Thus, a Right on Left torsion (backward
torsion).
5. A 30-year-old runner presents with lateral knee pain. OMT reveals a restricted proximal
fibular head that prefers anterior glide. What is the associated position of the distal fibular
head?
A. Posterior and superior
B. Posterior and inferior
C. Anterior and inferior
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with acute chest pain. An EKG shows ST-segment elevation in
leads II, III, and aVF. Which spinal levels would most likely show viscerosomatic reflexes
associated with this condition?
A. T1-T4 on the right
B. T1-T5 on the left
C. T5-T9 on the left
D. T10-T11 on the right
Answer: B
Conceptual Explanation: The patient is experiencing an inferior myocardial infarction.
The viscerosomatic reflex for the heart is located at T1-T5, typically more pronounced on
the left side.
,2. A 45-year-old female presents with recurrent episodes of vertigo, tinnitus, and hearing
loss. During a cranial exam, the physician notes that the sphenoid and occiput rotate in
opposite directions about an anteroposterior axis. Which strain pattern is this?
A. Torsion
B. Lateral strain
C. Vertical strain
D. Sidebending rotation
Answer: A
Conceptual Explanation: In a cranial torsion, the sphenoid and occiput rotate in opposite
directions about an AP axis. Vertigo and hearing loss can sometimes be associated with
temporal bone dysfunction related to these strains.
3. A 24-year-old male presents with a cough and fever. A chest X-ray shows a right lower lobe
infiltrate. Physical exam reveals a Chapman point at the intercostal space between the 4th
and 5th ribs on the right. What is the most likely diagnosis?
A. Upper lung pathology
B. Lower lung pathology
C. Liver pathology
D. Gallbladder pathology
Answer: B
, Conceptual Explanation: The anterior Chapman point for the lower lung is the 4th
intercostal space. The 3rd intercostal space corresponds to the upper lung.
4. A patient is diagnosed with a sacral torsion. L5 is found to be Sidebent Left and Rotated
Right. Which sacral torsion is most likely present?
A. Right on Left
B. Left on Left
C. Right on Right
D. Left on Right
Answer: A
Conceptual Explanation: According to Fryette’s laws applied to the L5-sacrum
relationship, the sacrum rotates in the opposite direction of L5 rotation, and the seated
flexion test is positive on the side opposite the axis. L5 rotated right implies a left sacral
rotation. L5 sidebent left implies a left sacral axis. Thus, a Right on Left torsion (backward
torsion).
5. A 30-year-old runner presents with lateral knee pain. OMT reveals a restricted proximal
fibular head that prefers anterior glide. What is the associated position of the distal fibular
head?
A. Posterior and superior
B. Posterior and inferior
C. Anterior and inferior
