UP-TO-DATE 2026
COMSAE Phase 1 Form 115 Style
EXAM QUESTIONS AND 100% ACCURATE
SOLUTIONS | Question And VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE
(OPP/OMT)
Question 1
A 35-year-old 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: A posterior innominate rotation is a shear of the ilium in which the ilium moves
posteriorly on the sacrum. In this dysfunction, the ipsilateral hamstrings are shortened,
whereas the iliopsoas is typically shortened in an anterior innominate .
Question 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 of the following 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 when a single segment is in a non-neutral position (flexion or
extension). Type I (neutral) mechanics involve rotation and sidebending to opposite sides .
Question 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 lung reflex points are
located in the 2nd and 3rd intercostal spaces, right and left parasternal regions .
Question 4
A patient with right lateral bending of the lumbar spine with rotation to the left.
According to Fryette, this is a:
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Neutral dysfunction
Correct Answer: A) Type I dysfunction
, Rationale: In Fryette's Type I (neutral) mechanics, sidebending and rotation occur to
opposite sides. Right lateral bending with left rotation is the classic Type I pattern, typically
occurring in group curves involving multiple vertebral segments .
Question 5
A 50-year-old 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: Viscerosomatic reflexes for the colon are located at T10–L1, often presenting as
tenderness at the 11th or 12th ribs. Chronic constipation suggests colonic dysfunction .
Question 6
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 muscle has a tender point located at the anterior medial knee. The
treatment position for the sartorius using counterstrain involves flexion, abduction, and
external rotation of the hip .
COMSAE Phase 1 Form 115 Style
EXAM QUESTIONS AND 100% ACCURATE
SOLUTIONS | Question And VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE
(OPP/OMT)
Question 1
A 35-year-old 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: A posterior innominate rotation is a shear of the ilium in which the ilium moves
posteriorly on the sacrum. In this dysfunction, the ipsilateral hamstrings are shortened,
whereas the iliopsoas is typically shortened in an anterior innominate .
Question 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 of the following 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 when a single segment is in a non-neutral position (flexion or
extension). Type I (neutral) mechanics involve rotation and sidebending to opposite sides .
Question 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 lung reflex points are
located in the 2nd and 3rd intercostal spaces, right and left parasternal regions .
Question 4
A patient with right lateral bending of the lumbar spine with rotation to the left.
According to Fryette, this is a:
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Neutral dysfunction
Correct Answer: A) Type I dysfunction
, Rationale: In Fryette's Type I (neutral) mechanics, sidebending and rotation occur to
opposite sides. Right lateral bending with left rotation is the classic Type I pattern, typically
occurring in group curves involving multiple vertebral segments .
Question 5
A 50-year-old 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: Viscerosomatic reflexes for the colon are located at T10–L1, often presenting as
tenderness at the 11th or 12th ribs. Chronic constipation suggests colonic dysfunction .
Question 6
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 muscle has a tender point located at the anterior medial knee. The
treatment position for the sartorius using counterstrain involves flexion, abduction, and
external rotation of the hip .
