Page 1 of 192
COMSAE Phase 1 Form 115 Practice Exam
Questions and Correct Answers (Verified)
Plus Rationales | 2026/2027 Q&A
1. A 35-year-old with chronic low back pain has a right
posterior innominate rotation. Which muscle is likely shortened?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Answer: B) Right hamstrings
Rationale: Posterior innominate rotation = ilium moves
posteriorly; ipsilateral hamstring is shortened. Opposite for
anterior innominate (iliopsoas).
,Page 2 of 192
2. During an osteopathic structural exam, you find a T4 spinous
process deviated left, with right rotation restriction. Fryette’s
type II mechanics apply. Which is true?
A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply
C) Rotation and sidebending occur to same side
D) Only rotation is restricted
Answer: C) Rotation and sidebending occur to same side
Rationale: Fryette’s type II (non-neutral): rotation and
sidebending to same side; type I (neutral) opposite.
3. A patient with asthma has tenderness at the 2nd intercostal
space, right parasternal region. This is a Chapman’s reflex for
which organ?
A) Kidney
B) Lung
,Page 3 of 192
C) Liver
D) Stomach
Answer: B) Lung
Rationale: Anterior Chapman’s points: lung – 2nd ICS
parasternal; posterior – T2-T4.
4. During a sacral motion test, you note that the right inferior
lateral angle (ILA) moves posterior more easily than the left.
Which torsion is present?
A) Left on left
B) Right on right
C) Left on right
D) Bilateral sacral flexion
Answer: B) Right on right
Rationale: In right-on-right torsion, right ILA moves posterior
more easily; L5 rotates to opposite side.
, Page 4 of 192
5. A 50-year-old with chronic constipation has a tender point
at the tip of the 12th rib on the right. Which viscerosomatic
reflex is most likely?
A) Colon
B) Stomach
C) Gallbladder
D) Appendix
Answer: A) Colon
Rationale: Colon reflexes: T10-L1, often tender at 11th/12th
ribs.
6. In counterstrain, you find a tender point at the anterior
medial knee. Which muscle is likely the primary dysfunction?
A) Vastus lateralis
B) Sartorius
C) Rectus femoris
D) Gracilis
COMSAE Phase 1 Form 115 Practice Exam
Questions and Correct Answers (Verified)
Plus Rationales | 2026/2027 Q&A
1. A 35-year-old with chronic low back pain has a right
posterior innominate rotation. Which muscle is likely shortened?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Answer: B) Right hamstrings
Rationale: Posterior innominate rotation = ilium moves
posteriorly; ipsilateral hamstring is shortened. Opposite for
anterior innominate (iliopsoas).
,Page 2 of 192
2. During an osteopathic structural exam, you find a T4 spinous
process deviated left, with right rotation restriction. Fryette’s
type II mechanics apply. Which is true?
A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply
C) Rotation and sidebending occur to same side
D) Only rotation is restricted
Answer: C) Rotation and sidebending occur to same side
Rationale: Fryette’s type II (non-neutral): rotation and
sidebending to same side; type I (neutral) opposite.
3. A patient with asthma has tenderness at the 2nd intercostal
space, right parasternal region. This is a Chapman’s reflex for
which organ?
A) Kidney
B) Lung
,Page 3 of 192
C) Liver
D) Stomach
Answer: B) Lung
Rationale: Anterior Chapman’s points: lung – 2nd ICS
parasternal; posterior – T2-T4.
4. During a sacral motion test, you note that the right inferior
lateral angle (ILA) moves posterior more easily than the left.
Which torsion is present?
A) Left on left
B) Right on right
C) Left on right
D) Bilateral sacral flexion
Answer: B) Right on right
Rationale: In right-on-right torsion, right ILA moves posterior
more easily; L5 rotates to opposite side.
, Page 4 of 192
5. A 50-year-old with chronic constipation has a tender point
at the tip of the 12th rib on the right. Which viscerosomatic
reflex is most likely?
A) Colon
B) Stomach
C) Gallbladder
D) Appendix
Answer: A) Colon
Rationale: Colon reflexes: T10-L1, often tender at 11th/12th
ribs.
6. In counterstrain, you find a tender point at the anterior
medial knee. Which muscle is likely the primary dysfunction?
A) Vastus lateralis
B) Sartorius
C) Rectus femoris
D) Gracilis
