Page 1 of 50
COMSAE PHASE 1 – FORM 113 2026
EXAMINATION COMPLETE (150) CURRENT
TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED
RATIONALES|GRADED A+.
COMSAE
Prepare for the COMSAE Phase 1 – Form 113 Examination with practice
questions covering anatomy, physiology, pathology, pharmacology,
microbiology, osteopathic principles, and clinical sciences. This study
guide helps reinforce essential medical knowledge and supports effective
osteopathic board exam preparation. Designed to improve clinical
reasoning skills and boost confidence in applying foundational and
clinical medicine concepts. Suitable for osteopathic medical students
preparing for COMLEX and COMSAE examinations.
Multiple choice.
Section 1: Gross Anatomy & Embryology (Questions 1–30)
1. Which bone articulates with the acetabulum to form the hip joint?
A. Tibia
B. Fibula
C. Femur
D. Patella
Answer: C. Femur – The femoral head articulates with the
acetabulum of the os coxae.
, Page 2 of 50
2. A stab wound to the superior mediastinum most directly risks
injury to which structure?
A. Brachiocephalic vein
B. Azygos vein
C. Phrenic nerve (already inferior)
D. Thoracic duct
Answer: A. Brachiocephalic vein – The left and right brachiocephalic
veins unite in the superior mediastinum to form the SVC.
3. During development, failure of the neural tube to close at the
cranial end causes:
A. Spina bifida occulta
B. Anencephaly
C. Meningocele
D. Chiari malformation
Answer: B. Anencephaly – Cranial neural tube defect; spina bifida is
caudal.
4. Which nerve is compressed in carpal tunnel syndrome?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Musculocutaneous nerve
Answer: B. Median nerve – The median nerve passes through the
carpal tunnel with flexor tendons.
5. The ligamentum teres (ligament of the head of the femur) carries
which artery?
A. Artery to the head of the femur
B. Obturator artery
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C. Medial circumflex femoral artery
D. Lateral circumflex femoral artery
Answer: A. Artery to the head of the femur – A branch of the
obturator artery; supplies femoral head in children.
6. A patient cannot evert the foot. Which nerve is damaged?
A. Tibial nerve
B. Superficial peroneal nerve
C. Deep peroneal nerve
D. Sural nerve
Answer: B. Superficial peroneal nerve – Innervates peroneus
longus/brevis (foot everters). Deep peroneal dorsiflexes.
7. The portal vein is formed by the union of:
A. Splenic vein and inferior mesenteric vein
B. Splenic vein and superior mesenteric vein
C. Superior mesenteric vein and inferior mesenteric vein
D. Gastric vein and splenic vein
Answer: B. Splenic vein and superior mesenteric vein – The IMV
drains into splenic vein.
8. A 45-year-old man has a stroke affecting the posterior cerebral
artery. Which deficit is most likely?
A. Motor weakness of legs
B. Contralateral homonymous hemianopia with macular sparing
C. Global aphasia
D. Ataxia
Answer: B. Contralateral homonymous hemianopia with macular
sparing – PCA supplies occipital lobe (visual cortex).
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9. The first branch of the abdominal aorta is:
A. Inferior phrenic artery
B. Celiac trunk
C. Superior mesenteric artery
D. Renal artery
Answer: A. Inferior phrenic artery – Often overlooked; celiac is
anterior, but the first paired branch is inferior phrenic.
10. Which pharyngeal arch contributes to the muscles of facial
expression?
A. First arch
B. Second arch
C. Third arch
D. Fourth arch
Answer: B. Second arch – Second arch gives facial nerve (CN VII)
and muscles of facial expression. First gives mastication.
11. A patient with a fractured clavicle at the junction of middle and
lateral thirds typically has weakness in which muscle?
A. Pectoralis major
B. Trapezius
C. Deltoid
D. Biceps brachii
Answer: C. Deltoid – Fracture can injure the axillary nerve or
compromise the clavicular head of deltoid origin, but more directly:
weakness in arm abduction >15°.
