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COMLEX-USA Level 1 Prep | COMSAE
Phase 1 Form 113 Direct Content Practice
Exam 200+ Questions with Bold Italic
Answers & Rationales for Osteopathic
Medical Students | pdf
Q1. A 32-year-old with chronic low back pain has a somatic
dysfunction diagnosed as a rotated innominate on the left. You
perform a muscle energy technique that engages the left gluteus
maximus and hamstrings. Which phase of muscle energy is the
activating force applied?
A) Initial resting phase
B) Phase I: agonist contraction against counterforce
C) Phase II: post-isometric relaxation
D) Phase III: repositioning to barrier
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Answer: B) Phase I: agonist contraction against counterforce
Rationale: Muscle energy technique uses an isometric
contraction of the patient’s muscle against a precise counterforce
from the physician (Phase I). This is followed by relaxation (Phase
II) and then movement to a new barrier (Phase III).
Q2. A 45-year-old with acute torticollis has a posterior tender
point at the tip of the transverse process of C2 on the right.
Chapman’s reflex points for which organ system may refer to this
location?
A) Kidney
B) Gallbladder
C) Stomach
D) Lung
Answer: B) Gallbladder
Rationale: Chapman’s reflexes are viscerosomatic reflexes. The
gallbladder reflex is classically located at the tip of the
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transverse process of C2 (posterior) and the intercostal space
between the 5th and 6th ribs anteriorly.
Q3. During an osteopathic structural exam, you ask the patient to
stand with feet together and arms at the sides, then close their
eyes. The patient sways significantly and begins to fall to the
left. This suggests dysfunction primarily involving which system?
A) Vestibular
B) Cerebellar
C) Proprioceptive
D) Parietal lobe
Answer: C) Proprioceptive
Rationale: Romberg test (swaying/falling with eyes closed)
indicates loss of proprioceptive input (dorsal columns). Opening
eyes corrects the sway because visual input compensates.
Q4. A 25-year-old has a diagnosis of asthma and on exam you
find a tender point at the 2nd intercostal space, midclavicular
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line on the right anterior chest. This Chapman’s reflex is most
likely associated with:
A) Gallbladder
B) Liver
C) Lung
D) Stomach
Answer: C) Lung
Rationale: The anterior Chapman’s reflex for the lungs is at the
2nd intercostal space, midclavicular line, and the posterior
reflex is between the 3rd and 4th thoracic vertebrae.
Viscerosomatic reflexes can be palpable in asthma.
Q5. A patient with chronic low back pain has a pelvic somatic
dysfunction. You diagnose a left innominate anterior rotation.
Which muscle energy treatment is most appropriate?
A) Patient is supine, left knee flexed, patient extends left hip
against resistance
COMLEX-USA Level 1 Prep | COMSAE
Phase 1 Form 113 Direct Content Practice
Exam 200+ Questions with Bold Italic
Answers & Rationales for Osteopathic
Medical Students | pdf
Q1. A 32-year-old with chronic low back pain has a somatic
dysfunction diagnosed as a rotated innominate on the left. You
perform a muscle energy technique that engages the left gluteus
maximus and hamstrings. Which phase of muscle energy is the
activating force applied?
A) Initial resting phase
B) Phase I: agonist contraction against counterforce
C) Phase II: post-isometric relaxation
D) Phase III: repositioning to barrier
,Page 2 of 148
Answer: B) Phase I: agonist contraction against counterforce
Rationale: Muscle energy technique uses an isometric
contraction of the patient’s muscle against a precise counterforce
from the physician (Phase I). This is followed by relaxation (Phase
II) and then movement to a new barrier (Phase III).
Q2. A 45-year-old with acute torticollis has a posterior tender
point at the tip of the transverse process of C2 on the right.
Chapman’s reflex points for which organ system may refer to this
location?
A) Kidney
B) Gallbladder
C) Stomach
D) Lung
Answer: B) Gallbladder
Rationale: Chapman’s reflexes are viscerosomatic reflexes. The
gallbladder reflex is classically located at the tip of the
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transverse process of C2 (posterior) and the intercostal space
between the 5th and 6th ribs anteriorly.
Q3. During an osteopathic structural exam, you ask the patient to
stand with feet together and arms at the sides, then close their
eyes. The patient sways significantly and begins to fall to the
left. This suggests dysfunction primarily involving which system?
A) Vestibular
B) Cerebellar
C) Proprioceptive
D) Parietal lobe
Answer: C) Proprioceptive
Rationale: Romberg test (swaying/falling with eyes closed)
indicates loss of proprioceptive input (dorsal columns). Opening
eyes corrects the sway because visual input compensates.
Q4. A 25-year-old has a diagnosis of asthma and on exam you
find a tender point at the 2nd intercostal space, midclavicular
, Page 4 of 148
line on the right anterior chest. This Chapman’s reflex is most
likely associated with:
A) Gallbladder
B) Liver
C) Lung
D) Stomach
Answer: C) Lung
Rationale: The anterior Chapman’s reflex for the lungs is at the
2nd intercostal space, midclavicular line, and the posterior
reflex is between the 3rd and 4th thoracic vertebrae.
Viscerosomatic reflexes can be palpable in asthma.
Q5. A patient with chronic low back pain has a pelvic somatic
dysfunction. You diagnose a left innominate anterior rotation.
Which muscle energy treatment is most appropriate?
A) Patient is supine, left knee flexed, patient extends left hip
against resistance
