COMSAE PRACTICE EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with sharp back pain. Palpation of the spine reveals that L2 is
rotated right and sidebent right. Which of the following describes this segmental
dysfunction?
A. Type II mechanics
B. Neutral mechanics
C. Type I mechanics
D. Physiologic motion
Answer: A
Conceptual Explanation: Type II mechanics (Non-neutral) involve a single vertebral
segment that is rotated and sidebent to the same side, often occurring in flexion or
extension.
2. A patient presents with mid-back pain. You find T6 is rotated left and sidebent right in a
neutral position. What is the correct diagnosis?
A. T6 NRrSl
,B. T6 ERrSr
C. T6 FRlSl
D. T6 NSlRr
Answer: D
Conceptual Explanation: In Type I neutral mechanics, the segment sidebends first, and
rotation occurs to the opposite side. If it is neutral, sidebent right, it must be rotated left.
3. During a cranial exam, the sphenobasilar synchondrosis (SBS) is found to move superiorly,
the paired bones undergo external rotation, and the midline bones undergo flexion. Which
phase of the cranial rhythmic impulse (CRI) is this?
A. Extension phase
B. Inhalation phase
C. Flexion phase
D. Exhalation phase
Answer: C
Conceptual Explanation: The flexion phase of the CRI involves the SBS moving superiorly,
external rotation of paired bones, and narrowing/lengthening of the cranium.
4. A 30-year-old female presents with epigastric pain. You find a tender point on the right
side of the 5th intercostal space. Which organ is this Chapman point associated with?
A. Gallbladder
, B. Stomach (Acidity)
C. Liver
D. Pancreas
Answer: C
Conceptual Explanation: The anterior Chapman point for the liver is located in the right
5th intercostal space.
5. A positive seated flexion test on the left, a deep sacral sulcus on the right, and a posterior
inferior lateral angle (ILA) on the left suggests which diagnosis?
A. Left on Left forward torsion
B. Right on Left backward torsion
C. Right on Right forward torsion
D. Left on Right backward torsion
Answer: D
Conceptual Explanation: A positive seated flexion test on the left indicates the
dysfunction is on the left side of the sacrum. A deep sulcus on the right and posterior ILA on
the left with a left seated flexion test points to a backward torsion (L on R).
6. A patient presents with pain at the tip of the 12th rib on the right side. This Chapman point
is most indicative of which condition?
A. Cystitis
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with sharp back pain. Palpation of the spine reveals that L2 is
rotated right and sidebent right. Which of the following describes this segmental
dysfunction?
A. Type II mechanics
B. Neutral mechanics
C. Type I mechanics
D. Physiologic motion
Answer: A
Conceptual Explanation: Type II mechanics (Non-neutral) involve a single vertebral
segment that is rotated and sidebent to the same side, often occurring in flexion or
extension.
2. A patient presents with mid-back pain. You find T6 is rotated left and sidebent right in a
neutral position. What is the correct diagnosis?
A. T6 NRrSl
,B. T6 ERrSr
C. T6 FRlSl
D. T6 NSlRr
Answer: D
Conceptual Explanation: In Type I neutral mechanics, the segment sidebends first, and
rotation occurs to the opposite side. If it is neutral, sidebent right, it must be rotated left.
3. During a cranial exam, the sphenobasilar synchondrosis (SBS) is found to move superiorly,
the paired bones undergo external rotation, and the midline bones undergo flexion. Which
phase of the cranial rhythmic impulse (CRI) is this?
A. Extension phase
B. Inhalation phase
C. Flexion phase
D. Exhalation phase
Answer: C
Conceptual Explanation: The flexion phase of the CRI involves the SBS moving superiorly,
external rotation of paired bones, and narrowing/lengthening of the cranium.
4. A 30-year-old female presents with epigastric pain. You find a tender point on the right
side of the 5th intercostal space. Which organ is this Chapman point associated with?
A. Gallbladder
, B. Stomach (Acidity)
C. Liver
D. Pancreas
Answer: C
Conceptual Explanation: The anterior Chapman point for the liver is located in the right
5th intercostal space.
5. A positive seated flexion test on the left, a deep sacral sulcus on the right, and a posterior
inferior lateral angle (ILA) on the left suggests which diagnosis?
A. Left on Left forward torsion
B. Right on Left backward torsion
C. Right on Right forward torsion
D. Left on Right backward torsion
Answer: D
Conceptual Explanation: A positive seated flexion test on the left indicates the
dysfunction is on the left side of the sacrum. A deep sulcus on the right and posterior ILA on
the left with a left seated flexion test points to a backward torsion (L on R).
6. A patient presents with pain at the tip of the 12th rib on the right side. This Chapman point
is most indicative of which condition?
A. Cystitis
