1 | Page
COMSAE Phase 1 Form 115 High-Yield Exam | 150
Comprehensive Practice Questions with Verified
Answers and Detailed Rationales 2026–2027 | OMM
Principles, Somatic Dysfunctions, Pharmacology &
Diagnosis | COMLEX Level 1 Exam Prep | Graded A+
| 100% Pass Guaranteed
SECTION 1: OSTEOPATHIC PRINCIPLES & OMM (Questions 1-40)
1. According to Fryette's first principle (Type I mechanics), when the
spine is in a neutral position, which occurs?
a) Side-bending and rotation occur to the same side
b) Side-bending and rotation occur to opposite sides
c) Only side-bending occurs
d) Only rotation occurs
Answer: b
Rationale: Fryette's first principle (Type I mechanics) states that when
the spine is in a neutral position, side-bending and rotation occur to
opposite sides. This is the most common finding in somatic dysfunction
[citation:5].
2. According to Fryette's second principle (Type II mechanics), when the
spine is in a non-neutral position, which occurs?
a) Side-bending and rotation occur to opposite sides
,2 | Page
b) Side-bending and rotation occur to the same side
c) Only side-bending occurs
d) Only rotation occurs
Answer: b
Rationale: Fryette's second principle states that when the spine is in a
non-neutral (flexed or extended) position, side-bending and rotation
occur to the same side [citation:5].
3. In a patient with a left transverse process of L3 that is more posterior
on palpation and the patient cannot sidebend left easily, which Fryette
principle applies?
a) Type I – neutral mechanics
b) Type II – non-neutral mechanics
c) Type III – rotational mechanics
d) Type IV – combined mechanics
Answer: b
Rationale: This presentation is consistent with Type II (non-neutral)
mechanics. The more posterior transverse process on the left with
restriction of side-bending to the left indicates a non-neutral somatic
dysfunction [citation:5].
4. The thoracic inlet is the terminal drainage point for lymphatic return
from which areas?
a) Lower extremities only
b) Abdomen and pelvis
,3 | Page
c) Head, neck, and upper extremities
d) Thoracic cavity only
Answer: c
Rationale: The thoracic inlet serves as the terminal drainage point for
lymphatic return from the head, neck, and upper extremities into the
venous system at the junction of the internal jugular and subclavian
veins [citation:5].
5. The lymphatic pump technique aims to achieve which effect?
a) Enhance lymphatic flow and reduce congestion
b) Increase arterial blood flow to the extremities
c) Reduce venous return
d) Stimulate the immune system directly
Answer: a
Rationale: The lymphatic pump technique is an osteopathic manipulative
treatment aimed at enhancing lymphatic flow and reducing congestion.
It is commonly used to support the immune system [citation:5].
6. Chapman reflex points are best described as:
a) Painful trigger points in skeletal muscle
b) Small, palpable nodular areas of tissue texture change
c) Points of maximal tenderness on the spine
d) Areas of decreased blood flow
Answer: b
, 4 | Page
Rationale: In osteopathic medicine, Chapman reflex points are small,
palpable nodular areas of tissue texture change that correspond to
visceral dysfunction [citation:5].
7. The anterior Chapman point for the stomach is located in which
intercostal space?
a) 4th intercostal space
b) 5th intercostal space
c) 6th intercostal space
d) 7th intercostal space
Answer: c
Rationale: The anterior Chapman point for the stomach is located in the
6th intercostal space near the sternum. The posterior point is near the
transverse process of T6 on the left [citation:5].
8. The posterior Chapman point for the stomach is located near which
vertebral level?
a) T4
b) T5
c) T6
d) T7
Answer: c
Rationale: The posterior Chapman point for the stomach is near the
transverse process of T6 on the left [citation:5].
COMSAE Phase 1 Form 115 High-Yield Exam | 150
Comprehensive Practice Questions with Verified
Answers and Detailed Rationales 2026–2027 | OMM
Principles, Somatic Dysfunctions, Pharmacology &
Diagnosis | COMLEX Level 1 Exam Prep | Graded A+
| 100% Pass Guaranteed
SECTION 1: OSTEOPATHIC PRINCIPLES & OMM (Questions 1-40)
1. According to Fryette's first principle (Type I mechanics), when the
spine is in a neutral position, which occurs?
a) Side-bending and rotation occur to the same side
b) Side-bending and rotation occur to opposite sides
c) Only side-bending occurs
d) Only rotation occurs
Answer: b
Rationale: Fryette's first principle (Type I mechanics) states that when
the spine is in a neutral position, side-bending and rotation occur to
opposite sides. This is the most common finding in somatic dysfunction
[citation:5].
2. According to Fryette's second principle (Type II mechanics), when the
spine is in a non-neutral position, which occurs?
a) Side-bending and rotation occur to opposite sides
,2 | Page
b) Side-bending and rotation occur to the same side
c) Only side-bending occurs
d) Only rotation occurs
Answer: b
Rationale: Fryette's second principle states that when the spine is in a
non-neutral (flexed or extended) position, side-bending and rotation
occur to the same side [citation:5].
3. In a patient with a left transverse process of L3 that is more posterior
on palpation and the patient cannot sidebend left easily, which Fryette
principle applies?
a) Type I – neutral mechanics
b) Type II – non-neutral mechanics
c) Type III – rotational mechanics
d) Type IV – combined mechanics
Answer: b
Rationale: This presentation is consistent with Type II (non-neutral)
mechanics. The more posterior transverse process on the left with
restriction of side-bending to the left indicates a non-neutral somatic
dysfunction [citation:5].
4. The thoracic inlet is the terminal drainage point for lymphatic return
from which areas?
a) Lower extremities only
b) Abdomen and pelvis
,3 | Page
c) Head, neck, and upper extremities
d) Thoracic cavity only
Answer: c
Rationale: The thoracic inlet serves as the terminal drainage point for
lymphatic return from the head, neck, and upper extremities into the
venous system at the junction of the internal jugular and subclavian
veins [citation:5].
5. The lymphatic pump technique aims to achieve which effect?
a) Enhance lymphatic flow and reduce congestion
b) Increase arterial blood flow to the extremities
c) Reduce venous return
d) Stimulate the immune system directly
Answer: a
Rationale: The lymphatic pump technique is an osteopathic manipulative
treatment aimed at enhancing lymphatic flow and reducing congestion.
It is commonly used to support the immune system [citation:5].
6. Chapman reflex points are best described as:
a) Painful trigger points in skeletal muscle
b) Small, palpable nodular areas of tissue texture change
c) Points of maximal tenderness on the spine
d) Areas of decreased blood flow
Answer: b
, 4 | Page
Rationale: In osteopathic medicine, Chapman reflex points are small,
palpable nodular areas of tissue texture change that correspond to
visceral dysfunction [citation:5].
7. The anterior Chapman point for the stomach is located in which
intercostal space?
a) 4th intercostal space
b) 5th intercostal space
c) 6th intercostal space
d) 7th intercostal space
Answer: c
Rationale: The anterior Chapman point for the stomach is located in the
6th intercostal space near the sternum. The posterior point is near the
transverse process of T6 on the left [citation:5].
8. The posterior Chapman point for the stomach is located near which
vertebral level?
a) T4
b) T5
c) T6
d) T7
Answer: c
Rationale: The posterior Chapman point for the stomach is near the
transverse process of T6 on the left [citation:5].
