COMSAE Phase 1 Form 115 Exam – 176 Practice
Questions with Answers & Rationales | COMLEX-
USA Level 1 Prep LATEST UPDATE THIS YEAR-
JUST RELEASED.pdf
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT) – Questions 1–40
Question 1
A 35-year-old patient with chronic low back pain presents with a right posterior
innominate rotation of the pelvis. Which muscle is most likely shortened and
contributing to this dysfunction?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Answer: B) Right hamstrings
In a posterior innominate rotation, the ilium moves posteriorly on the sacrum, and the
ipsilateral hamstring is shortened. The iliopsoas is shortened in an anterior innominate
rotation, not a posterior one.
Question 2
During an osteopathic structural examination, you find a T4 spinous process that is
,deviated to the left with restriction of right rotation. According to Fryette's Type II
mechanics, which statement correctly describes this dysfunction?
A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply to this dysfunction
C) Rotation and sidebending occur to the same side
D) Only rotation is restricted without sidebending
Answer: C) Rotation and sidebending occur to the same side
Fryette's Type II (non-neutral) mechanics state that rotation and sidebending occur to the
same side. Type I mechanics occur in neutral positions with rotation and sidebending to
opposite sides.
Question 3
A patient with a history of asthma presents with tenderness at the 2nd intercostal
space in the right parasternal region. This Chapman's reflex point is most indicative
of dysfunction in which organ system?
A) Kidney
B) Lung
C) Gallbladder
D) Heart
Answer: B) Lung
The anterior Chapman's reflex point for the lungs is located at the 2nd intercostal space in
the parasternal region. The posterior reflex point for the lungs is at T2-T4.
,Question 4
A patient presents with right lateral bending of the lumbar spine combined with
rotation to the left. According to Fryette's principles, this pattern is best classified as
which type of dysfunction?
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Neutral dysfunction
Answer: A) Type I dysfunction
Type I (neutral) mechanics involve sidebending and rotation occurring to opposite sides.
Right lateral bending with left rotation is the classic Type I pattern, which typically occurs in
group curves.
Question 5
A 50-year-old patient with chronic constipation has a tender point located at the tip of
the 12th rib on the right side. This viscerosomatic reflex is most likely associated
with dysfunction of which organ?
A) Colon
B) Stomach
C) Gallbladder
D) Appendix
Answer: A) Colon
Viscerosomatic reflexes for the colon are located at T10-L1, often presenting as tenderness
at the 11th or 12th ribs. The colon is a frequent source of viscerosomatic pain referral.
, Question 6
In counterstrain technique, you identify a tender point at the anterior medial aspect of
the knee. This tender point is most likely associated with dysfunction of which
muscle?
A) Vastus lateralis
B) Sartorius
C) Rectus femoris
D) Gracilis
Answer: B) Sartorius
The sartorius muscle tender point is located at the anterior medial knee. The counterstrain
treatment position involves flexion, abduction, and external rotation of the hip to relieve the
tender point.
Question 7
A patient is diagnosed with a right forward sacral torsion. Which of the following
statements correctly describes the relationship of L5 rotation in this dysfunction?
A) L5 rotates to the right side
B) L5 rotates to the left side
C) L5 remains in a neutral position
D) L5 rotates in a posterior direction
Answer: A) L5 rotates to the right side
In forward sacral torsion, L5 rotates to the same side as the oblique axis. Right forward
torsion with a right oblique axis causes L5 to rotate to the right.
Questions with Answers & Rationales | COMLEX-
USA Level 1 Prep LATEST UPDATE THIS YEAR-
JUST RELEASED.pdf
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT) – Questions 1–40
Question 1
A 35-year-old patient with chronic low back pain presents with a right posterior
innominate rotation of the pelvis. Which muscle is most likely shortened and
contributing to this dysfunction?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Answer: B) Right hamstrings
In a posterior innominate rotation, the ilium moves posteriorly on the sacrum, and the
ipsilateral hamstring is shortened. The iliopsoas is shortened in an anterior innominate
rotation, not a posterior one.
Question 2
During an osteopathic structural examination, you find a T4 spinous process that is
,deviated to the left with restriction of right rotation. According to Fryette's Type II
mechanics, which statement correctly describes this dysfunction?
A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply to this dysfunction
C) Rotation and sidebending occur to the same side
D) Only rotation is restricted without sidebending
Answer: C) Rotation and sidebending occur to the same side
Fryette's Type II (non-neutral) mechanics state that rotation and sidebending occur to the
same side. Type I mechanics occur in neutral positions with rotation and sidebending to
opposite sides.
Question 3
A patient with a history of asthma presents with tenderness at the 2nd intercostal
space in the right parasternal region. This Chapman's reflex point is most indicative
of dysfunction in which organ system?
A) Kidney
B) Lung
C) Gallbladder
D) Heart
Answer: B) Lung
The anterior Chapman's reflex point for the lungs is located at the 2nd intercostal space in
the parasternal region. The posterior reflex point for the lungs is at T2-T4.
,Question 4
A patient presents with right lateral bending of the lumbar spine combined with
rotation to the left. According to Fryette's principles, this pattern is best classified as
which type of dysfunction?
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Neutral dysfunction
Answer: A) Type I dysfunction
Type I (neutral) mechanics involve sidebending and rotation occurring to opposite sides.
Right lateral bending with left rotation is the classic Type I pattern, which typically occurs in
group curves.
Question 5
A 50-year-old patient with chronic constipation has a tender point located at the tip of
the 12th rib on the right side. This viscerosomatic reflex is most likely associated
with dysfunction of which organ?
A) Colon
B) Stomach
C) Gallbladder
D) Appendix
Answer: A) Colon
Viscerosomatic reflexes for the colon are located at T10-L1, often presenting as tenderness
at the 11th or 12th ribs. The colon is a frequent source of viscerosomatic pain referral.
, Question 6
In counterstrain technique, you identify a tender point at the anterior medial aspect of
the knee. This tender point is most likely associated with dysfunction of which
muscle?
A) Vastus lateralis
B) Sartorius
C) Rectus femoris
D) Gracilis
Answer: B) Sartorius
The sartorius muscle tender point is located at the anterior medial knee. The counterstrain
treatment position involves flexion, abduction, and external rotation of the hip to relieve the
tender point.
Question 7
A patient is diagnosed with a right forward sacral torsion. Which of the following
statements correctly describes the relationship of L5 rotation in this dysfunction?
A) L5 rotates to the right side
B) L5 rotates to the left side
C) L5 remains in a neutral position
D) L5 rotates in a posterior direction
Answer: A) L5 rotates to the right side
In forward sacral torsion, L5 rotates to the same side as the oblique axis. Right forward
torsion with a right oblique axis causes L5 to rotate to the right.
