COMSAE COMPREHENSIVE PRACTICE
EXAM 2026/2027 QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with chronic back pain. Physical examination reveals that L5 is
sidebent right and rotated right. Which of the following sacral findings is most likely
associated with this L5 dysfunction?
A. Right on right forward torsion
B. Right on left backward torsion
C. Left on right backward torsion
D. Left on left forward torsion
Answer: B
Conceptual Explanation: According to Fryette’s laws and sacral mechanics, L5 and the
sacrum rotate in opposite directions. If L5 is rotated right, the sacrum must rotate left.
Additionally, the sidebending of L5 (right) occurs on the same side as the sacral oblique
axis. Thus, L5 sidebent right indicates a right oblique axis. A left rotation on a right axis is a
backward torsion (R on L).
,2. A 24-year-old female athlete complains of pain along the lateral aspect of her right thigh.
Palpation reveals a exquisitely tender nodule along the posterior aspect of the iliotibial band.
This finding is most likely a Chapman reflex point for which organ?
A. Bladder
B. Ovaries
C. Colon
D. Kidneys
Answer: C
Conceptual Explanation: The Chapman reflex point for the colon is located along the
lateral aspect of the femur within the iliotibial band. Specifically, the right lateral thigh
corresponds to different sections of the colon depending on the vertical position along the
IT band.
3. In a patient with a cranial torsion strain, how are the sphenoid and occiput moving relative
to one another during the primary respiratory mechanism?
A. They rotate in the same direction about two parallel transverse axes
B. They rotate in opposite directions about a single AP axis
C. They rotate in opposite directions about two parallel transverse axes
D. They rotate in the same direction about a single AP axis
Answer: B
, Conceptual Explanation: A cranial torsion is defined as rotation of the sphenoid and
occiput in opposite directions about a single anterior-posterior (AP) axis. It is named for
the superior greater wing of the sphenoid.
4. A patient presents with a cough and fever. Palpation of the thoracic spine reveals T3-T4
paraspinal fullness and increased heat. Which of the following viscerosomatic reflex levels is
most likely involved in this pulmonary presentation?
A. T10-T11
B. T5-T9
C. T1-T4
D. T12-L2
Answer: C
Conceptual Explanation: Viscerosomatic reflexes for the lungs and upper respiratory
system are generally found at the levels of T1 through T4. T5-T9 is typically associated
with upper GI organs like the stomach and liver.
5. A patient is diagnosed with an inhalation dysfunction of rib 2 on the right. Which muscle
should be used as the activator for muscle energy treatment?
A. Anterior scalene
B. Posterior scalene
C. Pectoralis minor
EXAM 2026/2027 QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with chronic back pain. Physical examination reveals that L5 is
sidebent right and rotated right. Which of the following sacral findings is most likely
associated with this L5 dysfunction?
A. Right on right forward torsion
B. Right on left backward torsion
C. Left on right backward torsion
D. Left on left forward torsion
Answer: B
Conceptual Explanation: According to Fryette’s laws and sacral mechanics, L5 and the
sacrum rotate in opposite directions. If L5 is rotated right, the sacrum must rotate left.
Additionally, the sidebending of L5 (right) occurs on the same side as the sacral oblique
axis. Thus, L5 sidebent right indicates a right oblique axis. A left rotation on a right axis is a
backward torsion (R on L).
,2. A 24-year-old female athlete complains of pain along the lateral aspect of her right thigh.
Palpation reveals a exquisitely tender nodule along the posterior aspect of the iliotibial band.
This finding is most likely a Chapman reflex point for which organ?
A. Bladder
B. Ovaries
C. Colon
D. Kidneys
Answer: C
Conceptual Explanation: The Chapman reflex point for the colon is located along the
lateral aspect of the femur within the iliotibial band. Specifically, the right lateral thigh
corresponds to different sections of the colon depending on the vertical position along the
IT band.
3. In a patient with a cranial torsion strain, how are the sphenoid and occiput moving relative
to one another during the primary respiratory mechanism?
A. They rotate in the same direction about two parallel transverse axes
B. They rotate in opposite directions about a single AP axis
C. They rotate in opposite directions about two parallel transverse axes
D. They rotate in the same direction about a single AP axis
Answer: B
, Conceptual Explanation: A cranial torsion is defined as rotation of the sphenoid and
occiput in opposite directions about a single anterior-posterior (AP) axis. It is named for
the superior greater wing of the sphenoid.
4. A patient presents with a cough and fever. Palpation of the thoracic spine reveals T3-T4
paraspinal fullness and increased heat. Which of the following viscerosomatic reflex levels is
most likely involved in this pulmonary presentation?
A. T10-T11
B. T5-T9
C. T1-T4
D. T12-L2
Answer: C
Conceptual Explanation: Viscerosomatic reflexes for the lungs and upper respiratory
system are generally found at the levels of T1 through T4. T5-T9 is typically associated
with upper GI organs like the stomach and liver.
5. A patient is diagnosed with an inhalation dysfunction of rib 2 on the right. Which muscle
should be used as the activator for muscle energy treatment?
A. Anterior scalene
B. Posterior scalene
C. Pectoralis minor
