COMSAE Phase 1 Form 114 Exam And Practice Exam
Newest 2026/ 2027 Test Bank| Comprehensive
Osteopathic Medical Self Assessment Examination
Phase 1 Exam Prep With Complete 300 Real Exam
Questions And Correct Verified Answers/ Already
Graded A+ (Most Recent!!)
DOMAIN 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT)
Question 1
A 45-year-old male presents with low back pain after lifting a heavy box. On
examination, the standing flexion test shows superior movement of the right PSIS.
Which somatic dysfunction is most likely?
A. Right anterior innominate
B. Left posterior innominate
C. Right sacral torsion on a left oblique axis
D. Bilateral innominate rotation
Answer: A
Rationale: A positive standing flexion test on the right suggests iliosacral dysfunction.
Superior movement of the PSIS often correlates with a right anterior innominate,
where the ASIS is positioned anteriorly and inferiorly, creating a functional short leg.
Question 2
According to Fryette’s first principle (Type I mechanics), when the spine is in a
neutral position, sidebending and rotation occur:
A. To the same side
B. To opposite sides
C. Without rotation
D. Only in the lumbar spine
,Answer: B
Rationale: Fryette’s first principle states that in a neutral spine, sidebending and
rotation occur to opposite sides. For example, sidebending right is accompanied by
rotation left.
Question 3
A patient has a somatic dysfunction described as “left fibular head, posterior.”
Which motion is restricted?
A. Anterior glide
B. Posterior glide
C. Lateral glide
D. Medial glide
Answer: A
Rationale: A posterior fibular head indicates restricted anterior glide. The fibular
head is palpated posteriorly, and motion testing reveals restriction in anterior
translation.
Question 4
A 32-year-old female presents with chronic headaches and neck pain. On structural
exam, you find a Type I dysfunction at C3–C5. According to Fryette’s principles,
which best describes this dysfunction?
A. Neutral position, rotation and sidebending in opposite directions
B. Flexed position, rotation and sidebending in the same direction
C. Extended position, rotation and sidebending in opposite directions
D. Neutral position, rotation and sidebending in the same direction
Answer: A
Rationale: Fryette’s Type I mechanics occur in the neutral position, where rotation
and sidebending occur in opposite directions. Type II mechanics occur in a flexed or
extended position where rotation and sidebending occur to the same side.
,Question 5
A 45-year-old male undergoes a physical examination. The physician notes a
somatic dysfunction of the T5 thoracic vertebra. Palpation reveals that the T5
spinous process rotates preferentially to the right and sidebends preferentially to
the right. When the patient flexes his spine, the asymmetry worsens, but it
improves significantly when he extends his spine. According to Fryette’s principles,
how should this somatic dysfunction be named?
A. T5 Neutral R(R) S(L)
B. T5 Extended R(R) S(R)
C. T5 Flexed R(L) S(L)
D. T5 Extended R(L) S(R)
Answer: B
Rationale: Under Fryette’s Principle II, non-neutral thoracic dysfunctions occur at a
single vertebral segment where rotation and sidebending occur to the same side.
Because the asymmetry improves in extension, the restriction is in flexion, meaning the
vertebra is trapped in an extended position. The positional diagnosis is named for its
directional preferences: Extended, Rotated Right, and Sidebent Right.
Question 6
Which of the following best describes a Chapman point?
A. A viscerosomatic reflex point located on the anterior body wall
B. A trigger point in the muscle belly
C. A posterior spinal facet dysfunction
D. A cranial suture restriction
Answer: A
Rationale: Chapman points are anterior body wall neurolymphatic reflex points
associated with visceral dysfunction. They are used in osteopathic diagnosis and
treatment.
, Question 7
A patient with gallbladder disease is most likely to have a Chapman point located:
A. On the right lower rib cage
B. On the left lower rib cage
C. At the umbilicus
D. On the sternum
Answer: A
Rationale: Chapman points for the gallbladder are located on the right lower rib cage
(typically around the 6th–8th ribs). This is a viscerosomatic reflex used in OMT diagnosis.
Question 8
A sacral torsion is named for:
A. The direction of the superior sacral base and the axis of rotation
B. The direction of the inferior lateral angle only
C. The side of the positive standing flexion test only
D. The direction of the lumbar rotation only
Answer: A
Rationale: A sacral torsion is named for the direction of the superior sacral base
(e.g., right on left) and the oblique axis about which it rotates (e.g., left oblique axis).
Question 9
A patient has a right sacral torsion on a left oblique axis. Which of the following is
TRUE?
