COMSAE PHASE 1 FORM 113 PRACTICE EXAM QUESTIONS
COMPTETE WITH VERIFIED ANSWERS
Table of Contents
Section Domain Approx. Page
Questions Reference
I Osteopathic Principles & Practice 24 Section I
(OPP/OMT)
II Foundational Biomedical Sciences – 18 Section II
Anatomy & Embryology
III Foundational Biomedical Sciences – 18 Section III
Physiology
IV Foundational Biomedical Sciences – 16 Section IV
Biochemistry & Molecular Biology
V Foundational Biomedical Sciences – 16 Section V
Microbiology & Immunology
VI Foundational Biomedical Sciences – 18 Section VI
Pathology
VII Foundational Biomedical Sciences – 16 Section VII
Pharmacology
VIII Behavioral Science, Biostatistics & 10 Section VIII
Ethics
IX Public Health & Epidemiology 8 Section IX
X Clinical Systems & Multisystem 56 Section X
Integration
,Section I: Osteopathic Principles & Practice (OPP/OMT)
Question 1
A 45-year-old male presents with chronic low back pain. On osteopathic
structural examination, the physician notes that the right innominate
rotates anteriorly on a left oblique axis. Which of the following best
describes this somatic dysfunction?
A. Left on Right Forward Torsion
B. Right on Left Forward Torsion
C. Left on Right Backward Torsion
D. Right on Left Backward Torsion
Correct Answer: B
Rationale: A forward torsion of the innominate occurs when the bone
rotates anteriorly. The naming convention places the side of the
anterior rotation first, followed by the side of the oblique axis. Here, the
right innominate is anterior on a left oblique axis, making this a Right on
Left Forward Torsion.
Question 2
During a cranial examination, the physician palpates the sphenobasilar
synchondrosis (SBS) and notes that it moves superiorly during the
inhalation phase of primary respiration. The paired bones of the
cranium are externally rotating. Which cranial motion phase is this?
A. Extension
B. Torsion
,C. Flexion
D. Sidebending/Rotation
Correct Answer: C
Rationale: During the inhalation phase of the primary respiratory
mechanism, the SBS rises superiorly and the midline bones flex. This
flexion motion causes the paired bones of the cranium to externally
rotate. Extension is the opposite motion, occurring during exhalation.
Question 3
A 32-year-old female presents with acute onset of mid-thoracic pain
following a fall. Structural examination reveals a group curve of the
thoracic spine with sidebending and rotation to the same side, and the
vertebrae are rotated toward the convexity. Which Fryette principle is
being demonstrated?
A. Type I mechanics
B. Type II mechanics
C. Type III mechanics
D. Type IV mechanics
Correct Answer: A
Rationale: Fryette's Type I mechanics describe a group curve of two or
more vertebrae in which sidebending and rotation occur to opposite
sides (rotation toward the convexity). This is a physiologic, neutral
dysfunction that typically occurs in the thoracic and lumbar spine.
, Question 4
A patient presents with a sacral dysfunction. On examination, the right
sulcus is deeper than the left, and the right inferior lateral angle (ILA) is
more posterior than the left. The spring test is negative. What is the
most likely diagnosis?
A. Right on Left Torsion
B. Left on Right Torsion
C. Bilateral Sacral Flexion
D. Bilateral Sacral Extension
Correct Answer: B
Rationale: A negative spring test indicates a physiologic (forward) sacral
torsion. In a Left on Right torsion, the sacrum rotates left on a right
oblique axis. This causes the right sacral base to move anteriorly and
the right ILA to become posterior and inferior, resulting in a deeper
right sulcus and a prominent right ILA.
Question 5
A 55-year-old male with a history of gallstones presents with right
upper quadrant pain and associated somatic dysfunction. At which
spinal levels would you most likely expect to find viscerosomatic reflex
changes?
