COMSAE Phase 1 Form 115 Practice Exam-200 Practice
Questions with Verified Answers and Rationales | 2026/2027
Edition
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT)
1. A 35yearold with chronic low back pain has a right posterior innominate rotation. Which muscle is
likely shortened?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Correct Answer: B) Right hamstrings
Rationale: Posterior innominate rotation occurs when the ilium moves posteriorly; the ipsilateral
hamstring is shortened. For anterior innominate rotation, the iliopsoas would be the shortened muscle.
2. During an osteopathic structural exam, you find a T4 spinous process deviated left, with right rotation
restriction. Fryette's Type II mechanics apply. Which is true?
A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply
C) Rotation and sidebending occur to same side
D) Only rotation is restricted
,Correct Answer: C) Rotation and sidebending occur to same side
Rationale: Fryette's Type II (nonneutral) mechanics dictate that rotation and sidebending occur to the
same side. Type I (neutral) mechanics involve rotation and sidebending to opposite sides.
3. A patient with asthma has tenderness at the 2nd intercostal space, right parasternal region. This is a
Chapman's reflex for which organ?
A) Kidney
B) Lung
C) Liver
D) Spleen
Correct Answer: B) Lung
Rationale: Chapman's reflexes are viscerosomatic reflex points. The 2nd intercostal space, right
parasternal region corresponds to lung reflexes.
4. A patient with chronic constipation has a tender point at the tip of the 12th rib on the right. Which
viscerosomatic reflex is most likely?
A) Colon
B) Stomach
C) Gallbladder
D) Appendix
,Correct Answer: A) Colon
Rationale: Colon reflexes correspond to T10L1 spinal levels and often present as tenderness at the 11th
or 12th ribs.
5. In counterstrain, you find a tender point at the anterior medial knee. Which muscle is likely the
primary dysfunction?
A) Vastus lateralis
B) Sartorius
C) Rectus femoris
D) Gracilis
Correct Answer: B) Sartorius
Rationale: The Sartorius tender point is located at the anterior medial knee. The treatment position
involves flexion, abduction, and external rotation of the hip.
6. A patient has a right forward sacral torsion. Which of the following is correct regarding the L5
rotation?
A) L5 rotates right
B) L5 rotates left
C) L5 is neutral
D) L5 rotates posterior
, Correct Answer: A) L5 rotates right
Rationale: In forward sacral torsion, L5 rotates to the same side as the oblique axis.
7. During a cranial exam, you feel a "wax paper" crunching sensation. This indicates:
A) Normal flexion phase
B) Restricted occiput
C) Cranial rhythm abnormality
D) Sphenobasilar synchondrosis dysfunction
Correct Answer: A) Normal flexion phase
Rationale: The "wax paper" crunching sensation is characteristic of the normal flexion phase during
cranial examination.
8. Which muscle energy technique (MET) is used for a right anterior innominate?
A) Patient contracts right hamstrings against resistance
B) Patient contracts right hip flexors against resistance
C) Patient contracts left gluteus maximus
D) Patient relaxes completely
Correct Answer: B) Patient contracts right hip flexors against resistance
Questions with Verified Answers and Rationales | 2026/2027
Edition
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT)
1. A 35yearold with chronic low back pain has a right posterior innominate rotation. Which muscle is
likely shortened?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Correct Answer: B) Right hamstrings
Rationale: Posterior innominate rotation occurs when the ilium moves posteriorly; the ipsilateral
hamstring is shortened. For anterior innominate rotation, the iliopsoas would be the shortened muscle.
2. During an osteopathic structural exam, you find a T4 spinous process deviated left, with right rotation
restriction. Fryette's Type II mechanics apply. Which is true?
A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply
C) Rotation and sidebending occur to same side
D) Only rotation is restricted
,Correct Answer: C) Rotation and sidebending occur to same side
Rationale: Fryette's Type II (nonneutral) mechanics dictate that rotation and sidebending occur to the
same side. Type I (neutral) mechanics involve rotation and sidebending to opposite sides.
3. A patient with asthma has tenderness at the 2nd intercostal space, right parasternal region. This is a
Chapman's reflex for which organ?
A) Kidney
B) Lung
C) Liver
D) Spleen
Correct Answer: B) Lung
Rationale: Chapman's reflexes are viscerosomatic reflex points. The 2nd intercostal space, right
parasternal region corresponds to lung reflexes.
4. A patient with chronic constipation has a tender point at the tip of the 12th rib on the right. Which
viscerosomatic reflex is most likely?
A) Colon
B) Stomach
C) Gallbladder
D) Appendix
,Correct Answer: A) Colon
Rationale: Colon reflexes correspond to T10L1 spinal levels and often present as tenderness at the 11th
or 12th ribs.
5. In counterstrain, you find a tender point at the anterior medial knee. Which muscle is likely the
primary dysfunction?
A) Vastus lateralis
B) Sartorius
C) Rectus femoris
D) Gracilis
Correct Answer: B) Sartorius
Rationale: The Sartorius tender point is located at the anterior medial knee. The treatment position
involves flexion, abduction, and external rotation of the hip.
6. A patient has a right forward sacral torsion. Which of the following is correct regarding the L5
rotation?
A) L5 rotates right
B) L5 rotates left
C) L5 is neutral
D) L5 rotates posterior
, Correct Answer: A) L5 rotates right
Rationale: In forward sacral torsion, L5 rotates to the same side as the oblique axis.
7. During a cranial exam, you feel a "wax paper" crunching sensation. This indicates:
A) Normal flexion phase
B) Restricted occiput
C) Cranial rhythm abnormality
D) Sphenobasilar synchondrosis dysfunction
Correct Answer: A) Normal flexion phase
Rationale: The "wax paper" crunching sensation is characteristic of the normal flexion phase during
cranial examination.
8. Which muscle energy technique (MET) is used for a right anterior innominate?
A) Patient contracts right hamstrings against resistance
B) Patient contracts right hip flexors against resistance
C) Patient contracts left gluteus maximus
D) Patient relaxes completely
Correct Answer: B) Patient contracts right hip flexors against resistance
