COMSAE PHASE 1 ASA 115 – THE
COMPLETE QUESTION TEST BANK ALL
QUESTIONS WITH CORRECT VERIFIED
ANSWERS & DETAILED RATIONALES –
GRADED A+ FOR THE NEWEST 2026
SECTION 1: ANATOMY & NEUROANATOMY
Question 1
A 55-year-old man presents with difficulty chewing and deviation of the jaw
to the left upon opening the mouth. Which nerve is most likely affected?
A. Left trigeminal nerve (V3)
B. Right trigeminal nerve (V3)
C. Left facial nerve
D. Right facial nerve
Correct answer: A
RATIONALE: The motor fibers of V3 innervate the muscles of
mastication, including the lateral pterygoid. Unilateral damage causes the jaw
to deviate toward the weak side (ipsilateral) upon opening due to unopposed
action of the intact lateral pterygoid. Deviation to the left indicates left V3
involvement .
Question 2
A 45-year-old woman has a meningioma compressing the right optic nerve
near the optic canal. Which visual field defect would be expected?
A. Bitemporal hemianopia
B. Right monocular blindness
C. Left homonymous hemianopia
D. Right nasal hemianopia
, Correct answer: B
RATIONALE: A lesion anterior to the optic chiasm (e.g., optic nerve)
causes complete visual loss in the ipsilateral eye. Bitemporal hemianopia
occurs with chiasmal lesions. Homonymous hemianopia with lesions
posterior to the chiasm .
Question 3
A 28-year-old man sustains a knife wound to the upper medial arm. He has
sensory loss on the medial forearm and weakness of finger
abduction/adduction. Which nerve is injured?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Musculocutaneous nerve
Correct answer: A
RATIONALE: The ulnar nerve innervates intrinsic hand muscles
responsible for finger abduction/adduction (interossei) and provides
sensation to the medial 1½ fingers. Median nerve injury would affect thumb
opposition .
Question 4
A patient has a "claw hand" deformity with hyperextension at the MCP joints
and flexion at the IP joints of the ring and little fingers. Sensation is lost over
the medial hand. Which nerve is injured?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Axillary nerve
Correct answer: B
RATIONALE: Ulnar nerve injury causes paralysis of intrinsic hand
muscles (interossei, lumbricals 3/4), resulting in clawing of ring and little
fingers, and sensory loss over the ulnar 1½ fingers .
,Question 5
A lesion involving the medial medulla damages the corticospinal tract before
decussation. What deficit is expected?
A. Ipsilateral facial paralysis
B. Contralateral limb weakness
C. Ipsilateral loss of pain and temperature
D. Contralateral hearing loss
Correct answer: B
RATIONALE: Corticospinal fibers cross in the caudal medulla at the
pyramidal decussation. A lesion above the decussation causes contralateral
motor deficits .
Question 6
Which cranial nerve carries parasympathetic fibers responsible for pupillary
constriction?
A. CN II
B. CN III
C. CN V
D. CN VIII
Correct answer: B
RATIONALE: The oculomotor nerve (CN III) carries parasympathetic
fibers to the sphincter pupillae muscle .
SECTION 2: OSTEOPATHIC PRINCIPLES & PRACTICE
Question 7
An osteopathic structural exam on a 30-year-old female reveals a restricted T5
segment. The segment prefers rotation right and sidebending right. It
improves when the patient slumps forward into spinal flexion. What is the
correct diagnosis?
A. T5 Neutral SR RL
B. T5 Extended RR SR
, C. T5 Flexed RR SR
D. T5 Flexed RL SL
Correct answer: C
RATIONALE: Since it improves in flexion, the dysfunction is Flexed (F).
According to Fryette's Second Law (Type II), rotation and sidebending occur
to the same side (RRSR) .
Question 8
During a cranial exam, the physician notes that the sphenoid base moves
superiorly during the inhalation phase of the primary respiratory mechanism.
What is this motion called?
A. Extension
B. Flexion
C. Torsion
D. Sidebending-Rotation
Correct answer: B
RATIONALE: In cranial flexion, the midline bones (sphenoid and
occiput) rotate in opposite directions, causing the sphenobasilar
synchondrosis (SBS) to rise superiorly .
Question 9
A 45-year-old female presents with left-sided neck pain and limited range of
motion. Palpation reveals a tender, hypertonic left sternocleidomastoid
muscle with restrictions in cervical rotation and lateral flexion to the left.
Which OMT approach is most appropriate initially?
