COMSAE 115 COMPREHENSIVE
OSTEOPATHIC MEDICAL SELF-
ASSESSMENT EXAM 2026/2027
1. A 45-year-old male presents with right upper quadrant pain. Palpation reveals a tender
nodule in the right 6th intercostal space at the midclavicular line. Which organ is most likely
associated with this Chapman reflex?
A. Stomach
B. Liver
C. Gallbladder
D. Pancreas
Answer: C
Conceptual Explanation: The anterior Chapman reflex point for the gallbladder is located
in the right 6th intercostal space at the midclavicular line.
2. A patient presents with a thoracic dysfunction described as T5-T9 N SL RR. Which of
Fryette’s laws best describes this finding?
A. Nelson’s Law
,B. Law II
C. Law III
D. Law I
Answer: D
Conceptual Explanation: Fryette Law I states that in neutral, sidebending and rotation
occur to opposite sides in a group of vertebrae.
3. When evaluating a patient for sacral torsion, you find L5 is rotated right. Which of the
following is most consistent with this finding?
A. A right-on-right forward torsion
B. A right-on-left backward torsion
C. A neutral sacrum
D. A left-on-left forward torsion
Answer: D
Conceptual Explanation: According to the rules of L5 on the sacrum, L5 and the sacrum
rotate in opposite directions in forward torsions (L5 R and Sacrum L).
4. A patient has an inhalation rib dysfunction of Rib 3. Which muscle is the primary activator
used during post-isometric relaxation muscle energy?
A. Anterior Scalene
B. Middle Scalene
, C. Pectoralis Minor
D. Posterior Scalene
Answer: C
Conceptual Explanation: Pectoralis minor is the primary muscle used to treat
inhalation/exhalation dysfunctions of ribs 3-5.
5. During the flexion phase of the primary respiratory mechanism (PRM), which movement
occurs at the sphenobasilar synchondrosis (SBS)?
A. The SBS rotates right
B. The SBS moves inferiorly
C. The SBS moves superiorly
D. The SBS rotates left
Answer: C
Conceptual Explanation: During cranial flexion, the base of the sphenoid and the base of
the occiput move superiorly, resulting in the SBS rising.
6. Where is the index finger placed when performing the vault hold?
A. Pre-auricular area
B. Mastoid process of the temporal bone
C. Zygomatic arch
OSTEOPATHIC MEDICAL SELF-
ASSESSMENT EXAM 2026/2027
1. A 45-year-old male presents with right upper quadrant pain. Palpation reveals a tender
nodule in the right 6th intercostal space at the midclavicular line. Which organ is most likely
associated with this Chapman reflex?
A. Stomach
B. Liver
C. Gallbladder
D. Pancreas
Answer: C
Conceptual Explanation: The anterior Chapman reflex point for the gallbladder is located
in the right 6th intercostal space at the midclavicular line.
2. A patient presents with a thoracic dysfunction described as T5-T9 N SL RR. Which of
Fryette’s laws best describes this finding?
A. Nelson’s Law
,B. Law II
C. Law III
D. Law I
Answer: D
Conceptual Explanation: Fryette Law I states that in neutral, sidebending and rotation
occur to opposite sides in a group of vertebrae.
3. When evaluating a patient for sacral torsion, you find L5 is rotated right. Which of the
following is most consistent with this finding?
A. A right-on-right forward torsion
B. A right-on-left backward torsion
C. A neutral sacrum
D. A left-on-left forward torsion
Answer: D
Conceptual Explanation: According to the rules of L5 on the sacrum, L5 and the sacrum
rotate in opposite directions in forward torsions (L5 R and Sacrum L).
4. A patient has an inhalation rib dysfunction of Rib 3. Which muscle is the primary activator
used during post-isometric relaxation muscle energy?
A. Anterior Scalene
B. Middle Scalene
, C. Pectoralis Minor
D. Posterior Scalene
Answer: C
Conceptual Explanation: Pectoralis minor is the primary muscle used to treat
inhalation/exhalation dysfunctions of ribs 3-5.
5. During the flexion phase of the primary respiratory mechanism (PRM), which movement
occurs at the sphenobasilar synchondrosis (SBS)?
A. The SBS rotates right
B. The SBS moves inferiorly
C. The SBS moves superiorly
D. The SBS rotates left
Answer: C
Conceptual Explanation: During cranial flexion, the base of the sphenoid and the base of
the occiput move superiorly, resulting in the SBS rising.
6. Where is the index finger placed when performing the vault hold?
A. Pre-auricular area
B. Mastoid process of the temporal bone
C. Zygomatic arch
