COMAT Osteopathic Principles & Practice
(OPP/OMM) Exam V1
1. A 28-year-old male presents with neck stiffness after a motor vehicle collision. Physical
examination reveals the occipito-atlantal (OA) joint is restricted in right translation, and the
restriction improves with neck extension. What is the correct diagnosis?
A. OA Freely Moving Left, Sidebent Right
B. OA Flexed, Sidebent Right, Rotated Left
C. OA Extended, Sidebent Left, Rotated Right
D. OA Extended, Sidebent Right, Rotated Left
Correct Answer: D
Explanation: The OA joint follows modified Fryette mechanics where sidebending and
rotation occur to opposite sides. Translation to the right is equivalent to sidebending to the
left; since the joint is restricted in right translation, it is restricted in left sidebending,
meaning it prefers right sidebending and left rotation. Because the restriction improves in
extension, the diagnosis is OA extended, sidebent right, and rotated left (OA E SrRl).
2. A 45-year-old female presents with epigastric pain and nausea. On examination, a firm,
pea-sized, hypersensitive nodule is palpated in the right 5th intercostal space near the mid-
clavicular line. This point is most likely associated with which organ?
A. Stomach
,B. Gallbladder
C. Liver
D. Pancreas
Correct Answer: C
Explanation: The anterior Chapman point for the liver is located in the right 5th
intercostal space. Chapman points are small, smooth, firm, and exquisitely tender nodules
that represent viscerosomatic reflexes. Common pitfalls include confusing the liver point
(5th) with the gallbladder point (right 6th intercostal space).
3. A 34-year-old patient presents with low back pain. Examination reveals a positive seated
flexion test on the right. A deep sacral sulcus is noted on the left, and the left inferior lateral
angle is posterior. The spring test is negative. What is the sacral diagnosis?
A. Left-on-Left Forward Torsion
B. Right-on-Left Backward Torsion
C. Left-on-Right Backward Torsion
D. Right-on-Right Forward Torsion
Correct Answer: D
Explanation: A positive seated flexion test indicates the side of the dysfunction (Right). A
negative spring test indicates a forward torsion (neutral). In a Right-on-Right (R on R)
torsion, the sacrum rotates right on a right oblique axis, resulting in a deep left sulcus and a
, posterior right ILA; however, the seated flexion is positive on the opposite side of the axis
(Right). This clinical reasoning is essential for diagnosing sacral torsions correctly on the
COMAT.
4. A 55-year-old male with a history of chronic obstructive pulmonary disease (COPD)
presents for a routine visit. Which of the following Chapman points would most likely be
found in this patient?
A. Between the 2nd and 3rd ribs
B. Between the 3rd and 4th ribs
C. Between the 4th and 5th ribs
D. Between the 5th and 6th ribs
Correct Answer: B
Explanation: The anterior Chapman reflex points for the upper lung are found in the 3rd
intercostal space, and the lower lung is in the 4th intercostal space. Chronic lung conditions
like COPD often present with these myofascial findings due to prolonged sympathetic
stimulation. Examiners often test these points to assess the candidate’s knowledge of
viscerosomatic relationships.
5. A 22-year-old athlete complains of lateral knee pain. Examination reveals a posterior
fibular head on the right. Which of the following describes the correct positioning for Muscle
Energy treatment?
A. Invert and plantarflex the foot
(OPP/OMM) Exam V1
1. A 28-year-old male presents with neck stiffness after a motor vehicle collision. Physical
examination reveals the occipito-atlantal (OA) joint is restricted in right translation, and the
restriction improves with neck extension. What is the correct diagnosis?
A. OA Freely Moving Left, Sidebent Right
B. OA Flexed, Sidebent Right, Rotated Left
C. OA Extended, Sidebent Left, Rotated Right
D. OA Extended, Sidebent Right, Rotated Left
Correct Answer: D
Explanation: The OA joint follows modified Fryette mechanics where sidebending and
rotation occur to opposite sides. Translation to the right is equivalent to sidebending to the
left; since the joint is restricted in right translation, it is restricted in left sidebending,
meaning it prefers right sidebending and left rotation. Because the restriction improves in
extension, the diagnosis is OA extended, sidebent right, and rotated left (OA E SrRl).
2. A 45-year-old female presents with epigastric pain and nausea. On examination, a firm,
pea-sized, hypersensitive nodule is palpated in the right 5th intercostal space near the mid-
clavicular line. This point is most likely associated with which organ?
A. Stomach
,B. Gallbladder
C. Liver
D. Pancreas
Correct Answer: C
Explanation: The anterior Chapman point for the liver is located in the right 5th
intercostal space. Chapman points are small, smooth, firm, and exquisitely tender nodules
that represent viscerosomatic reflexes. Common pitfalls include confusing the liver point
(5th) with the gallbladder point (right 6th intercostal space).
3. A 34-year-old patient presents with low back pain. Examination reveals a positive seated
flexion test on the right. A deep sacral sulcus is noted on the left, and the left inferior lateral
angle is posterior. The spring test is negative. What is the sacral diagnosis?
A. Left-on-Left Forward Torsion
B. Right-on-Left Backward Torsion
C. Left-on-Right Backward Torsion
D. Right-on-Right Forward Torsion
Correct Answer: D
Explanation: A positive seated flexion test indicates the side of the dysfunction (Right). A
negative spring test indicates a forward torsion (neutral). In a Right-on-Right (R on R)
torsion, the sacrum rotates right on a right oblique axis, resulting in a deep left sulcus and a
, posterior right ILA; however, the seated flexion is positive on the opposite side of the axis
(Right). This clinical reasoning is essential for diagnosing sacral torsions correctly on the
COMAT.
4. A 55-year-old male with a history of chronic obstructive pulmonary disease (COPD)
presents for a routine visit. Which of the following Chapman points would most likely be
found in this patient?
A. Between the 2nd and 3rd ribs
B. Between the 3rd and 4th ribs
C. Between the 4th and 5th ribs
D. Between the 5th and 6th ribs
Correct Answer: B
Explanation: The anterior Chapman reflex points for the upper lung are found in the 3rd
intercostal space, and the lower lung is in the 4th intercostal space. Chronic lung conditions
like COPD often present with these myofascial findings due to prolonged sympathetic
stimulation. Examiners often test these points to assess the candidate’s knowledge of
viscerosomatic relationships.
5. A 22-year-old athlete complains of lateral knee pain. Examination reveals a posterior
fibular head on the right. Which of the following describes the correct positioning for Muscle
Energy treatment?
A. Invert and plantarflex the foot
