COMSAE FORM 116 PRACTICE EXAM
QUESTIONS AND VERIFIED ANSWERS
1. A 24-year-old male presents with thoracic pain. Physical examination reveals that T5 is
rotated right and sidebent right, and the findings improve with spinal flexion. Which of the
following is the most likely diagnosis?
A. T5 Neutral, Sidebent Right, Rotated Left
B. T5 Extended, Rotated Right, Sidebent Right
C. T5 Extended, Rotated Left, Sidebent Left
D. T5 Flexed, Rotated Right, Sidebent Right
Answer: D
Conceptual Explanation: The diagnosis is T5 Flexed, Rotated Right, Sidebent Right (F
RRSR). According to Fryette’s Law II, which applies to single vertebral segments in flexion
or extension, rotation and sidebending occur to the same side. Since the position improves
in flexion, the segment is flexed.
2. A 45-year-old female with a history of chronic constipation presents for an osteopathic
evaluation. Which of the following Chapman points is most likely to be found on physical
examination?
A. 2nd intercostal space near the sternum
,B. Medial aspect of the IT band
C. Lateral aspect of the IT band
D. Tip of the 12th rib
Answer: C
Conceptual Explanation: The Chapman point for the colon (specifically the descending
colon) is located on the lateral aspect of the IT band. The medial IT band corresponds to the
ileum.
3. A 65-year-old male is diagnosed with a sacral torsion. Examination reveals a negative
seated flexion test on the right, a deep right sacral sulcus, and a posterior left inferior lateral
angle. Which of the following L5 findings is most likely present?
A. L5 Rotated Left, Sidebent Left
B. L5 Rotated Left, Sidebent Right
C. L5 Rotated Right, Sidebent Left
D. L5 Rotated Right, Sidebent Right
Answer: B
Conceptual Explanation: The sacral diagnosis is a Left-on-Left forward torsion (Right
deep sulcus, Left posterior ILA, negative seated flexion on the side of the axis). In a forward
torsion, L5 follows Fryette’s Type I mechanics: neutral, sidebent to the side of the axis
, (left), and rotated opposite (right). Actually, for a L-on-L torsion, the axis is Left. L5
sidebends to the side of the axis (Left) and rotates opposite (Right). Therefore, L5 N SL RR.
4. During an evaluation of a newborn, the physician notes that the sphenobasilar
synchondrosis (SBS) moves superiorly during the inhalation phase of the primary respiratory
mechanism. What is this motion called?
A. Extension
B. Torsion
C. Flexion
D. Sidebending-Rotation
Answer: C
Conceptual Explanation: During the inhalation phase of the PRM, the SBS rises (moves
superiorly) and the paired bones externally rotate. This is defined as cranial flexion.
5. A 52-year-old male with hypertension presents with a persistent cough after starting a new
medication. Which of the following is the mechanism of action of this drug?
A. Inhibition of Angiotensin-converting enzyme
B. Inhibition of the Na-K-Cl symporter
C. Blockade of AT1 receptors
D. Antagonism of L-type calcium channels
Answer: A
QUESTIONS AND VERIFIED ANSWERS
1. A 24-year-old male presents with thoracic pain. Physical examination reveals that T5 is
rotated right and sidebent right, and the findings improve with spinal flexion. Which of the
following is the most likely diagnosis?
A. T5 Neutral, Sidebent Right, Rotated Left
B. T5 Extended, Rotated Right, Sidebent Right
C. T5 Extended, Rotated Left, Sidebent Left
D. T5 Flexed, Rotated Right, Sidebent Right
Answer: D
Conceptual Explanation: The diagnosis is T5 Flexed, Rotated Right, Sidebent Right (F
RRSR). According to Fryette’s Law II, which applies to single vertebral segments in flexion
or extension, rotation and sidebending occur to the same side. Since the position improves
in flexion, the segment is flexed.
2. A 45-year-old female with a history of chronic constipation presents for an osteopathic
evaluation. Which of the following Chapman points is most likely to be found on physical
examination?
A. 2nd intercostal space near the sternum
,B. Medial aspect of the IT band
C. Lateral aspect of the IT band
D. Tip of the 12th rib
Answer: C
Conceptual Explanation: The Chapman point for the colon (specifically the descending
colon) is located on the lateral aspect of the IT band. The medial IT band corresponds to the
ileum.
3. A 65-year-old male is diagnosed with a sacral torsion. Examination reveals a negative
seated flexion test on the right, a deep right sacral sulcus, and a posterior left inferior lateral
angle. Which of the following L5 findings is most likely present?
A. L5 Rotated Left, Sidebent Left
B. L5 Rotated Left, Sidebent Right
C. L5 Rotated Right, Sidebent Left
D. L5 Rotated Right, Sidebent Right
Answer: B
Conceptual Explanation: The sacral diagnosis is a Left-on-Left forward torsion (Right
deep sulcus, Left posterior ILA, negative seated flexion on the side of the axis). In a forward
torsion, L5 follows Fryette’s Type I mechanics: neutral, sidebent to the side of the axis
, (left), and rotated opposite (right). Actually, for a L-on-L torsion, the axis is Left. L5
sidebends to the side of the axis (Left) and rotates opposite (Right). Therefore, L5 N SL RR.
4. During an evaluation of a newborn, the physician notes that the sphenobasilar
synchondrosis (SBS) moves superiorly during the inhalation phase of the primary respiratory
mechanism. What is this motion called?
A. Extension
B. Torsion
C. Flexion
D. Sidebending-Rotation
Answer: C
Conceptual Explanation: During the inhalation phase of the PRM, the SBS rises (moves
superiorly) and the paired bones externally rotate. This is defined as cranial flexion.
5. A 52-year-old male with hypertension presents with a persistent cough after starting a new
medication. Which of the following is the mechanism of action of this drug?
A. Inhibition of Angiotensin-converting enzyme
B. Inhibition of the Na-K-Cl symporter
C. Blockade of AT1 receptors
D. Antagonism of L-type calcium channels
Answer: A