A. The sacral base is rotated right
B. The sacral base is rotated left
C. The inferior lateral angle is rotated left
D. The lumbar spine is sidebent left
Newest 2026/ 2027 Test Bank| Comprehensive
Osteopathic Medical Self Assessment Examination
Phase 1 Exam Prep With Complete 300 Real Exam
Questions And Correct Verified Answers/ Already
Graded A+ (Most Recent!!)
DOMAIN 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT)
Question 1
A 45-year-old male presents with low back pain after lifting a heavy box. On
examination, the standing flexion test shows superior movement of the right PSIS.
Which somatic dysfunction is most likely?
A. Right anterior innominate
B. Left posterior innominate
C. Right sacral torsion on a left oblique axis
D. Bilateral innominate rotation
Answer: A
Rationale: A positive standing flexion test on the right suggests iliosacral dysfunction.
Superior movement of the PSIS often correlates with a right anterior innominate,
where the ASIS is positioned anteriorly and inferiorly, creating a functional short leg.
Question 2
According to Fryette’s first principle (Type I mechanics), when the spine is in a
neutral position, sidebending and rotation occur:
A. To the same side
B. To opposite sides
C. Without rotation
D. Only in the lumbar spine
,Answer: B
Rationale: Fryette’s first principle states that in a neutral spine, sidebending and
rotation occur to opposite sides. For example, sidebending right is accompanied by
rotation left.
Question 3
A patient has a somatic dysfunction described as “left fibular head, posterior.”
Which motion is restricted?
A. Anterior glide
B. Posterior glide
C. Lateral glide
D. Medial glide
Answer: A
Rationale: A posterior fibular head indicates restricted anterior glide. The fibular
head is palpated posteriorly, and motion testing reveals restriction in anterior
translation.
Question 4
A 32-year-old female presents with chronic headaches and neck pain. On structural
exam, you find a Type I dysfunction at C3–C5. According to Fryette’s principles,
which best describes this dysfunction?
A. Neutral position, rotation and sidebending in opposite directions
B. Flexed position, rotation and sidebending in the same direction
C. Extended position, rotation and sidebending in opposite directions
D. Neutral position, rotation and sidebending in the same direction
Answer: A
Rationale: Fryette’s Type I mechanics occur in the neutral position, where rotation
and sidebending occur in opposite directions. Type II mechanics occur in a flexed or
extended position where rotation and sidebending occur to the same side.
,Question 5
A 45-year-old male undergoes a physical examination. The physician notes a
somatic dysfunction of the T5 thoracic vertebra. Palpation reveals that the T5
spinous process rotates preferentially to the right and sidebends preferentially to
the right. When the patient flexes his spine, the asymmetry worsens, but it
improves significantly when he extends his spine. According to Fryette’s principles,
how should this somatic dysfunction be named?
A. T5 Neutral R(R) S(L)
B. T5 Extended R(R) S(R)
C. T5 Flexed R(L) S(L)
D. T5 Extended R(L) S(R)
Answer: B
Rationale: Under Fryette’s Principle II, non-neutral thoracic dysfunctions occur at a
single vertebral segment where rotation and sidebending occur to the same side.
Because the asymmetry improves in extension, the restriction is in flexion, meaning the
vertebra is trapped in an extended position. The positional diagnosis is named for its
directional preferences: Extended, Rotated Right, and Sidebent Right.
Question 6
Which of the following best describes a Chapman point?
A. A viscerosomatic reflex point located on the anterior body wall
B. A trigger point in the muscle belly
C. A posterior spinal facet dysfunction
D. A cranial suture restriction
Answer: A
Rationale: Chapman points are anterior body wall neurolymphatic reflex points
associated with visceral dysfunction. They are used in osteopathic diagnosis and
treatment.
, Question 7
A patient with gallbladder disease is most likely to have a Chapman point located:
A. On the right lower rib cage
B. On the left lower rib cage
C. At the umbilicus
D. On the sternum
Answer: A
Rationale: Chapman points for the gallbladder are located on the right lower rib cage
(typically around the 6th–8th ribs). This is a viscerosomatic reflex used in OMT diagnosis.
Question 8
A sacral torsion is named for:
A. The direction of the superior sacral base and the axis of rotation
B. The direction of the inferior lateral angle only
C. The side of the positive standing flexion test only
D. The direction of the lumbar rotation only
Answer: A
Rationale: A sacral torsion is named for the direction of the superior sacral base
(e.g., right on left) and the oblique axis about which it rotates (e.g., left oblique axis).
Question 9
A patient has a right sacral torsion on a left oblique axis. Which of the following is
TRUE?
A. The sacral base is rotated right
B. The sacral base is rotated left
C. The inferior lateral angle is rotated left
D. The lumbar spine is sidebent left
