COMSAE Phase 1 Form 116 exam
QUESTIONS AND VERIFIED ANSWERS
WITH RATIONALES JUST RELEASED.pdf
1. A 45-year-old woman presents with epigastric burning and bloating after
meals. OMT reveals tenderness and increased tissue texture at the right T6-
T8 paraspinal region. Which viscerosomatic reflex best explains this finding?
A) Gallbladder
B) Pancreas
C) Stomach
D) Liver
Correct ,,,answer,,,: C) Stomach
Rationale: The stomach corresponds to spinal levels T6-T9 on the right. The
epigastric symptoms (burning, bloating after meals) point toward gastric
dysfunction. While the gallbladder reflex is also right-sided at T7-T9, the symptom
pattern is more consistent with stomach pathology .
2. A patient has chronic abdominal pain and fatty stools. Examination reveals
an anterior Chapman reflex point at the right 7th intercostal space near the
costochondral junction. Which organ is most likely involved?
A) Kidney
B) Pancreas
,C) Ovary
D) Appendix
Correct ,,,answer,,,: B) Pancreas
Rationale: The anterior Chapman point for the pancreas is located at the right 7th
intercostal space near the costochondral junction (posterior point is between T7
and T8 on the right). Pancreatic dysfunction often presents with epigastric pain
radiating to the back and steatorrhea (fatty stools) .
3. According to Fryette's first principle (Type I mechanics), when the spine is
in a neutral position (neither flexed nor extended), which of the following
occurs?
A) Sidebending and rotation occur to the same side
B) Sidebending occurs without rotation
C) Sidebending and rotation occur to opposite sides
D) Rotation occurs without sidebending
Correct ,,,answer,,,: C) Sidebending and rotation occur to opposite sides
Rationale: Fryette's first law states that when multiple vertebral segments are in
neutral, sidebending is accompanied by rotation in the opposite direction. This is a
key difference from Type II mechanics (non-neutral) .
4. A 35-year-old with chronic low back pain has a somatic dysfunction
characterized by ease of sidebending to the right and restriction of
,sidebending to the left. According to Fryette's laws, this most likely
represents:
A) Type I dysfunction (neutral mechanics)
B) Type II dysfunction (non-neutral mechanics)
C) Type III dysfunction
D) A normal functional spinal unit
Correct ,,,answer,,,: B) Type II dysfunction (non-neutral mechanics)
Rationale: Fryette's second law states that when the spine is in a non-neutral
position (flexed or extended), sidebending and rotation occur in opposite
directions. Restriction of sidebending to the left indicates a Type II dysfunction .
5. A 28-year-old presents with acute torticollis after sleeping in an awkward
position. Cervical examination shows the head rotated to the left and sidebent
to the right. The most likely diagnosis is:
A) Right rotated, right sidebent somatic dysfunction
B) Left rotated, left sidebent somatic dysfunction
C) Left rotated, right sidebent somatic dysfunction
D) Right rotated, left sidebent somatic dysfunction
Correct ,,,answer,,,: D) Right rotated, left sidebent somatic dysfunction
Rationale: In acute torticollis, the head is rotated away from the side of the
dysfunction and sidebent toward the side of the dysfunction. This presentation
describes rotation left with sidebending right, so the dysfunction is right rotated,
left sidebent .
, 6. A patient with low back pain has a right short leg in the supine position that
equalizes when sitting. The most likely diagnosis is:
A) Structural short right leg
B) Anterior innominate rotation on the left
C) Anterior innominate rotation on the right
D) Iliosacral shear
Correct ,,,answer,,,: C) Anterior innominate rotation on the right
Rationale: A short leg in supine that equalizes when sitting indicates a pelvic
dysfunction rather than a true structural leg length discrepancy. Anterior
innominate rotation on the right causes the right leg to appear shorter in supine
because the innominate rotates anteriorly, moving the acetabulum superiorly and
posteriorly .
7. A 28-year-old woman has a positive seated flexion test on the left. On
examination, the left sacral sulcus is deep and the left inferior lateral angle
(ILA) is prominent posteriorly and inferiorly. What is the most likely
diagnosis?