A. T1-T4
B. T5-T9
C. T10-T12
D. L1-L2
Correct Answer: B
COMPTETE WITH VERIFIED ANSWERS
Table of Contents
Section Domain Approx. Page
Questions Reference
I Osteopathic Principles & Practice 24 Section I
(OPP/OMT)
II Foundational Biomedical Sciences – 18 Section II
Anatomy & Embryology
III Foundational Biomedical Sciences – 18 Section III
Physiology
IV Foundational Biomedical Sciences – 16 Section IV
Biochemistry & Molecular Biology
V Foundational Biomedical Sciences – 16 Section V
Microbiology & Immunology
VI Foundational Biomedical Sciences – 18 Section VI
Pathology
VII Foundational Biomedical Sciences – 16 Section VII
Pharmacology
VIII Behavioral Science, Biostatistics & 10 Section VIII
Ethics
IX Public Health & Epidemiology 8 Section IX
X Clinical Systems & Multisystem 56 Section X
Integration
,Section I: Osteopathic Principles & Practice (OPP/OMT)
Question 1
A 45-year-old male presents with chronic low back pain. On osteopathic
structural examination, the physician notes that the right innominate
rotates anteriorly on a left oblique axis. Which of the following best
describes this somatic dysfunction?
A. Left on Right Forward Torsion
B. Right on Left Forward Torsion
C. Left on Right Backward Torsion
D. Right on Left Backward Torsion
Correct Answer: B
Rationale: A forward torsion of the innominate occurs when the bone
rotates anteriorly. The naming convention places the side of the
anterior rotation first, followed by the side of the oblique axis. Here, the
right innominate is anterior on a left oblique axis, making this a Right on
Left Forward Torsion.
Question 2
During a cranial examination, the physician palpates the sphenobasilar
synchondrosis (SBS) and notes that it moves superiorly during the
inhalation phase of primary respiration. The paired bones of the
cranium are externally rotating. Which cranial motion phase is this?
A. Extension
B. Torsion
,C. Flexion
D. Sidebending/Rotation
Correct Answer: C
Rationale: During the inhalation phase of the primary respiratory
mechanism, the SBS rises superiorly and the midline bones flex. This
flexion motion causes the paired bones of the cranium to externally
rotate. Extension is the opposite motion, occurring during exhalation.
Question 3
A 32-year-old female presents with acute onset of mid-thoracic pain
following a fall. Structural examination reveals a group curve of the
thoracic spine with sidebending and rotation to the same side, and the
vertebrae are rotated toward the convexity. Which Fryette principle is
being demonstrated?
A. Type I mechanics
B. Type II mechanics
C. Type III mechanics
D. Type IV mechanics
Correct Answer: A
Rationale: Fryette's Type I mechanics describe a group curve of two or
more vertebrae in which sidebending and rotation occur to opposite
sides (rotation toward the convexity). This is a physiologic, neutral
dysfunction that typically occurs in the thoracic and lumbar spine.
, Question 4
A patient presents with a sacral dysfunction. On examination, the right
sulcus is deeper than the left, and the right inferior lateral angle (ILA) is
more posterior than the left. The spring test is negative. What is the
most likely diagnosis?
A. Right on Left Torsion
B. Left on Right Torsion
C. Bilateral Sacral Flexion
D. Bilateral Sacral Extension
Correct Answer: B
Rationale: A negative spring test indicates a physiologic (forward) sacral
torsion. In a Left on Right torsion, the sacrum rotates left on a right
oblique axis. This causes the right sacral base to move anteriorly and
the right ILA to become posterior and inferior, resulting in a deeper
right sulcus and a prominent right ILA.
Question 5
A 55-year-old male with a history of gallstones presents with right
upper quadrant pain and associated somatic dysfunction. At which
spinal levels would you most likely expect to find viscerosomatic reflex
changes?
A. T1-T4
B. T5-T9
C. T10-T12
D. L1-L2
Correct Answer: B
