COMSAE Phase 1 Form 116 Comprehensive
Practice Exam: Questions with Answers &
Clinical Rationales
,SECTION 1: OSTEOPATHIC PRINCIPLES & OMM (Questions 1-15)
Question 1
A 45-year-old female presents with chronic low back pain. On examination, you find that the L5
vertebra is restricted in flexion, rotates more easily to the left, and sidebends more easily to the
left. According to Fryette's principles, how should this dysfunction be documented?
A) L5 Flexed RR SR
B) L5 Flexed LR SL
C) L5 Extended RR SR
D) L5 Neutral LR SR
Answer: B) L5 Flexed LR SL
Rationale: Fryette's Type II (non-neutral) dysfunctions occur in flexion or extension with rotation
and sidebending in the same direction. Since the segment is restricted in flexion with rotation left
(LR) and sidebending left (SL), the correct documentation is "L5 Flexed LR SL" .
,Question 2
A 32-year-old female presents with chronic headaches and neck pain. On structural exam, you
find a Type I dysfunction at C3-C5. According to Fryette's principles, which of the following best
describes this dysfunction?
A) Neutral position, rotation and sidebending in opposite directions
B) Flexed position, rotation and sidebending in the same direction
C) Extended position, rotation and sidebending in opposite directions
D) Neutral position, rotation and sidebending in the same direction
Answer: A) Neutral position, rotation and sidebending in opposite directions
, Rationale: Fryette's Type I mechanics occur in the neutral position, where rotation and
sidebending occur in opposite directions. This typically involves multiple segments and is related
to group curve dysfunctions .
Question 3
A patient presents with a left deep sacral sulcus that is deeper and more tender than the right, with
the left ILA being anterior and superior. This describes which sacral torsion pattern?
A) Left on left sacral torsion
B) Right on left sacral torsion
C) Left on right sacral torsion
D) Bilateral sacral torsion
Answer: A) Left on left sacral torsion
Practice Exam: Questions with Answers &
Clinical Rationales
,SECTION 1: OSTEOPATHIC PRINCIPLES & OMM (Questions 1-15)
Question 1
A 45-year-old female presents with chronic low back pain. On examination, you find that the L5
vertebra is restricted in flexion, rotates more easily to the left, and sidebends more easily to the
left. According to Fryette's principles, how should this dysfunction be documented?
A) L5 Flexed RR SR
B) L5 Flexed LR SL
C) L5 Extended RR SR
D) L5 Neutral LR SR
Answer: B) L5 Flexed LR SL
Rationale: Fryette's Type II (non-neutral) dysfunctions occur in flexion or extension with rotation
and sidebending in the same direction. Since the segment is restricted in flexion with rotation left
(LR) and sidebending left (SL), the correct documentation is "L5 Flexed LR SL" .
,Question 2
A 32-year-old female presents with chronic headaches and neck pain. On structural exam, you
find a Type I dysfunction at C3-C5. According to Fryette's principles, which of the following best
describes this dysfunction?
A) Neutral position, rotation and sidebending in opposite directions
B) Flexed position, rotation and sidebending in the same direction
C) Extended position, rotation and sidebending in opposite directions
D) Neutral position, rotation and sidebending in the same direction
Answer: A) Neutral position, rotation and sidebending in opposite directions
, Rationale: Fryette's Type I mechanics occur in the neutral position, where rotation and
sidebending occur in opposite directions. This typically involves multiple segments and is related
to group curve dysfunctions .
Question 3
A patient presents with a left deep sacral sulcus that is deeper and more tender than the right, with
the left ILA being anterior and superior. This describes which sacral torsion pattern?
A) Left on left sacral torsion
B) Right on left sacral torsion
C) Left on right sacral torsion
D) Bilateral sacral torsion
Answer: A) Left on left sacral torsion
