COMSAE FORM 113 COMPREHENSIVE
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with epigastric pain that radiates to the back. On physical
examination, tissue texture changes are noted at the level of T5-T9. Which of the following
organs is most likely associated with this viscerosomatic reflex?
A. Pancreas
B. Kidney
C. Heart
D. Bladder
Answer: A
Conceptual Explanation: The pancreas has viscerosomatic reflex levels from T5-T9. The
heart is T1-T5, the kidney is T10-L1, and the bladder is T11-L2.
2. During a cranial examination, the physician finds that the sphenoid and occiput rotate in
opposite directions about a single AP axis. This describes which strain pattern?
A. Lateral Strain
,B. Sidebending-Rotation
C. Vertical Strain
D. Torsion
Answer: D
Conceptual Explanation: A torsion is a cranial strain pattern where the sphenoid and
occiput rotate in opposite directions about a single anterior-posterior (AP) axis.
3. A patient is diagnosed with a right-on-left sacral torsion. What would be the expected
position of L5?
A. L5 Neutral, Sidebent Left, Rotated Right
B. L5 Neutral, Sidebent Right, Rotated Left
C. L5 Flexed, Rotated Left, Sidebent Left
D. L5 Extended, Rotated Right, Sidebent Right
Answer: A
Conceptual Explanation: In a sacral torsion, L5 follows Fryette’s laws relative to the
sacrum. For a backward torsion (Right on Left), L5 is neutral, rotated opposite to the sacral
rotation (rotated Right), and sidebent to the side of the axis (sidebent Left).
4. A 24-year-old female presents with acute right lower quadrant pain. A Chapman point is
palpated on the tip of the 12th rib on the right. What is the most likely diagnosis?
A. Appendicitis
, B. Ovarian cyst
C. Ureterolithiasis
D. Cholecystitis
Answer: A
Conceptual Explanation: The anterior Chapman point for the appendix is the tip of the
12th rib on the right.
5. While evaluating the cervical spine of a patient with headaches, you find that C2 is easier
to rotate to the right than to the left. When the head is flexed, the restriction becomes more
prominent. What is the diagnosis?
A. C2 Neutral, Rotated Right, Sidebent Left
B. C2 Flexed, Rotated Right, Sidebent Right
C. C2 Extended, Rotated Right, Sidebent Right
D. C2 Extended, Rotated Left, Sidebent Left
Answer: C
Conceptual Explanation: If C2 rotates right and the restriction worsens in flexion, it is
extended (E RrSr). C2-C7 follow Fryette Law II (Rotation and Sidebending to the same
side).
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with epigastric pain that radiates to the back. On physical
examination, tissue texture changes are noted at the level of T5-T9. Which of the following
organs is most likely associated with this viscerosomatic reflex?
A. Pancreas
B. Kidney
C. Heart
D. Bladder
Answer: A
Conceptual Explanation: The pancreas has viscerosomatic reflex levels from T5-T9. The
heart is T1-T5, the kidney is T10-L1, and the bladder is T11-L2.
2. During a cranial examination, the physician finds that the sphenoid and occiput rotate in
opposite directions about a single AP axis. This describes which strain pattern?
A. Lateral Strain
,B. Sidebending-Rotation
C. Vertical Strain
D. Torsion
Answer: D
Conceptual Explanation: A torsion is a cranial strain pattern where the sphenoid and
occiput rotate in opposite directions about a single anterior-posterior (AP) axis.
3. A patient is diagnosed with a right-on-left sacral torsion. What would be the expected
position of L5?
A. L5 Neutral, Sidebent Left, Rotated Right
B. L5 Neutral, Sidebent Right, Rotated Left
C. L5 Flexed, Rotated Left, Sidebent Left
D. L5 Extended, Rotated Right, Sidebent Right
Answer: A
Conceptual Explanation: In a sacral torsion, L5 follows Fryette’s laws relative to the
sacrum. For a backward torsion (Right on Left), L5 is neutral, rotated opposite to the sacral
rotation (rotated Right), and sidebent to the side of the axis (sidebent Left).
4. A 24-year-old female presents with acute right lower quadrant pain. A Chapman point is
palpated on the tip of the 12th rib on the right. What is the most likely diagnosis?
A. Appendicitis
, B. Ovarian cyst
C. Ureterolithiasis
D. Cholecystitis
Answer: A
Conceptual Explanation: The anterior Chapman point for the appendix is the tip of the
12th rib on the right.
5. While evaluating the cervical spine of a patient with headaches, you find that C2 is easier
to rotate to the right than to the left. When the head is flexed, the restriction becomes more
prominent. What is the diagnosis?
A. C2 Neutral, Rotated Right, Sidebent Left
B. C2 Flexed, Rotated Right, Sidebent Right
C. C2 Extended, Rotated Right, Sidebent Right
D. C2 Extended, Rotated Left, Sidebent Left
Answer: C
Conceptual Explanation: If C2 rotates right and the restriction worsens in flexion, it is
extended (E RrSr). C2-C7 follow Fryette Law II (Rotation and Sidebending to the same
side).
