COMSAE Exam 35: Comprehensive -Question
Practice Bank with Answers and Rationales
SECTION 1: OSTEOPATHIC PRINCIPLES AND PRACTICE (Questions 1-20)
,Question 1
A 35-year-old patient with chronic low back pain is found to have a right posterior innominate
rotation. Which muscle is most likely shortened?
- A) Left quadratus lumborum
- B) Right hamstrings
- C) Right iliopsoas
- D) Left gluteus maximus
Answer: B) Right hamstrings
Rationale: A posterior innominate rotation involves the ilium moving posteriorly on the sacrum. In
this dysfunction, the ipsilateral hamstrings are shortened, pulling the ischium inferiorly and
posteriorly. The iliopsoas is typically shortened in an anterior innominate rotation. Understanding
muscle imbalances in pelvic dysfunctions is fundamental to osteopathic manipulative treatment .
,Question 2
A patient presents with a Type I somatic dysfunction of the thoracic spine. According to Fryette's
principles, which statement is correct?
- A) The vertebrae are sidebent and rotated in opposite directions
- B) The vertebrae are sidebent and rotated in the same direction
- C) The dysfunction is non-neutral and fixed in flexion
- D) The dysfunction is not amenable to muscle energy technique
Answer: B) The vertebrae are sidebent and rotated in the same direction
Rationale: Fryette's first principle (Type I) states that when the spine is in a neutral position,
sidebending is accompanied by rotation to the opposite side. Type II (non-neutral) involves
sidebending and rotation to the same side. This distinction is crucial for accurate diagnosis and
treatment planning in osteopathic manipulative medicine .
, Question 3
Chapman's reflex points are located in which anatomical structures?
- A) Deep skeletal muscles
- B) Superficial fascia and skin
- C) Joint capsules
- D) Visceral organs
Answer: B) Superficial fascia and skin
Rationale: Chapman's reflexes are small fascial tissue texture abnormalities located in the
superficial fascia and skin. They are associated with visceral dysfunction and are used
diagnostically in osteopathic practice. Each reflex point corresponds to a specific organ system .
Question 4
Which viscerosomatic reflex corresponds to the heart?
Practice Bank with Answers and Rationales
SECTION 1: OSTEOPATHIC PRINCIPLES AND PRACTICE (Questions 1-20)
,Question 1
A 35-year-old patient with chronic low back pain is found to have a right posterior innominate
rotation. Which muscle is most likely shortened?
- A) Left quadratus lumborum
- B) Right hamstrings
- C) Right iliopsoas
- D) Left gluteus maximus
Answer: B) Right hamstrings
Rationale: A posterior innominate rotation involves the ilium moving posteriorly on the sacrum. In
this dysfunction, the ipsilateral hamstrings are shortened, pulling the ischium inferiorly and
posteriorly. The iliopsoas is typically shortened in an anterior innominate rotation. Understanding
muscle imbalances in pelvic dysfunctions is fundamental to osteopathic manipulative treatment .
,Question 2
A patient presents with a Type I somatic dysfunction of the thoracic spine. According to Fryette's
principles, which statement is correct?
- A) The vertebrae are sidebent and rotated in opposite directions
- B) The vertebrae are sidebent and rotated in the same direction
- C) The dysfunction is non-neutral and fixed in flexion
- D) The dysfunction is not amenable to muscle energy technique
Answer: B) The vertebrae are sidebent and rotated in the same direction
Rationale: Fryette's first principle (Type I) states that when the spine is in a neutral position,
sidebending is accompanied by rotation to the opposite side. Type II (non-neutral) involves
sidebending and rotation to the same side. This distinction is crucial for accurate diagnosis and
treatment planning in osteopathic manipulative medicine .
, Question 3
Chapman's reflex points are located in which anatomical structures?
- A) Deep skeletal muscles
- B) Superficial fascia and skin
- C) Joint capsules
- D) Visceral organs
Answer: B) Superficial fascia and skin
Rationale: Chapman's reflexes are small fascial tissue texture abnormalities located in the
superficial fascia and skin. They are associated with visceral dysfunction and are used
diagnostically in osteopathic practice. Each reflex point corresponds to a specific organ system .
Question 4
Which viscerosomatic reflex corresponds to the heart?
