COMSAE 115 HIGH-YIELD EXAM PREP
COMSAE 115 HIGH-YIELD EXAM PREP NEWEST 2026/2027 ACTUAL
EXAM COMPLETE 176 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) WITH RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
Core Systems Covered: OMM (Cranial, Sacral, Fryette's), Cardiology, Pulmonology,
Renal, GI, Endocrine, Repro, Heme/Onc, Ethics/Biostats, and Microbiology.
Structure: 4 sections of 44 questions each
Contents
Section 1 ................................................................................................................ 2
Section 2 .............................................................................................................. 29
Section 3 .............................................................................................................. 56
Section 4 .............................................................................................................. 83
1|Page
, COMSAE 115 HIGH-YIELD EXAM PREP
Section 1
1. A 28-year-old female presents with a headache. Physical exam reveals a
restricted cranial rhythmic impulse. Palpation of the sphenobasilar synchondrosis
(SBS) reveals that the base of the sphenoid moves superiorly while the base of the
occiput moves inferiorly. Which of the following is the most likely diagnosis?
A. Flexion dysfunction
B. Extension dysfunction
C. Superior vertical shear
D. Inferior vertical shear
E. Torsion
Correct Answer: C. Superior vertical shear
Rationale: In a vertical shear, the sphenoid and occiput rotate in the same
direction about two transverse axes. A superior shear occurs when the base of the
sphenoid moves superiorly relative to the occiput. (Note: In flexion, both move
superiorly; in extension, both move inferiorly).
2. A 62-year-old male with a history of chronic smoking presents with a persistent
cough and weight loss. He has a drooping right eyelid and a constricted right pupil.
Chest X-ray reveals a mass in the apex of the right lung. Which of the following
structures is most likely compressed?
A. Recurrent laryngeal nerve
B. Phrenic nerve
C. Superior cervical ganglion
2|Page
, COMSAE 115 HIGH-YIELD EXAM PREP
D. Stellate ganglion
E. Vagus nerve
Correct Answer: D. Stellate ganglion
Rationale: This is a Pancoast tumor causing Horner Syndrome (ptosis, miosis,
anhidrosis). The sympathetic fibers to the face pass through the cervicothoracic
(stellate) ganglion, which sits near the apex of the lung.
3. During a routine physical, a patient is found to have a Chapman’s point located
at the second intercostal space, near the sternum. This reflex point is associated
with which of the following organs?
A. Thyroid
B. Heart
C. Esophagus
D. Upper Lung
E. Liver
Correct Answer: B. Heart
Rationale: Chapman’s points are high-yield. 2nd ICS = Heart/Thyroid/Esophagus
(Heart is the most common board answer for 2nd ICS). 3rd ICS = Upper Lung; 4th
ICS = Lower Lung.
3|Page
, COMSAE 115 HIGH-YIELD EXAM PREP
4. A 45-year-old male presents with low back pain. Examination shows a L2
segment that is rotated right and sidebent right. When the patient slumps
forward, the asymmetry worsens. What is the correct Type II diagnosis?
A. L2 Neutral SR RR
B. L2 Flexed SR RR
C. L2 Extended SR RR
D. L2 Flexed RR SR
E. L2 Extended RR SR
Correct Answer: C. L2 Extended SR RR
Rationale: Fryette’s Laws: Type II occurs at a single segment. Sidebending and
Rotation occur to the same side. If it worsens in flexion (slumping forward), it
"likes" extension. Therefore, it is an Extended dysfunction.
5. A 19-year-old male is brought to the ER after a football injury. He is unable to
initiate abduction of the right arm. An MRI shows a tear in a muscle of the rotator
cuff. Which of the following muscles is most likely injured?
A. Infraspinatus
B. Subscapularis
C. Teres minor
D. Supraspinatus
E. Teres major
Correct Answer: D. Supraspinatus
4|Page
COMSAE 115 HIGH-YIELD EXAM PREP NEWEST 2026/2027 ACTUAL
EXAM COMPLETE 176 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) WITH RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
Core Systems Covered: OMM (Cranial, Sacral, Fryette's), Cardiology, Pulmonology,
Renal, GI, Endocrine, Repro, Heme/Onc, Ethics/Biostats, and Microbiology.
Structure: 4 sections of 44 questions each
Contents
Section 1 ................................................................................................................ 2
Section 2 .............................................................................................................. 29
Section 3 .............................................................................................................. 56
Section 4 .............................................................................................................. 83
1|Page
, COMSAE 115 HIGH-YIELD EXAM PREP
Section 1
1. A 28-year-old female presents with a headache. Physical exam reveals a
restricted cranial rhythmic impulse. Palpation of the sphenobasilar synchondrosis
(SBS) reveals that the base of the sphenoid moves superiorly while the base of the
occiput moves inferiorly. Which of the following is the most likely diagnosis?
A. Flexion dysfunction
B. Extension dysfunction
C. Superior vertical shear
D. Inferior vertical shear
E. Torsion
Correct Answer: C. Superior vertical shear
Rationale: In a vertical shear, the sphenoid and occiput rotate in the same
direction about two transverse axes. A superior shear occurs when the base of the
sphenoid moves superiorly relative to the occiput. (Note: In flexion, both move
superiorly; in extension, both move inferiorly).
2. A 62-year-old male with a history of chronic smoking presents with a persistent
cough and weight loss. He has a drooping right eyelid and a constricted right pupil.
Chest X-ray reveals a mass in the apex of the right lung. Which of the following
structures is most likely compressed?
A. Recurrent laryngeal nerve
B. Phrenic nerve
C. Superior cervical ganglion
2|Page
, COMSAE 115 HIGH-YIELD EXAM PREP
D. Stellate ganglion
E. Vagus nerve
Correct Answer: D. Stellate ganglion
Rationale: This is a Pancoast tumor causing Horner Syndrome (ptosis, miosis,
anhidrosis). The sympathetic fibers to the face pass through the cervicothoracic
(stellate) ganglion, which sits near the apex of the lung.
3. During a routine physical, a patient is found to have a Chapman’s point located
at the second intercostal space, near the sternum. This reflex point is associated
with which of the following organs?
A. Thyroid
B. Heart
C. Esophagus
D. Upper Lung
E. Liver
Correct Answer: B. Heart
Rationale: Chapman’s points are high-yield. 2nd ICS = Heart/Thyroid/Esophagus
(Heart is the most common board answer for 2nd ICS). 3rd ICS = Upper Lung; 4th
ICS = Lower Lung.
3|Page
, COMSAE 115 HIGH-YIELD EXAM PREP
4. A 45-year-old male presents with low back pain. Examination shows a L2
segment that is rotated right and sidebent right. When the patient slumps
forward, the asymmetry worsens. What is the correct Type II diagnosis?
A. L2 Neutral SR RR
B. L2 Flexed SR RR
C. L2 Extended SR RR
D. L2 Flexed RR SR
E. L2 Extended RR SR
Correct Answer: C. L2 Extended SR RR
Rationale: Fryette’s Laws: Type II occurs at a single segment. Sidebending and
Rotation occur to the same side. If it worsens in flexion (slumping forward), it
"likes" extension. Therefore, it is an Extended dysfunction.
5. A 19-year-old male is brought to the ER after a football injury. He is unable to
initiate abduction of the right arm. An MRI shows a tear in a muscle of the rotator
cuff. Which of the following muscles is most likely injured?
A. Infraspinatus
B. Subscapularis
C. Teres minor
D. Supraspinatus
E. Teres major
Correct Answer: D. Supraspinatus
4|Page
