COMSAE 115 COMPREHENSIVE FINAL
EXAM 2026/2027 QUESTIONS AND
ANSWERS
1. A 45-year-old female presents with acute right upper quadrant pain that radiates to her
right scapula. On physical examination, she has a positive Murphy’s sign. Which Chapman’s
point would most likely be tender in this patient?
A. Right 5th intercostal space
B. Left 6th intercostal space
C. Right 7th intercostal space
D. Right 6th intercostal space
Answer: D
Conceptual Explanation: The anterior Chapman’s reflex point for the gallbladder is
located in the right 6th intercostal space, between the midclavicular and midaxillary lines.
This matches the patient’s presentation of biliary colic/cholecystitis.
,2. A patient is diagnosed with a sacral torsion where the seated flexion test is positive on the
right, the deep sulcus is on the left, and the sacral promontory is posterior on the right. What
is the diagnosis?
A. Left-on-left forward torsion
B. Right-on-left backward torsion
C. Left-on-right backward torsion
D. Right-on-right forward torsion
Answer: B
Conceptual Explanation: A positive seated flexion test on the right indicates the side of
the dysfunction. A deep sulcus on the left means the left side is anterior (or the right is
posterior). A posterior right promontory suggests a backward torsion. In a backward
torsion, the axis is opposite the side of the positive flexion test. Therefore, it is a Right-on-
left backward torsion.
3. According to Fryette’s Laws, which of the following best describes Type II somatic
dysfunction in the thoracic spine?
A. A single segment involving sidebending and rotation to the same side in flexion or
extension.
B. A group of segments involving sidebending and rotation to the same side in neutral.
C. A group of segments involving sidebending and rotation to opposite sides in neutral.
, D. A single segment involving sidebending and rotation to opposite sides in flexion or
extension.
Answer: A
Conceptual Explanation: Fryette’s Second Law states that in the thoracic and lumbar
spine, when the spine is significantly flexed or extended (non-neutral), a single segment
will sidebend and rotate to the same side.
4. During a cranial examination, the physician notes that the sphenobasilar synchondrosis
(SBS) moves superiorly during the inhalation phase of the primary respiratory mechanism.
What is this motion called?
A. Sidebending-Rotation
B. Extension
C. Torsion
D. Flexion
Answer: D
Conceptual Explanation: In cranial flexion, the SBS rises (moves superiorly), the paired
bones externally rotate, and the AP diameter of the cranium decreases while the transverse
diameter increases.
5. A patient presents with a somatic dysfunction of the 3rd rib. During inhalation, the rib
moves easily, but it stops moving during exhalation. What is the diagnosis?
A. Inhalation dysfunction of rib 3
EXAM 2026/2027 QUESTIONS AND
ANSWERS
1. A 45-year-old female presents with acute right upper quadrant pain that radiates to her
right scapula. On physical examination, she has a positive Murphy’s sign. Which Chapman’s
point would most likely be tender in this patient?
A. Right 5th intercostal space
B. Left 6th intercostal space
C. Right 7th intercostal space
D. Right 6th intercostal space
Answer: D
Conceptual Explanation: The anterior Chapman’s reflex point for the gallbladder is
located in the right 6th intercostal space, between the midclavicular and midaxillary lines.
This matches the patient’s presentation of biliary colic/cholecystitis.
,2. A patient is diagnosed with a sacral torsion where the seated flexion test is positive on the
right, the deep sulcus is on the left, and the sacral promontory is posterior on the right. What
is the diagnosis?
A. Left-on-left forward torsion
B. Right-on-left backward torsion
C. Left-on-right backward torsion
D. Right-on-right forward torsion
Answer: B
Conceptual Explanation: A positive seated flexion test on the right indicates the side of
the dysfunction. A deep sulcus on the left means the left side is anterior (or the right is
posterior). A posterior right promontory suggests a backward torsion. In a backward
torsion, the axis is opposite the side of the positive flexion test. Therefore, it is a Right-on-
left backward torsion.
3. According to Fryette’s Laws, which of the following best describes Type II somatic
dysfunction in the thoracic spine?
A. A single segment involving sidebending and rotation to the same side in flexion or
extension.
B. A group of segments involving sidebending and rotation to the same side in neutral.
C. A group of segments involving sidebending and rotation to opposite sides in neutral.
, D. A single segment involving sidebending and rotation to opposite sides in flexion or
extension.
Answer: A
Conceptual Explanation: Fryette’s Second Law states that in the thoracic and lumbar
spine, when the spine is significantly flexed or extended (non-neutral), a single segment
will sidebend and rotate to the same side.
4. During a cranial examination, the physician notes that the sphenobasilar synchondrosis
(SBS) moves superiorly during the inhalation phase of the primary respiratory mechanism.
What is this motion called?
A. Sidebending-Rotation
B. Extension
C. Torsion
D. Flexion
Answer: D
Conceptual Explanation: In cranial flexion, the SBS rises (moves superiorly), the paired
bones externally rotate, and the AP diameter of the cranium decreases while the transverse
diameter increases.
5. A patient presents with a somatic dysfunction of the 3rd rib. During inhalation, the rib
moves easily, but it stops moving during exhalation. What is the diagnosis?
A. Inhalation dysfunction of rib 3
