COMSAE - Comprehensive Osteopathic Medical Self-Assessment Examination Musculoskeletal System Questions and Answers

Question 1

A 45-year-old male presents with acute, colicky right upper quadrant pain that is exacerbated by fatty meals.
On osteopathic structural exam, you note tissue texture changes and paraspinal hypertonicity from T5 to T9 on the right.
Which of the following anterior Chapman's points would most likely be present in this patient?

Accepted Answer

In the 6th intercostal space on the right at the mid-mammary line

Answer

In the 2nd intercostal space near the sternum on the right

Answer

In the 5th intercostal space from the mid-mammary line to the sternum on the left

Answer

On the tip of the twelfth rib on the right

Question 2

A 28-year-old female presents with low back pain and constipation. Osteopathic examination reveals a sacral somatic dysfunction. Which of the following osteopathic manipulative treatment (OMT) techniques would be particularly effective for addressing both the somatic dysfunction and the patient's visceral symptoms?

Accepted Answer

Sacral rocking (articulatory technique)

Answer

Cervical spine muscle energy

Answer

Thoracic spine high-velocity, low-amplitude (HVLA)

Answer

Rib raising

Question 3

Which of the following describes the physiological principle behind the muscle energy technique (MET) of post-isometric relaxation?

Accepted Answer

Activating the Golgi tendon organ to induce reflex muscle inhibition

Answer

Stretching the muscle spindle to cause a reflex muscle contraction

Answer

Applying deep pressure to a tender point to release muscle tension

Answer

Using the respiratory cycle to influence fascial tension

Question 4

A 65-year-old female with a history of rheumatoid arthritis presents with symmetrical pain, swelling, and stiffness in the small joints of her hands and feet, which is worse in the morning. Which of the following physical exam findings would be most specific for this patient's condition?

Accepted Answer

Boutonnière and swan-neck deformities

Answer

Heberden's nodes

Answer

Positive Finkelstein's test

Answer

Crepitus on passive range of motion

Question 5

A patient is diagnosed with a left unilateral sacral flexion. During the osteopathic structural exam, which of the following findings would be expected?

Accepted Answer

Positive seated flexion test on the left, deep sacral sulcus on the left, and posterior/inferior ILA on the left

Answer

Positive seated flexion test on the right, deep sacral sulcus on the left, and posterior/inferior ILA on the left

Answer

Positive seated flexion test on the right, deep sacral sulcus on the right, and posterior/inferior ILA on the right

Answer

Positive seated flexion test on the left, shallow sacral sulcus on the left, and anterior/superior ILA on the left

Question 6

A patient complains of mid-back pain. Layer-by-layer palpation reveals ropy, hypertonic paraspinal muscles at the T5-T9 level on the left, along with skin that feels boggy and moist. The patient has a history of gastritis. This clinical picture is most representative of which of the following phenomena?

Accepted Answer

Viscero-somatic reflex

Answer

Somato-somatic reflex

Answer

Chapman's reflex

Answer

Somato-visceral reflex