COMSAE PHASE 6 COMPREHENSIVE
PRACTICE EXAM QUESTIONS AND
VERIFIED ANSWERS
1. A 45-year-old male presents with epigastric pain that radiates to his back. Physical exam
reveals tissue texture changes at T5-T9. Which of the following viscerosomatic reflexes
corresponds to the pancreas?
A. T5-T9 on the left
B. T5-T9 on the right
C. T10-T11 on the left
D. T12-L2 on the right
Answer: B
Conceptual Explanation: The viscerosomatic reflex for the pancreas is localized to T5-T9
on the right side, while the stomach is typically T5-T9 on the left.
2. A 24-year-old female presents with a diagnosis of L/L sacral torsion. Which of the following
findings would be expected on physical examination?
A. Positive seated flexion test on the right
B. Deep right sacral sulcus
C. Prominent left inferior lateral angle
,D. Negative sphinx test
D. Negative sphinx test
Answer: D
Conceptual Explanation: In a forward sacral torsion (L/L), the sphinx test is negative
because the sacral base moves forward (improving symmetry). A positive seated flexion
test would be on the left.
3. A patient with a Cobb angle of 35 degrees is diagnosed with scoliosis. Which of the
following is the most appropriate next step in management?
A. Observation every 6 months
B. Bracing
C. Surgical consultation
D. Osteopathic Manipulative Treatment only
Answer: B
Conceptual Explanation: For scoliosis, a Cobb angle between 20-45 degrees in a skeletally
immature patient warrants bracing. Angles >45-50 degrees require surgery.
4. Anterior Cervical 7 (AC7) counterstrain point is located where?
A. On the posterior aspect of the C7 spinous process
B. On the superior aspect of the medial clavicle
C. On the lateral aspect of the C7 transverse process
, D. On the lateral aspect of the first rib
Answer: B
Conceptual Explanation: The AC7 tender point is located on the posterior-superior
surface of the clavicle at the clavicular attachment of the sternocleidomastoid muscle.
5. Which cranial strain pattern is characterized by the sphenoid and occiput rotating in the
same direction about two transverse axes?
A. Torsion
B. Vertical Strain
C. Sidebending-Rotation
D. Flexion
Answer: B
Conceptual Explanation: A vertical strain occurs when the sphenoid base moves
superiorly (Superior Strain) or inferiorly (Inferior Strain) relative to the occiput about two
parallel transverse axes.
6. A patient presents with sharp pain at the tip of the right 12th rib. Which Chapman point is
located here?
A. Gallbladder
B. Kidney
C. Appendix
PRACTICE EXAM QUESTIONS AND
VERIFIED ANSWERS
1. A 45-year-old male presents with epigastric pain that radiates to his back. Physical exam
reveals tissue texture changes at T5-T9. Which of the following viscerosomatic reflexes
corresponds to the pancreas?
A. T5-T9 on the left
B. T5-T9 on the right
C. T10-T11 on the left
D. T12-L2 on the right
Answer: B
Conceptual Explanation: The viscerosomatic reflex for the pancreas is localized to T5-T9
on the right side, while the stomach is typically T5-T9 on the left.
2. A 24-year-old female presents with a diagnosis of L/L sacral torsion. Which of the following
findings would be expected on physical examination?
A. Positive seated flexion test on the right
B. Deep right sacral sulcus
C. Prominent left inferior lateral angle
,D. Negative sphinx test
D. Negative sphinx test
Answer: D
Conceptual Explanation: In a forward sacral torsion (L/L), the sphinx test is negative
because the sacral base moves forward (improving symmetry). A positive seated flexion
test would be on the left.
3. A patient with a Cobb angle of 35 degrees is diagnosed with scoliosis. Which of the
following is the most appropriate next step in management?
A. Observation every 6 months
B. Bracing
C. Surgical consultation
D. Osteopathic Manipulative Treatment only
Answer: B
Conceptual Explanation: For scoliosis, a Cobb angle between 20-45 degrees in a skeletally
immature patient warrants bracing. Angles >45-50 degrees require surgery.
4. Anterior Cervical 7 (AC7) counterstrain point is located where?
A. On the posterior aspect of the C7 spinous process
B. On the superior aspect of the medial clavicle
C. On the lateral aspect of the C7 transverse process
, D. On the lateral aspect of the first rib
Answer: B
Conceptual Explanation: The AC7 tender point is located on the posterior-superior
surface of the clavicle at the clavicular attachment of the sternocleidomastoid muscle.
5. Which cranial strain pattern is characterized by the sphenoid and occiput rotating in the
same direction about two transverse axes?
A. Torsion
B. Vertical Strain
C. Sidebending-Rotation
D. Flexion
Answer: B
Conceptual Explanation: A vertical strain occurs when the sphenoid base moves
superiorly (Superior Strain) or inferiorly (Inferior Strain) relative to the occiput about two
parallel transverse axes.
6. A patient presents with sharp pain at the tip of the right 12th rib. Which Chapman point is
located here?
A. Gallbladder
B. Kidney
C. Appendix
