COMSAE PHASE 1 FORM 113
OSTEOPATHIC PRINCIPLES & OMM
PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
A 42-year-old patient presents with chronic thoracic discomfort.
Structural examination reveals tissue texture abnormalities,
asymmetry, restricted motion, and tenderness involving several
thoracic segments. Which osteopathic concept best describes
these findings?
A. Chapman reflexes
B. TART criteria
C. Fryette's first law
D. Viscerosomatic facilitation
Correct Answer: B. TART criteria
Rationale: TART represents Tissue texture abnormality,
Asymmetry, Restriction of motion, and Tenderness. These findings
are used to identify somatic dysfunction during the osteopathic
structural examination.
,Question 2
Which statement best represents the osteopathic principle that
structure and function are reciprocally interrelated?
A. Structural abnormalities never influence physiologic function.
B. Physiologic dysfunction can occur independently of anatomic
changes.
C. Changes in structure can affect function, and altered function
can affect structure.
D. Structural treatment should always precede medical
treatment.
Correct Answer: C. Changes in structure can affect function,
and altered function can affect structure.
Rationale: Osteopathic philosophy recognizes a reciprocal
relationship between structure and function. Dysfunction in
musculoskeletal structures can influence physiologic processes,
while altered physiologic function can produce structural
adaptations.
Question 3
A patient has a thoracic somatic dysfunction in which the
vertebrae are neutral, rotated left, and side-bent right. Which
Fryette principle describes this pattern?
A. First principle
B. Second principle
C. Third principle
D. Fifth principle
,Correct Answer: A. First principle
Rationale: Fryette's first principle describes group dysfunctions
occurring when the spine is in a neutral position. Rotation and
side-bending occur in opposite directions.
Question 4
A single thoracic vertebra is restricted in extension and
demonstrates rotation and side-bending to the same side. Which
Fryette principle is most applicable?
A. First principle
B. Second principle
C. Third principle
D. Fourth principle
Correct Answer: B. Second principle
Rationale: Fryette's second principle describes nonneutral
mechanics involving a single vertebral segment. In flexion or
extension, rotation and side-bending occur to the same side.
Question 5
A patient has an extended, rotated right, side-bent right thoracic
dysfunction. Which position would generally improve the
dysfunction?
A. Extension
B. Flexion
C. Rotation left only
D. Side-bending left only
, Correct Answer: B. Flexion
Rationale: An extended dysfunction is typically identified because
the segment prefers extension and is restricted in flexion. Bringing
the segment into flexion moves it away from its dysfunctional
position and toward its restrictive barrier.
Question 6
Which finding most strongly distinguishes a type II thoracic
dysfunction from a type I dysfunction?
A. Multiple vertebrae are involved.
B. Rotation and side-bending occur in opposite directions.
C. The dysfunction occurs in a neutral position.
D. Rotation and side-bending occur in the same direction.
Correct Answer: D. Rotation and side-bending occur in the
same direction.
Rationale: Type II mechanics involve a nonneutral segment, such
as flexion or extension, with rotation and side-bending occurring
in the same direction. Type I group mechanics involve opposite
directions of rotation and side-bending.
Question 7
A patient with chronic abdominal pathology develops increased
tissue texture changes and tenderness over the corresponding
spinal segments. What type of reflex is most likely responsible?
A. Somatosomatic reflex
B. Viscerosomatic reflex
OSTEOPATHIC PRINCIPLES & OMM
PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
A 42-year-old patient presents with chronic thoracic discomfort.
Structural examination reveals tissue texture abnormalities,
asymmetry, restricted motion, and tenderness involving several
thoracic segments. Which osteopathic concept best describes
these findings?
A. Chapman reflexes
B. TART criteria
C. Fryette's first law
D. Viscerosomatic facilitation
Correct Answer: B. TART criteria
Rationale: TART represents Tissue texture abnormality,
Asymmetry, Restriction of motion, and Tenderness. These findings
are used to identify somatic dysfunction during the osteopathic
structural examination.
,Question 2
Which statement best represents the osteopathic principle that
structure and function are reciprocally interrelated?
A. Structural abnormalities never influence physiologic function.
B. Physiologic dysfunction can occur independently of anatomic
changes.
C. Changes in structure can affect function, and altered function
can affect structure.
D. Structural treatment should always precede medical
treatment.
Correct Answer: C. Changes in structure can affect function,
and altered function can affect structure.
Rationale: Osteopathic philosophy recognizes a reciprocal
relationship between structure and function. Dysfunction in
musculoskeletal structures can influence physiologic processes,
while altered physiologic function can produce structural
adaptations.
Question 3
A patient has a thoracic somatic dysfunction in which the
vertebrae are neutral, rotated left, and side-bent right. Which
Fryette principle describes this pattern?
A. First principle
B. Second principle
C. Third principle
D. Fifth principle
,Correct Answer: A. First principle
Rationale: Fryette's first principle describes group dysfunctions
occurring when the spine is in a neutral position. Rotation and
side-bending occur in opposite directions.
Question 4
A single thoracic vertebra is restricted in extension and
demonstrates rotation and side-bending to the same side. Which
Fryette principle is most applicable?
A. First principle
B. Second principle
C. Third principle
D. Fourth principle
Correct Answer: B. Second principle
Rationale: Fryette's second principle describes nonneutral
mechanics involving a single vertebral segment. In flexion or
extension, rotation and side-bending occur to the same side.
Question 5
A patient has an extended, rotated right, side-bent right thoracic
dysfunction. Which position would generally improve the
dysfunction?
A. Extension
B. Flexion
C. Rotation left only
D. Side-bending left only
, Correct Answer: B. Flexion
Rationale: An extended dysfunction is typically identified because
the segment prefers extension and is restricted in flexion. Bringing
the segment into flexion moves it away from its dysfunctional
position and toward its restrictive barrier.
Question 6
Which finding most strongly distinguishes a type II thoracic
dysfunction from a type I dysfunction?
A. Multiple vertebrae are involved.
B. Rotation and side-bending occur in opposite directions.
C. The dysfunction occurs in a neutral position.
D. Rotation and side-bending occur in the same direction.
Correct Answer: D. Rotation and side-bending occur in the
same direction.
Rationale: Type II mechanics involve a nonneutral segment, such
as flexion or extension, with rotation and side-bending occurring
in the same direction. Type I group mechanics involve opposite
directions of rotation and side-bending.
Question 7
A patient with chronic abdominal pathology develops increased
tissue texture changes and tenderness over the corresponding
spinal segments. What type of reflex is most likely responsible?
A. Somatosomatic reflex
B. Viscerosomatic reflex