12. The ureter passes _____ to the uterine artery in females.
A. Anterior
B. Posterior
COMSAE PHASE 1 – FORM 113 2026
EXAMINATION COMPLETE (150) CURRENT
TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED
RATIONALES|GRADED A+.
COMSAE
Prepare for the COMSAE Phase 1 – Form 113 Examination with practice
questions covering anatomy, physiology, pathology, pharmacology,
microbiology, osteopathic principles, and clinical sciences. This study
guide helps reinforce essential medical knowledge and supports effective
osteopathic board exam preparation. Designed to improve clinical
reasoning skills and boost confidence in applying foundational and
clinical medicine concepts. Suitable for osteopathic medical students
preparing for COMLEX and COMSAE examinations.
Multiple choice.
Section 1: Gross Anatomy & Embryology (Questions 1–30)
1. Which bone articulates with the acetabulum to form the hip joint?
A. Tibia
B. Fibula
C. Femur
D. Patella
Answer: C. Femur – The femoral head articulates with the
acetabulum of the os coxae.
, Page 2 of 50
2. A stab wound to the superior mediastinum most directly risks
injury to which structure?
A. Brachiocephalic vein
B. Azygos vein
C. Phrenic nerve (already inferior)
D. Thoracic duct
Answer: A. Brachiocephalic vein – The left and right brachiocephalic
veins unite in the superior mediastinum to form the SVC.
3. During development, failure of the neural tube to close at the
cranial end causes:
A. Spina bifida occulta
B. Anencephaly
C. Meningocele
D. Chiari malformation
Answer: B. Anencephaly – Cranial neural tube defect; spina bifida is
caudal.
4. Which nerve is compressed in carpal tunnel syndrome?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Musculocutaneous nerve
Answer: B. Median nerve – The median nerve passes through the
carpal tunnel with flexor tendons.
5. The ligamentum teres (ligament of the head of the femur) carries
which artery?
A. Artery to the head of the femur
B. Obturator artery
, Page 3 of 50
C. Medial circumflex femoral artery
D. Lateral circumflex femoral artery
Answer: A. Artery to the head of the femur – A branch of the
obturator artery; supplies femoral head in children.
6. A patient cannot evert the foot. Which nerve is damaged?
A. Tibial nerve
B. Superficial peroneal nerve
C. Deep peroneal nerve
D. Sural nerve
Answer: B. Superficial peroneal nerve – Innervates peroneus
longus/brevis (foot everters). Deep peroneal dorsiflexes.
7. The portal vein is formed by the union of:
A. Splenic vein and inferior mesenteric vein
B. Splenic vein and superior mesenteric vein
C. Superior mesenteric vein and inferior mesenteric vein
D. Gastric vein and splenic vein
Answer: B. Splenic vein and superior mesenteric vein – The IMV
drains into splenic vein.
8. A 45-year-old man has a stroke affecting the posterior cerebral
artery. Which deficit is most likely?
A. Motor weakness of legs
B. Contralateral homonymous hemianopia with macular sparing
C. Global aphasia
D. Ataxia
Answer: B. Contralateral homonymous hemianopia with macular
sparing – PCA supplies occipital lobe (visual cortex).
, Page 4 of 50
9. The first branch of the abdominal aorta is:
A. Inferior phrenic artery
B. Celiac trunk
C. Superior mesenteric artery
D. Renal artery
Answer: A. Inferior phrenic artery – Often overlooked; celiac is
anterior, but the first paired branch is inferior phrenic.
10. Which pharyngeal arch contributes to the muscles of facial
expression?
A. First arch
B. Second arch
C. Third arch
D. Fourth arch
Answer: B. Second arch – Second arch gives facial nerve (CN VII)
and muscles of facial expression. First gives mastication.
11. A patient with a fractured clavicle at the junction of middle and
lateral thirds typically has weakness in which muscle?
A. Pectoralis major
B. Trapezius
C. Deltoid
D. Biceps brachii
Answer: C. Deltoid – Fracture can injure the axillary nerve or
compromise the clavicular head of deltoid origin, but more directly:
weakness in arm abduction >15°.
12. The ureter passes _____ to the uterine artery in females.
A. Anterior
B. Posterior
