Comsae Phase 1 Form 114 Practice Exam
Actual 2026/2027 Questions With Verified
Answers, Complete Rationales &
Osteopathic References
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE
(OPP)
**1. A 45-year-old male presents with low back pain after lifting
a box. The standing flexion test shows superior movement of
the right PSIS. Which somatic dysfunction is most likely?**
A. Right posterior innominate
B. Right anterior innominate
C. Left anterior innominate
D. Left sacral torsion
**Correct answer:** B. Right anterior innominate
**Rationale:** A positive standing flexion test on the right
localizes the dysfunction to the right side. In a right anterior
innominate rotation, the right ASIS is positioned anteriorly and
inferiorly, while the PSIS moves superiorly during forward
flexion .
,---
**2. According to Fryette's first principle (Type I mechanics),
when the spine is in a neutral position, sidebending and rotation
occur:**
A. To the same side
B. To opposite sides
C. Without rotation
D. Only in the lumbar spine
**Correct answer:** B. To opposite sides
**Rationale:** Fryette's first principle states that when multiple
vertebral segments are in a neutral position, sidebending and
rotation occur in opposite directions. For example, sidebending
right is accompanied by rotation left .
---
**3. A 45-year-old male presents with a restricted T5 segment.
The segment prefers rotation to the right and sidebending to
the right. It improves when the patient bends 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. T5 Flexed RR SR
**Rationale:** Because the dysfunction improves in flexion, the
segment is diagnosed as Flexed. According to Fryette's Second
Law (Type II mechanics), when a single segment is in a non-
neutral position, rotation and side-bending occur in the same
direction .
---
**4. A 34-year-old patient presents with symptoms suggestive
of acute appendicitis. Where is the anterior Chapman's reflex
point for the appendix located?**
A. At the tip of the right 12th rib
B. At the tip of the right 11th rib
C. At the periumbilical region
D. At the right 5th intercostal space
**Correct answer:** B. At the tip of the right 11th rib
Actual 2026/2027 Questions With Verified
Answers, Complete Rationales &
Osteopathic References
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE
(OPP)
**1. A 45-year-old male presents with low back pain after lifting
a box. The standing flexion test shows superior movement of
the right PSIS. Which somatic dysfunction is most likely?**
A. Right posterior innominate
B. Right anterior innominate
C. Left anterior innominate
D. Left sacral torsion
**Correct answer:** B. Right anterior innominate
**Rationale:** A positive standing flexion test on the right
localizes the dysfunction to the right side. In a right anterior
innominate rotation, the right ASIS is positioned anteriorly and
inferiorly, while the PSIS moves superiorly during forward
flexion .
,---
**2. According to Fryette's first principle (Type I mechanics),
when the spine is in a neutral position, sidebending and rotation
occur:**
A. To the same side
B. To opposite sides
C. Without rotation
D. Only in the lumbar spine
**Correct answer:** B. To opposite sides
**Rationale:** Fryette's first principle states that when multiple
vertebral segments are in a neutral position, sidebending and
rotation occur in opposite directions. For example, sidebending
right is accompanied by rotation left .
---
**3. A 45-year-old male presents with a restricted T5 segment.
The segment prefers rotation to the right and sidebending to
the right. It improves when the patient bends 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. T5 Flexed RR SR
**Rationale:** Because the dysfunction improves in flexion, the
segment is diagnosed as Flexed. According to Fryette's Second
Law (Type II mechanics), when a single segment is in a non-
neutral position, rotation and side-bending occur in the same
direction .
---
**4. A 34-year-old patient presents with symptoms suggestive
of acute appendicitis. Where is the anterior Chapman's reflex
point for the appendix located?**
A. At the tip of the right 12th rib
B. At the tip of the right 11th rib
C. At the periumbilical region
D. At the right 5th intercostal space
**Correct answer:** B. At the tip of the right 11th rib
