COMSAE Phase 1 Form 115 Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | ( GRADED A+)
Instant Download
Section 1: Osteopathic Principles & Practice (OPP)
Question 1
A 45-year-old woman presents with epigastric burning and
bloating after meals for several months. On osteopathic structural
exam, you find tenderness and increased tissue texture at the
right T6-T8 paraspinal region. Which viscerosomatic reflex best
explains this finding?
A) Gallbladder
B) Stomach
C) Pancreas
D) Liver
Correct Answer: B – Stomach
Rationale: Viscerosomatic reflexes map spinal cord levels to
organs. The stomach corresponds to T6-T9, with a predilection for
the right side in many sources. Gallbladder (T7-T9) often presents
on the right, but the epigastric symptoms and bilateral T6-T8
tenderness more specifically point to the stomach. Pancreas (T6-
,T10) can be similar, but the history of epigastric burning is classic
for gastritis/PUD.
Question 2
A 28-year-old runner presents with chronic low back pain. On
seated flexion test, the right PSIS moves superiorly earlier and
more than the left. In the prone position, the right ILA is more
posterior than the left. Which of the following is the most likely
diagnosis?
A) Right anterior innominate rotation
B) Right posterior innominate rotation
C) Left anterior innominate rotation
D) Left posterior innominate rotation
Correct Answer: B – Right posterior innominate rotation
Rationale: The seated flexion test is used to assess iliosacral
dysfunction. If the right PSIS moves superiorly earlier, it indicates
the right ilium is restricted and is likely in a posterior position
relative to the sacrum. A posterior innominate rotation will have
the ILA (inferior lateral angle) more posterior.
Question 3
During a screening exam, you palpate a small, tender nodule in
the second intercostal space, right parasternal region. This
Chapman's point is most likely associated with which condition?
A) Mitral valve dysfunction
,B) Gastric ulcer
C) Appendicitis
D) Pulmonary congestion
Correct Answer: A – Mitral valve dysfunction
Rationale: Anterior Chapman's points for the heart are located in
the 2nd-5th intercostal spaces parasternally. The mitral valve
corresponds to the right 2nd intercostal space. Gastric points are
lower (6th-7th ribs). Appendicitis points are at the tip of the 12th
rib on the right. Pulmonary points are more lateral.
Question 4
Which of the following is a characteristic of Type I somatic
dysfunction according to Fryette's principles?
A) Involves a single vertebra
B) Sidebending and rotation occur to the same side
C) Occurs in neutral mechanics
D) Involves non-neutral mechanics
Correct Answer: C – Occurs in neutral mechanics
Rationale: Fryette's Type I dysfunction occurs with neutral
mechanics, involves multiple vertebrae, and sidebending and
rotation occur in opposite directions. Type II occurs in non-neutral
mechanics.
, Question 5
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
C) Liver
D) Stomach
Correct Answer: B – Lung
Rationale: Chapman's reflexes are viscerosomatic reflex points.
The 2nd intercostal space, right parasternal region corresponds to
lung reflexes.
Question 6
According to Fryette's first principle (Type I mechanics), when the
spine is in a neutral position, side-bending and rotation occur:
A) To the same side
B) To opposite sides
C) Sidebending occurs without rotation
D) Rotation occurs without sidebending
Correct Answer: B – To opposite sides
Rationale: Fryette’s first principle (Type I mechanics) describes
that when multiple vertebral segments are in a neutral position,
side-bending and rotation occur in opposite directions.
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | ( GRADED A+)
Instant Download
Section 1: Osteopathic Principles & Practice (OPP)
Question 1
A 45-year-old woman presents with epigastric burning and
bloating after meals for several months. On osteopathic structural
exam, you find tenderness and increased tissue texture at the
right T6-T8 paraspinal region. Which viscerosomatic reflex best
explains this finding?
A) Gallbladder
B) Stomach
C) Pancreas
D) Liver
Correct Answer: B – Stomach
Rationale: Viscerosomatic reflexes map spinal cord levels to
organs. The stomach corresponds to T6-T9, with a predilection for
the right side in many sources. Gallbladder (T7-T9) often presents
on the right, but the epigastric symptoms and bilateral T6-T8
tenderness more specifically point to the stomach. Pancreas (T6-
,T10) can be similar, but the history of epigastric burning is classic
for gastritis/PUD.
Question 2
A 28-year-old runner presents with chronic low back pain. On
seated flexion test, the right PSIS moves superiorly earlier and
more than the left. In the prone position, the right ILA is more
posterior than the left. Which of the following is the most likely
diagnosis?
A) Right anterior innominate rotation
B) Right posterior innominate rotation
C) Left anterior innominate rotation
D) Left posterior innominate rotation
Correct Answer: B – Right posterior innominate rotation
Rationale: The seated flexion test is used to assess iliosacral
dysfunction. If the right PSIS moves superiorly earlier, it indicates
the right ilium is restricted and is likely in a posterior position
relative to the sacrum. A posterior innominate rotation will have
the ILA (inferior lateral angle) more posterior.
Question 3
During a screening exam, you palpate a small, tender nodule in
the second intercostal space, right parasternal region. This
Chapman's point is most likely associated with which condition?
A) Mitral valve dysfunction
,B) Gastric ulcer
C) Appendicitis
D) Pulmonary congestion
Correct Answer: A – Mitral valve dysfunction
Rationale: Anterior Chapman's points for the heart are located in
the 2nd-5th intercostal spaces parasternally. The mitral valve
corresponds to the right 2nd intercostal space. Gastric points are
lower (6th-7th ribs). Appendicitis points are at the tip of the 12th
rib on the right. Pulmonary points are more lateral.
Question 4
Which of the following is a characteristic of Type I somatic
dysfunction according to Fryette's principles?
A) Involves a single vertebra
B) Sidebending and rotation occur to the same side
C) Occurs in neutral mechanics
D) Involves non-neutral mechanics
Correct Answer: C – Occurs in neutral mechanics
Rationale: Fryette's Type I dysfunction occurs with neutral
mechanics, involves multiple vertebrae, and sidebending and
rotation occur in opposite directions. Type II occurs in non-neutral
mechanics.
, Question 5
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
C) Liver
D) Stomach
Correct Answer: B – Lung
Rationale: Chapman's reflexes are viscerosomatic reflex points.
The 2nd intercostal space, right parasternal region corresponds to
lung reflexes.
Question 6
According to Fryette's first principle (Type I mechanics), when the
spine is in a neutral position, side-bending and rotation occur:
A) To the same side
B) To opposite sides
C) Sidebending occurs without rotation
D) Rotation occurs without sidebending
Correct Answer: B – To opposite sides
Rationale: Fryette’s first principle (Type I mechanics) describes
that when multiple vertebral segments are in a neutral position,
side-bending and rotation occur in opposite directions.
