COMSAE COMPREHENSIVE STUDY
GUIDE 2026/2027 QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with acute onset right lower quadrant pain. On physical
examination, a tender point is palpated at the tip of the right 12th rib. This Chapman point is
most indicative of pathology in which organ?
A. Appendix
B. Gallbladder
C. Bladder
D. Colon
Answer: A
Conceptual Explanation: The anterior Chapman point for the appendix is located at the
tip of the right 12th rib. The posterior point is at the transverse process of T11.
2. Which of the following describes a Fryette’s Law II spinal dysfunction?
A. Occurs in neutral and involves a group of segments
B. Occurs primarily in the cervical spine during sidebending
,C. Rotation and sidebending occur to opposite sides in a neutral state
D. Rotation and sidebending occur to the same side in a non-neutral state
Answer: D
Conceptual Explanation: Fryette Law II states that in a non-neutral (flexed or extended)
state, a single vertebral segment will rotate and sidebend to the same side.
3. A patient presents with a cranial strain where the sphenoid and occiput have rotated in
opposite directions around an anterior-posterior axis. What is the diagnosis?
A. Vertical strain
B. Torsion
C. Lateral strain
D. Sidebending rotation
Answer: B
Conceptual Explanation: A cranial torsion is named for the greater wing of the sphenoid
that is superior, involving rotation of the sphenoid and occiput in opposite directions
around an AP axis.
4. A 58-year-old female with a history of myocardial infarction is found to have tissue texture
changes from T1-T5. Which of the following best describes this reflex?
A. Viscerosomatic reflex
B. Somatosomatic reflex
, C. Somatovisceral reflex
D. Viscerovisceral reflex
Answer: A
Conceptual Explanation: A viscerosomatic reflex occurs when localized visceral stimuli
produce patterns of reflex response in segmentally related somatic structures. The heart’s
sympathetic innervation is T1-T5.
5. In a patient with a Left-on-Left forward sacral torsion, what would you expect to find
regarding L5?
A. L5 is Neutral, Sidebent Right, Rotated Left
B. L5 is Flexed, Sidebent Left, Rotated Left
C. L5 is Neutral, Sidebent Left, Rotated Right
D. L5 is Extended, Sidebent Right, Rotated Right
Answer: C
Conceptual Explanation: According to the rules of sacral torsion, L5 rotates in the
opposite direction of the sacral rotation. For a L on L torsion, the sacrum rotates left, so L5
must rotate right. In forward torsions, L5 follows neutral (Law I) mechanics.
6. Which of the following muscles is used as the motor engine to treat an exhalation
dysfunction of ribs 3-5 using Muscle Energy?
A. Anterior Scalene
GUIDE 2026/2027 QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with acute onset right lower quadrant pain. On physical
examination, a tender point is palpated at the tip of the right 12th rib. This Chapman point is
most indicative of pathology in which organ?
A. Appendix
B. Gallbladder
C. Bladder
D. Colon
Answer: A
Conceptual Explanation: The anterior Chapman point for the appendix is located at the
tip of the right 12th rib. The posterior point is at the transverse process of T11.
2. Which of the following describes a Fryette’s Law II spinal dysfunction?
A. Occurs in neutral and involves a group of segments
B. Occurs primarily in the cervical spine during sidebending
,C. Rotation and sidebending occur to opposite sides in a neutral state
D. Rotation and sidebending occur to the same side in a non-neutral state
Answer: D
Conceptual Explanation: Fryette Law II states that in a non-neutral (flexed or extended)
state, a single vertebral segment will rotate and sidebend to the same side.
3. A patient presents with a cranial strain where the sphenoid and occiput have rotated in
opposite directions around an anterior-posterior axis. What is the diagnosis?
A. Vertical strain
B. Torsion
C. Lateral strain
D. Sidebending rotation
Answer: B
Conceptual Explanation: A cranial torsion is named for the greater wing of the sphenoid
that is superior, involving rotation of the sphenoid and occiput in opposite directions
around an AP axis.
4. A 58-year-old female with a history of myocardial infarction is found to have tissue texture
changes from T1-T5. Which of the following best describes this reflex?
A. Viscerosomatic reflex
B. Somatosomatic reflex
, C. Somatovisceral reflex
D. Viscerovisceral reflex
Answer: A
Conceptual Explanation: A viscerosomatic reflex occurs when localized visceral stimuli
produce patterns of reflex response in segmentally related somatic structures. The heart’s
sympathetic innervation is T1-T5.
5. In a patient with a Left-on-Left forward sacral torsion, what would you expect to find
regarding L5?
A. L5 is Neutral, Sidebent Right, Rotated Left
B. L5 is Flexed, Sidebent Left, Rotated Left
C. L5 is Neutral, Sidebent Left, Rotated Right
D. L5 is Extended, Sidebent Right, Rotated Right
Answer: C
Conceptual Explanation: According to the rules of sacral torsion, L5 rotates in the
opposite direction of the sacral rotation. For a L on L torsion, the sacrum rotates left, so L5
must rotate right. In forward torsions, L5 follows neutral (Law I) mechanics.
6. Which of the following muscles is used as the motor engine to treat an exhalation
dysfunction of ribs 3-5 using Muscle Energy?
A. Anterior Scalene
