COMSAE 115 COMPREHENSIVE
MEDICAL AND OSTEOPATHIC EXAM
PREP QUESTIONS AND ANSWERS
1. A 45-year-old male presents with acute onset of severe low back pain after lifting a heavy
box. Physical examination reveals a positive straight leg raise test on the right at 30 degrees
and weakness in right big toe extension. Which nerve root is most likely affected?
A. L3
B. L4
C. S1
D. L5
Answer: D
Conceptual Explanation: Big toe extension is primarily mediated by the L5 nerve root. A
herniated disc at the L4-L5 level typically compresses the L5 nerve root, leading to
weakness in the extensor hallucis longus and sensory loss over the dorsal aspect of the
foot.
,2. In the treatment of a patient with an inhalation rib dysfunction of ribs 3-5, which muscle is
most appropriately utilized during Muscle Energy treatment?
A. Scalene muscles
B. Pectoralis minor
C. Serratus anterior
D. Latissimus dorsi
Answer: B
Conceptual Explanation: For inhalation dysfunctions, the goal is to move the rib into
exhalation. However, muscle energy for ribs is typically used for exhalation dysfunctions. If
treating ribs 3-5 exhalation dysfunction, the pectoralis minor is used. For an inhalation
dysfunction, the corrective force is directed toward exhalation during the patient’s
breathing cycle.
3. A 28-year-old female presents with a headache described as a tight band around her head.
She notes increased stress at work. Osteopathic exam reveals hypertonicity of the
suboccipital muscles. What is the most likely cranial strain pattern associated with this
presentation?
A. Torsion
B. Vertical strain
C. Sphenobasilar synchondrosis (SBS) compression
D. Lateral strain
, Answer: C
Conceptual Explanation: A ‘bowling ball’ headache or a band-like pressure is classically
associated with SBS compression, often resulting from trauma or significant muscle tension
at the base of the skull.
4. A patient presents with a Chapman point located on the lateral aspect of the middle to
lower femur (iliotibial band). This point is most diagnostic for dysfunction in which organ?
A. Bladder
B. Ovaries
C. Colon
D. Prostate
Answer: C
Conceptual Explanation: The Chapman point for the colon is located along the iliotibial
band. The specific position along the IT band corresponds to different segments of the
colon (e.g., right IT band for ascending colon).
5. Which of the following describes the correct motion of the sacrum during craniosacral
extension?
A. Sacral base moves posteriorly (counseling)
B. Sacral base moves superiorly
C. Sacral base moves anteriorly (nutation)
MEDICAL AND OSTEOPATHIC EXAM
PREP QUESTIONS AND ANSWERS
1. A 45-year-old male presents with acute onset of severe low back pain after lifting a heavy
box. Physical examination reveals a positive straight leg raise test on the right at 30 degrees
and weakness in right big toe extension. Which nerve root is most likely affected?
A. L3
B. L4
C. S1
D. L5
Answer: D
Conceptual Explanation: Big toe extension is primarily mediated by the L5 nerve root. A
herniated disc at the L4-L5 level typically compresses the L5 nerve root, leading to
weakness in the extensor hallucis longus and sensory loss over the dorsal aspect of the
foot.
,2. In the treatment of a patient with an inhalation rib dysfunction of ribs 3-5, which muscle is
most appropriately utilized during Muscle Energy treatment?
A. Scalene muscles
B. Pectoralis minor
C. Serratus anterior
D. Latissimus dorsi
Answer: B
Conceptual Explanation: For inhalation dysfunctions, the goal is to move the rib into
exhalation. However, muscle energy for ribs is typically used for exhalation dysfunctions. If
treating ribs 3-5 exhalation dysfunction, the pectoralis minor is used. For an inhalation
dysfunction, the corrective force is directed toward exhalation during the patient’s
breathing cycle.
3. A 28-year-old female presents with a headache described as a tight band around her head.
She notes increased stress at work. Osteopathic exam reveals hypertonicity of the
suboccipital muscles. What is the most likely cranial strain pattern associated with this
presentation?
A. Torsion
B. Vertical strain
C. Sphenobasilar synchondrosis (SBS) compression
D. Lateral strain
, Answer: C
Conceptual Explanation: A ‘bowling ball’ headache or a band-like pressure is classically
associated with SBS compression, often resulting from trauma or significant muscle tension
at the base of the skull.
4. A patient presents with a Chapman point located on the lateral aspect of the middle to
lower femur (iliotibial band). This point is most diagnostic for dysfunction in which organ?
A. Bladder
B. Ovaries
C. Colon
D. Prostate
Answer: C
Conceptual Explanation: The Chapman point for the colon is located along the iliotibial
band. The specific position along the IT band corresponds to different segments of the
colon (e.g., right IT band for ascending colon).
5. Which of the following describes the correct motion of the sacrum during craniosacral
extension?
A. Sacral base moves posteriorly (counseling)
B. Sacral base moves superiorly
C. Sacral base moves anteriorly (nutation)