A) Left on left sacral torsion
B) Right on right sacral torsion
C) Left unilateral sacral flexion
D) Left unilateral sacral extension
Correct ,,,answer,,,: A) Left on left sacral torsion
Rationale: The seated flexion test points to the side of dysfunction (left). A deep
sacral sulcus and a prominent (posterior) ILA on the same side indicate a sacral
QUESTIONS AND VERIFIED ANSWERS
WITH RATIONALES JUST RELEASED.pdf
1. A 45-year-old woman presents with epigastric burning and bloating after
meals. OMT reveals tenderness and increased tissue texture at the right T6-
T8 paraspinal region. Which viscerosomatic reflex best explains this finding?
A) Gallbladder
B) Pancreas
C) Stomach
D) Liver
Correct ,,,answer,,,: C) Stomach
Rationale: The stomach corresponds to spinal levels T6-T9 on the right. The
epigastric symptoms (burning, bloating after meals) point toward gastric
dysfunction. While the gallbladder reflex is also right-sided at T7-T9, the symptom
pattern is more consistent with stomach pathology .
2. A patient has chronic abdominal pain and fatty stools. Examination reveals
an anterior Chapman reflex point at the right 7th intercostal space near the
costochondral junction. Which organ is most likely involved?
A) Kidney
B) Pancreas
,C) Ovary
D) Appendix
Correct ,,,answer,,,: B) Pancreas
Rationale: The anterior Chapman point for the pancreas is located at the right 7th
intercostal space near the costochondral junction (posterior point is between T7
and T8 on the right). Pancreatic dysfunction often presents with epigastric pain
radiating to the back and steatorrhea (fatty stools) .
3. According to Fryette's first principle (Type I mechanics), when the spine is
in a neutral position (neither flexed nor extended), which of the following
occurs?
A) Sidebending and rotation occur to the same side
B) Sidebending occurs without rotation
C) Sidebending and rotation occur to opposite sides
D) Rotation occurs without sidebending
Correct ,,,answer,,,: C) Sidebending and rotation occur to opposite sides
Rationale: Fryette's first law states that when multiple vertebral segments are in
neutral, sidebending is accompanied by rotation in the opposite direction. This is a
key difference from Type II mechanics (non-neutral) .
4. A 35-year-old with chronic low back pain has a somatic dysfunction
characterized by ease of sidebending to the right and restriction of
,sidebending to the left. According to Fryette's laws, this most likely
represents:
A) Type I dysfunction (neutral mechanics)
B) Type II dysfunction (non-neutral mechanics)
C) Type III dysfunction
D) A normal functional spinal unit
Correct ,,,answer,,,: B) Type II dysfunction (non-neutral mechanics)
Rationale: Fryette's second law states that when the spine is in a non-neutral
position (flexed or extended), sidebending and rotation occur in opposite
directions. Restriction of sidebending to the left indicates a Type II dysfunction .
5. A 28-year-old presents with acute torticollis after sleeping in an awkward
position. Cervical examination shows the head rotated to the left and sidebent
to the right. The most likely diagnosis is:
A) Right rotated, right sidebent somatic dysfunction
B) Left rotated, left sidebent somatic dysfunction
C) Left rotated, right sidebent somatic dysfunction
D) Right rotated, left sidebent somatic dysfunction
Correct ,,,answer,,,: D) Right rotated, left sidebent somatic dysfunction
Rationale: In acute torticollis, the head is rotated away from the side of the
dysfunction and sidebent toward the side of the dysfunction. This presentation
describes rotation left with sidebending right, so the dysfunction is right rotated,
left sidebent .
, 6. A patient with low back pain has a right short leg in the supine position that
equalizes when sitting. The most likely diagnosis is:
A) Structural short right leg
B) Anterior innominate rotation on the left
C) Anterior innominate rotation on the right
D) Iliosacral shear
Correct ,,,answer,,,: C) Anterior innominate rotation on the right
Rationale: A short leg in supine that equalizes when sitting indicates a pelvic
dysfunction rather than a true structural leg length discrepancy. Anterior
innominate rotation on the right causes the right leg to appear shorter in supine
because the innominate rotates anteriorly, moving the acetabulum superiorly and
posteriorly .
7. A 28-year-old woman has a positive seated flexion test on the left. On
examination, the left sacral sulcus is deep and the left inferior lateral angle
(ILA) is prominent posteriorly and inferiorly. What is the most likely
diagnosis?
A) Left on left sacral torsion
B) Right on right sacral torsion
C) Left unilateral sacral flexion
D) Left unilateral sacral extension
Correct ,,,answer,,,: A) Left on left sacral torsion
Rationale: The seated flexion test points to the side of dysfunction (left). A deep
sacral sulcus and a prominent (posterior) ILA on the same side indicate a sacral
