Page 1 of 198
COMLEX USA Level 1 Prep | COMSAE Phase
1 Form 113 Direct Content Practice Exam 200+
Questions with Bold Italic Answers &
Rationales for Osteopathic Medical Students |
pdf
Question 1
A 45-year-old male presents with chronic low back pain. During
evaluation, you note a Type I (neutral) somatic dysfunction in the
lumbar spine. According to Fryette's principles, how would you
describe this dysfunction?
A) A group of vertebrae is flexed or extended with restricted
side bending in one direction and rotation to the opposite side
B) A single vertebra is dysfunctional in a flexed or extended
position
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C) A group of vertebrae is side bent and rotated in opposite
directions
D) A group of vertebrae is side bent and rotated in the same
direction
Rationale: Fryette's Type I dysfunction (neutral mechanics) occurs
when a group of vertebrae in a neutral position (neither flexed
nor extended) exhibits side bending and rotation in the same
direction. Type II (non-neutral) involves a single vertebra with
side bending and rotation in opposite directions when the spine is
flexed or extended .
Question 2
A 28-year-old female presents with right-sided tension
headaches. On examination, you find tenderness at the medial
aspect of the right knee, approximately 2 cm proximal to the
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joint line. This finding is most consistent with a Chapman's reflex
point for which organ?
A) Gallbladder
B) Appendix
C) Kidney
D) Spleen
Rationale: The Chapman's reflex point for the appendix is
located at the medial aspect of the right knee, approximately 1-
2 cm proximal to the joint line. Chapman's reflexes are
gangliform contractions in the deep fascia that represent
visceral-somatic reflexes. Points for the gallbladder are found
near the right costal margin, not the knee .
Question 3
During a cranial osteopathic evaluation, you place your hands on
the patient's head with your thenar eminences contacting the
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greater wings of the sphenoid and your fingers resting along the
temporal bones. You then assess the flexion-extension motion of
the sphenobasilar synchondrosis (SBS). This hand placement
describes which cranial technique?
A) Vault Hold
B) Frontal Lift
C) Temporal Lift
D) Occipito-Atlantal Decompression
Rationale: The Vault Hold (also called the Sphenobasilar Hold)
uses the thenar eminences on the greater wings of the sphenoid
with fingers resting on the temporal bones to assess the inherent
rhythmic motion (Cranial Rhythmic Impulse) of the SBS .
Question 4
A 32-year-old patient involved in a rear-end collision several
weeks ago presents with neck pain. You diagnose an acute Type
COMLEX USA Level 1 Prep | COMSAE Phase
1 Form 113 Direct Content Practice Exam 200+
Questions with Bold Italic Answers &
Rationales for Osteopathic Medical Students |
Question 1
A 45-year-old male presents with chronic low back pain. During
evaluation, you note a Type I (neutral) somatic dysfunction in the
lumbar spine. According to Fryette's principles, how would you
describe this dysfunction?
A) A group of vertebrae is flexed or extended with restricted
side bending in one direction and rotation to the opposite side
B) A single vertebra is dysfunctional in a flexed or extended
position
,Page 2 of 198
C) A group of vertebrae is side bent and rotated in opposite
directions
D) A group of vertebrae is side bent and rotated in the same
direction
Rationale: Fryette's Type I dysfunction (neutral mechanics) occurs
when a group of vertebrae in a neutral position (neither flexed
nor extended) exhibits side bending and rotation in the same
direction. Type II (non-neutral) involves a single vertebra with
side bending and rotation in opposite directions when the spine is
flexed or extended .
Question 2
A 28-year-old female presents with right-sided tension
headaches. On examination, you find tenderness at the medial
aspect of the right knee, approximately 2 cm proximal to the
,Page 3 of 198
joint line. This finding is most consistent with a Chapman's reflex
point for which organ?
A) Gallbladder
B) Appendix
C) Kidney
D) Spleen
Rationale: The Chapman's reflex point for the appendix is
located at the medial aspect of the right knee, approximately 1-
2 cm proximal to the joint line. Chapman's reflexes are
gangliform contractions in the deep fascia that represent
visceral-somatic reflexes. Points for the gallbladder are found
near the right costal margin, not the knee .
Question 3
During a cranial osteopathic evaluation, you place your hands on
the patient's head with your thenar eminences contacting the
, Page 4 of 198
greater wings of the sphenoid and your fingers resting along the
temporal bones. You then assess the flexion-extension motion of
the sphenobasilar synchondrosis (SBS). This hand placement
describes which cranial technique?
A) Vault Hold
B) Frontal Lift
C) Temporal Lift
D) Occipito-Atlantal Decompression
Rationale: The Vault Hold (also called the Sphenobasilar Hold)
uses the thenar eminences on the greater wings of the sphenoid
with fingers resting on the temporal bones to assess the inherent
rhythmic motion (Cranial Rhythmic Impulse) of the SBS .
Question 4
A 32-year-old patient involved in a rear-end collision several
weeks ago presents with neck pain. You diagnose an acute Type