A. HVLA thrust directly to the left cervical spine
B. Muscle energy technique to lengthen the hypertonic sternocleidomastoid
C. Indirect myofascial release on the right sternocleidomastoid
D. Joint mobilization to decompress the cervical nerve roots
Correct answer: B
RATIONALE: Muscle energy technique (MET) engages the patient's
muscles against precise directional resistance. For a hypertonic
COMPLETE QUESTION TEST BANK ALL
QUESTIONS WITH CORRECT VERIFIED
ANSWERS & DETAILED RATIONALES –
GRADED A+ FOR THE NEWEST 2026
SECTION 1: ANATOMY & NEUROANATOMY
Question 1
A 55-year-old man presents with difficulty chewing and deviation of the jaw
to the left upon opening the mouth. Which nerve is most likely affected?
A. Left trigeminal nerve (V3)
B. Right trigeminal nerve (V3)
C. Left facial nerve
D. Right facial nerve
Correct answer: A
RATIONALE: The motor fibers of V3 innervate the muscles of
mastication, including the lateral pterygoid. Unilateral damage causes the jaw
to deviate toward the weak side (ipsilateral) upon opening due to unopposed
action of the intact lateral pterygoid. Deviation to the left indicates left V3
involvement .
Question 2
A 45-year-old woman has a meningioma compressing the right optic nerve
near the optic canal. Which visual field defect would be expected?
A. Bitemporal hemianopia
B. Right monocular blindness
C. Left homonymous hemianopia
D. Right nasal hemianopia
, Correct answer: B
RATIONALE: A lesion anterior to the optic chiasm (e.g., optic nerve)
causes complete visual loss in the ipsilateral eye. Bitemporal hemianopia
occurs with chiasmal lesions. Homonymous hemianopia with lesions
posterior to the chiasm .
Question 3
A 28-year-old man sustains a knife wound to the upper medial arm. He has
sensory loss on the medial forearm and weakness of finger
abduction/adduction. Which nerve is injured?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Musculocutaneous nerve
Correct answer: A
RATIONALE: The ulnar nerve innervates intrinsic hand muscles
responsible for finger abduction/adduction (interossei) and provides
sensation to the medial 1½ fingers. Median nerve injury would affect thumb
opposition .
Question 4
A patient has a "claw hand" deformity with hyperextension at the MCP joints
and flexion at the IP joints of the ring and little fingers. Sensation is lost over
the medial hand. Which nerve is injured?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Axillary nerve
Correct answer: B
RATIONALE: Ulnar nerve injury causes paralysis of intrinsic hand
muscles (interossei, lumbricals 3/4), resulting in clawing of ring and little
fingers, and sensory loss over the ulnar 1½ fingers .
,Question 5
A lesion involving the medial medulla damages the corticospinal tract before
decussation. What deficit is expected?
A. Ipsilateral facial paralysis
B. Contralateral limb weakness
C. Ipsilateral loss of pain and temperature
D. Contralateral hearing loss
Correct answer: B
RATIONALE: Corticospinal fibers cross in the caudal medulla at the
pyramidal decussation. A lesion above the decussation causes contralateral
motor deficits .
Question 6
Which cranial nerve carries parasympathetic fibers responsible for pupillary
constriction?
A. CN II
B. CN III
C. CN V
D. CN VIII
Correct answer: B
RATIONALE: The oculomotor nerve (CN III) carries parasympathetic
fibers to the sphincter pupillae muscle .
SECTION 2: OSTEOPATHIC PRINCIPLES & PRACTICE
Question 7
An osteopathic structural exam on a 30-year-old female reveals a restricted T5
segment. The segment prefers rotation right and sidebending right. It
improves when the patient slumps forward into spinal flexion. What is the
correct diagnosis?
A. T5 Neutral SR RL
B. T5 Extended RR SR
, C. T5 Flexed RR SR
D. T5 Flexed RL SL
Correct answer: C
RATIONALE: Since it improves in flexion, the dysfunction is Flexed (F).
According to Fryette's Second Law (Type II), rotation and sidebending occur
to the same side (RRSR) .
Question 8
During a cranial exam, the physician notes that the sphenoid base moves
superiorly during the inhalation phase of the primary respiratory mechanism.
What is this motion called?
A. Extension
B. Flexion
C. Torsion
D. Sidebending-Rotation
Correct answer: B
RATIONALE: In cranial flexion, the midline bones (sphenoid and
occiput) rotate in opposite directions, causing the sphenobasilar
synchondrosis (SBS) to rise superiorly .
Question 9
A 45-year-old female presents with left-sided neck pain and limited range of
motion. Palpation reveals a tender, hypertonic left sternocleidomastoid
muscle with restrictions in cervical rotation and lateral flexion to the left.
Which OMT approach is most appropriate initially?
A. HVLA thrust directly to the left cervical spine
B. Muscle energy technique to lengthen the hypertonic sternocleidomastoid
C. Indirect myofascial release on the right sternocleidomastoid
D. Joint mobilization to decompress the cervical nerve roots
Correct answer: B
RATIONALE: Muscle energy technique (MET) engages the patient's
muscles against precise directional resistance. For a hypertonic
