Mastering COMSAE Form 111: A -Question
Self-Assessment with OMT and Core Medical
Rationales
,Section 1: Osteopathic Principles & Practice
Question 1
A 45-year-old woman presents with epigastric burning and bloating after meals for several months.
On osteopathic structural exam, you find tenderness and increased tissue texture at the right T6-
T8 paraspinal region. Which viscerosomatic reflex best explains this finding?
A) Gallbladder
B) Stomach
C) Pancreas
D) Liver
Answer: B) Stomach
Rationale: Viscerosomatic reflexes map spinal cord levels to organs. The stomach corresponds to
T6-T9, often presenting on the right side. Gallbladder (T7-T9) also presents on the right, but the
,epigastric symptoms point specifically to the stomach. Recognizing spinal levels for common
organs is essential for COMSAE .
Question 2
A patient with chronic constipation has a tender anterior Chapman point at the tip of the left 12th
rib. Which part of the colon is affected?
A) Ascending colon
B) Transverse colon
C) Descending colon
D) Sigmoid colon
Answer: C) Descending colon
, Rationale: The anterior Chapman reflex for the descending colon is located at the tip of the left
12th rib. The ascending colon corresponds to the right 11th rib, while the transverse colon is
associated with T8-T9 posteriorly .
Question 3
A patient with chronic GERD has a tender anterior Chapman point at the right 6th intercostal
space near the sternum. Which spinal level is most likely dyssynchronous?
A) T2-T4
B) T5-T7
C) T8-T10
D) T10-L1
Answer: B) T5-T7
Self-Assessment with OMT and Core Medical
Rationales
,Section 1: Osteopathic Principles & Practice
Question 1
A 45-year-old woman presents with epigastric burning and bloating after meals for several months.
On osteopathic structural exam, you find tenderness and increased tissue texture at the right T6-
T8 paraspinal region. Which viscerosomatic reflex best explains this finding?
A) Gallbladder
B) Stomach
C) Pancreas
D) Liver
Answer: B) Stomach
Rationale: Viscerosomatic reflexes map spinal cord levels to organs. The stomach corresponds to
T6-T9, often presenting on the right side. Gallbladder (T7-T9) also presents on the right, but the
,epigastric symptoms point specifically to the stomach. Recognizing spinal levels for common
organs is essential for COMSAE .
Question 2
A patient with chronic constipation has a tender anterior Chapman point at the tip of the left 12th
rib. Which part of the colon is affected?
A) Ascending colon
B) Transverse colon
C) Descending colon
D) Sigmoid colon
Answer: C) Descending colon
, Rationale: The anterior Chapman reflex for the descending colon is located at the tip of the left
12th rib. The ascending colon corresponds to the right 11th rib, while the transverse colon is
associated with T8-T9 posteriorly .
Question 3
A patient with chronic GERD has a tender anterior Chapman point at the right 6th intercostal
space near the sternum. Which spinal level is most likely dyssynchronous?
A) T2-T4
B) T5-T7
C) T8-T10
D) T10-L1
Answer: B) T5-T7
