COMSAE Style Practice Questions:
Osteopathic & Clinical Vignettes with
Answers and Rationales
SECTION 1: OSTEOPATHIC PRINCIPLES AND PRACTICE
,1. A patient presents following a fall with a blow to the front of the head. Which sphenobasilar
synchondrosis (SBS) strain pattern is most likely?
A. Lateral strain
B. Torsion
C. Compression
D. Vertical strain
Correct Answer: C - Compression
Rationale: A blow to the front or back of the head typically causes SBS compression. This pattern
results from direct anteroposterior force, causing the basisphenoid and basiocciput to approximate
.
,2. A 45-year-old construction worker presents with chronic low back pain. During osteopathic
evaluation, you note a somatic dysfunction at L5 with restriction of motion in extension, rotation to
the right, and sidebending to the left. This is best described as:
A. Type I dysfunction
B. Type II dysfunction
C. Neutral dysfunction
D. Non-neutral dysfunction
Correct Answer: B - Type II dysfunction
Rationale: Type II somatic dysfunctions are characterized by restriction in one direction of rotation
and sidebending, typically in a non-neutral position. The described pattern (extension, rotation
right, sidebending left) indicates a Type II dysfunction. Type I dysfunctions involve rotation and
sidebending to opposite directions in a neutral position.
, 3. The viscerosomatic reflex for the kidney and ureter corresponds to which spinal levels?
A. T5-T9
B. T9-T11
C. T10-L1
D. T11-L2
Correct Answer: C - T10-L1
Rationale: The kidney and ureter receive viscerosomatic innervation at spinal levels T10-L1, with
some sources specifically noting T10-11 for the kidney and ureter . This is important for
diagnosing renal pathology and understanding referred pain patterns.
Osteopathic & Clinical Vignettes with
Answers and Rationales
SECTION 1: OSTEOPATHIC PRINCIPLES AND PRACTICE
,1. A patient presents following a fall with a blow to the front of the head. Which sphenobasilar
synchondrosis (SBS) strain pattern is most likely?
A. Lateral strain
B. Torsion
C. Compression
D. Vertical strain
Correct Answer: C - Compression
Rationale: A blow to the front or back of the head typically causes SBS compression. This pattern
results from direct anteroposterior force, causing the basisphenoid and basiocciput to approximate
.
,2. A 45-year-old construction worker presents with chronic low back pain. During osteopathic
evaluation, you note a somatic dysfunction at L5 with restriction of motion in extension, rotation to
the right, and sidebending to the left. This is best described as:
A. Type I dysfunction
B. Type II dysfunction
C. Neutral dysfunction
D. Non-neutral dysfunction
Correct Answer: B - Type II dysfunction
Rationale: Type II somatic dysfunctions are characterized by restriction in one direction of rotation
and sidebending, typically in a non-neutral position. The described pattern (extension, rotation
right, sidebending left) indicates a Type II dysfunction. Type I dysfunctions involve rotation and
sidebending to opposite directions in a neutral position.
, 3. The viscerosomatic reflex for the kidney and ureter corresponds to which spinal levels?
A. T5-T9
B. T9-T11
C. T10-L1
D. T11-L2
Correct Answer: C - T10-L1
Rationale: The kidney and ureter receive viscerosomatic innervation at spinal levels T10-L1, with
some sources specifically noting T10-11 for the kidney and ureter . This is important for
diagnosing renal pathology and understanding referred pain patterns.
