COMSAE PHASE 1 FORM 114 Actual
EXAM – 180 QUESTIONS AND
ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
Section 1: Osteopathic Principles & Practice (OPP) – Questions
1–25
Q1. A 45-year-old male presents with low back pain after lifting a
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) Right anterior innominate
Rationale: A positive standing flexion test on the right suggests
iliosacral dysfunction on that side. For a right anterior innominate,
the right ASIS is positioned more inferiorly, creating a functional
short right leg and a positive standing flexion test on the right.
,Q2. A 35-year-old with chronic low back pain has a short left leg
on observation. Pelvic landmarks reveal a left posterior inferior
iliac spine (PIIS) and a right anterior superior iliac spine (ASIS)
more cephalad. What is the most likely somatic dysfunction?
A) Left on left torsion
B) Right on right torsion
C) Left on right torsion
D) Right on left torsion
Answer: C) Left on right torsion
Rationale: "Left on right" torsion means the left innominate
rotates anteriorly (ASIS down) relative to the sacrum, while the
right rotates posteriorly – consistent with left PIIS and right ASIS
being higher.
Q3. 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) To opposite sides
Rationale: Fryette's first principle states that in a neutral spine
(neither flexed nor extended), sidebending and rotation occur to
opposite sides.
Q4. A 30-year-old female with chronic headaches undergoes
OMM. You find that the right mastoid process is posterior and
,inferior compared to the left. Which somatic dysfunction best
describes this finding?
A) Right rotation, right sidebending (Type I)
B) Left rotation, right sidebending (Type II)
C) Right rotation, left sidebending (Type II)
D) Left rotation, left sidebending (Type I)
Answer: B) Left rotation, right sidebending
Rationale: The mastoid process moving posterior indicates
rotation to the opposite side. The mastoid moving inferior
indicates sidebending to the same side (Type II mechanics:
rotation and sidebending occur in opposite directions). Here, right
mastoid is posterior/inferior → rotation to the left, sidebending to
the right.
Q5. Which Chapman reflex point is associated with the kidney?
A) Midpoint of the clavicle, 2nd intercostal space
B) Tip of the 12th rib, 1 inch lateral to the spine
C) Umbilicus, 2 inches inferior
D) Medial humeral epicondyle
Answer: B) Tip of the 12th rib, ~1 inch lateral to spine
Rationale: The kidney Chapman reflex is located at the tip of the
12th rib, approximately 1 inch lateral to the spinous process.
Q6. A patient with asthma has tenderness at the 2nd intercostal
space, sternal border. This represents a Chapman reflex for which
organ?
A) Heart
, B) Lungs
-- D) Liver
Answer: B) Lungs
Rationale: Anterior lung Chapman points are located at the 2nd–
4th intercostal spaces parasternal.
Q7. The cranial rhythmic impulse (CRI) is most commonly
palpated at what rate in adults?
A) 2–4 cycles/min
B) 8–12 cycles/min
C) 16–20 cycles/min
D) 24–30 cycles/min
Answer: B) 8–12 cycles/min
Rationale: The cranial rhythmic impulse (CRI) is typically palpated
at a rate of 8–12 cycles per minute in adults.
Q8. Which muscle energy treatment is preferred for an acute
torticollis with left rotation and right sidebending restriction at
C2?
A) Left rotation, right sidebending against resistance
B) Right rotation, left sidebending (away from restriction)
with isometric contraction
C) Neutral position only
D) Traction without rotation
Answer: B) Right rotation, left sidebending
Rationale: In Type II somatic dysfunction, the isometric
contraction is applied away from the restrictive barrier.
EXAM – 180 QUESTIONS AND
ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
Section 1: Osteopathic Principles & Practice (OPP) – Questions
1–25
Q1. A 45-year-old male presents with low back pain after lifting a
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) Right anterior innominate
Rationale: A positive standing flexion test on the right suggests
iliosacral dysfunction on that side. For a right anterior innominate,
the right ASIS is positioned more inferiorly, creating a functional
short right leg and a positive standing flexion test on the right.
,Q2. A 35-year-old with chronic low back pain has a short left leg
on observation. Pelvic landmarks reveal a left posterior inferior
iliac spine (PIIS) and a right anterior superior iliac spine (ASIS)
more cephalad. What is the most likely somatic dysfunction?
A) Left on left torsion
B) Right on right torsion
C) Left on right torsion
D) Right on left torsion
Answer: C) Left on right torsion
Rationale: "Left on right" torsion means the left innominate
rotates anteriorly (ASIS down) relative to the sacrum, while the
right rotates posteriorly – consistent with left PIIS and right ASIS
being higher.
Q3. 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) To opposite sides
Rationale: Fryette's first principle states that in a neutral spine
(neither flexed nor extended), sidebending and rotation occur to
opposite sides.
Q4. A 30-year-old female with chronic headaches undergoes
OMM. You find that the right mastoid process is posterior and
,inferior compared to the left. Which somatic dysfunction best
describes this finding?
A) Right rotation, right sidebending (Type I)
B) Left rotation, right sidebending (Type II)
C) Right rotation, left sidebending (Type II)
D) Left rotation, left sidebending (Type I)
Answer: B) Left rotation, right sidebending
Rationale: The mastoid process moving posterior indicates
rotation to the opposite side. The mastoid moving inferior
indicates sidebending to the same side (Type II mechanics:
rotation and sidebending occur in opposite directions). Here, right
mastoid is posterior/inferior → rotation to the left, sidebending to
the right.
Q5. Which Chapman reflex point is associated with the kidney?
A) Midpoint of the clavicle, 2nd intercostal space
B) Tip of the 12th rib, 1 inch lateral to the spine
C) Umbilicus, 2 inches inferior
D) Medial humeral epicondyle
Answer: B) Tip of the 12th rib, ~1 inch lateral to spine
Rationale: The kidney Chapman reflex is located at the tip of the
12th rib, approximately 1 inch lateral to the spinous process.
Q6. A patient with asthma has tenderness at the 2nd intercostal
space, sternal border. This represents a Chapman reflex for which
organ?
A) Heart
, B) Lungs
-- D) Liver
Answer: B) Lungs
Rationale: Anterior lung Chapman points are located at the 2nd–
4th intercostal spaces parasternal.
Q7. The cranial rhythmic impulse (CRI) is most commonly
palpated at what rate in adults?
A) 2–4 cycles/min
B) 8–12 cycles/min
C) 16–20 cycles/min
D) 24–30 cycles/min
Answer: B) 8–12 cycles/min
Rationale: The cranial rhythmic impulse (CRI) is typically palpated
at a rate of 8–12 cycles per minute in adults.
Q8. Which muscle energy treatment is preferred for an acute
torticollis with left rotation and right sidebending restriction at
C2?
A) Left rotation, right sidebending against resistance
B) Right rotation, left sidebending (away from restriction)
with isometric contraction
C) Neutral position only
D) Traction without rotation
Answer: B) Right rotation, left sidebending
Rationale: In Type II somatic dysfunction, the isometric
contraction is applied away from the restrictive barrier.
