COMSAE Phase 1 Comprehensive Practice
Exam: High-Yield Questions with Answers &
Rationales
Section 1: Osteopathic Principles & Practice (Questions 1-15)
,Question 1
A patient presents with a structural exam revealing a restricted T5 segment. The segment prefers
rotation to the right and side-bending to the right. It improves when the patient slumps forward into
spinal flexion. What is the correct diagnosis?
A) T5 Neutral SR RL
B) T5 Extended RR SR
C) T5 Flexed RR SR
D) T5 Flexed RL SL
Answer: C) T5 Flexed RR SR
Rationale: Because the dysfunction improves in flexion, the segment is diagnosed as Flexed.
According to Fryette's Second Law (Type II mechanics), when a single segment is in a non-neutral
position (flexion or extension), rotation and side-bending occur in the same direction. Hence,
rotation right and side-bending right yields "Flexed RR SR" .
,Question 2
According to Fryette's first principle (Type I mechanics), when the spine is in a neutral position
(neither flexed nor extended), which of the following occurs?
A) Side-bending and rotation occur to the same side
B) Side-bending occurs without rotation
C) Side-bending and rotation occur to opposite sides
D) Rotation occurs without side-bending
Answer: C) Side-bending and rotation occur to opposite sides
Rationale: Fryette's first principle describes that when multiple vertebral segments are in neutral
position, side-bending and rotation occur in opposite directions. This is a Type I mechanics pattern
.
, Question 3
In Muscle Energy Technique (MET), the patient's contraction force should be:
A) Maximal contraction against a fixed barrier
B) Submaximal (approximately 20% of maximal) isometric contraction
C) Eccentric contraction only
D) Isotonic contraction through full range
Answer: B) Submaximal (approximately 20% of maximal) isometric contraction
Rationale: MET uses a gentle (submaximal, ~20% effort), isometric contraction by the patient,
followed by relaxation and repositioning to the new barrier. This avoids muscle fatigue and injury .
Exam: High-Yield Questions with Answers &
Rationales
Section 1: Osteopathic Principles & Practice (Questions 1-15)
,Question 1
A patient presents with a structural exam revealing a restricted T5 segment. The segment prefers
rotation to the right and side-bending to the right. It improves when the patient slumps forward into
spinal flexion. What is the correct diagnosis?
A) T5 Neutral SR RL
B) T5 Extended RR SR
C) T5 Flexed RR SR
D) T5 Flexed RL SL
Answer: C) T5 Flexed RR SR
Rationale: Because the dysfunction improves in flexion, the segment is diagnosed as Flexed.
According to Fryette's Second Law (Type II mechanics), when a single segment is in a non-neutral
position (flexion or extension), rotation and side-bending occur in the same direction. Hence,
rotation right and side-bending right yields "Flexed RR SR" .
,Question 2
According to Fryette's first principle (Type I mechanics), when the spine is in a neutral position
(neither flexed nor extended), which of the following occurs?
A) Side-bending and rotation occur to the same side
B) Side-bending occurs without rotation
C) Side-bending and rotation occur to opposite sides
D) Rotation occurs without side-bending
Answer: C) Side-bending and rotation occur to opposite sides
Rationale: Fryette's first principle describes that when multiple vertebral segments are in neutral
position, side-bending and rotation occur in opposite directions. This is a Type I mechanics pattern
.
, Question 3
In Muscle Energy Technique (MET), the patient's contraction force should be:
A) Maximal contraction against a fixed barrier
B) Submaximal (approximately 20% of maximal) isometric contraction
C) Eccentric contraction only
D) Isotonic contraction through full range
Answer: B) Submaximal (approximately 20% of maximal) isometric contraction
Rationale: MET uses a gentle (submaximal, ~20% effort), isometric contraction by the patient,
followed by relaxation and repositioning to the new barrier. This avoids muscle fatigue and injury .
