We present a coupled forward-adjoint Monte Carlo (cFAMC) method to determine the spatially resolved sensitivity distributions produced by optical interrogation of three-dimensional (3-D) tissue volumes. We develop a general computational framework that computes the spatial and angular distributions of the forward-adjoint light fields to provide accurate computations in mesoscopic tissue volumes. We provide full computational details of the cFAMC method and provide results for low- and high-scattering tissues probed using a single pair of optical fibers. We examine the effects of source-detector separation and orientation on the sensitivity distributions and consider how the degree of angular discretization used in the 3-D tissue model impacts the accuracy of the resulting absorption sensitivity profiles. We discuss the value of such computations for optical imaging and the design of optical measurements.