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100+ Free AOBNMM NMM/OMM Practice Questions

Pass your AOBNMM Neuromusculoskeletal Medicine Primary Certifying Examination exam on the first try — instant access, no signup required.

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~80-90% Pass Rate
100+ Questions
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Question 1
Score: 0/0

Which OMT technique is appropriate for postoperative ileus to encourage GI motility?

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2026 Statistics

Key Facts: AOBNMM NMM/OMM Exam

$600

Fee Per Component (3 components)

AOBNMM 2026

$1,800

Total Initial Certification Cost

AOBNMM 2026

150 MCQs

Written Exam Questions

AOBNMM Written Exam

3 hours

Written Exam Time Limit

AOBNMM

6 cases

Oral Exam Cases (50 minutes total)

AOBNMM Oral Exam

~80-90%

First-Attempt Pass Rate (historical)

AOBNMM published rates

AOBNMM is the DO-unique osteopathic specialty certification, requiring NMM/OMM residency training plus three exam components (Written/Oral/Practical) at $600 each ($1,800 total). The 3-hour Written has 150 case-based MCQs, the Oral covers six cases in two 25-minute sessions, and the Practical is a one-day in-person hands-on evaluation. The blueprint emphasizes palpatory diagnosis, OMT techniques (direct, indirect, cranial, lymphatic), regional applications (cervical through extremities), Fryette's principles, Chapman's reflexes, viscerosomatic reflexes, and integration with primary care.

Sample AOBNMM NMM/OMM Practice Questions

Try these sample questions to test your AOBNMM NMM/OMM exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which of the following is NOT one of the four components of TART criteria for somatic dysfunction?
A.Tissue texture change
B.Asymmetry of bony landmarks
C.Restricted motion
D.Range of motion symmetry
Explanation: TART criteria for diagnosing somatic dysfunction include Tissue texture change, Asymmetry of bony landmarks, Restricted motion, and Tenderness. Symmetric range of motion is normal, not a marker of dysfunction.
2According to Fryette's Type I principle, when the thoracic or lumbar spine is in a neutral position and group sidebending occurs, which of the following is true?
A.Rotation occurs to the same side as sidebending
B.Rotation occurs to the opposite side of sidebending
C.There is no rotation component
D.Rotation depends only on the operator's preference
Explanation: Fryette's Type I (neutral mechanics): in neutral position, sidebending and rotation occur to OPPOSITE sides; typically involves a group of three or more segments. Type II (non-neutral): in flexion or extension, sidebending and rotation occur to the SAME side, usually single-segment.
3Which OMT technique uses a 90-second passive hold at the position of comfort with continuous tender-point monitoring, followed by slow passive return to neutral?
A.High-velocity low-amplitude (HVLA)
B.Muscle energy
C.Counterstrain (Strain-Counterstrain / Jones technique)
D.Myofascial release
Explanation: Counterstrain (Strain-Counterstrain), developed by Lawrence Jones, places the patient passively into a position of comfort that reduces tenderness at the monitored tender point by at least 70%. The position is held for 90 seconds, then the patient is returned slowly to neutral.
4A patient has a tender point at the medial PSIS region described as 'posterior lumbar 5 (PL5).' Which is the appropriate position for counterstrain treatment?
A.Extension, sidebending toward, rotation toward
B.Flexion, sidebending away, rotation away
C.Pure flexion only
D.Pure extension only
Explanation: Posterior lumbar tender points are generally treated in extension with sidebending and rotation toward the tender point. For PL5 (medial PSIS area), this typically involves extension, ipsilateral sidebending, and rotation, modified to achieve 70%+ relief of tenderness at the monitored point.
5Which is an ABSOLUTE contraindication to cervical HVLA?
A.Mild cervical somatic dysfunction
B.Down syndrome with atlantoaxial instability
C.Stable migraine headaches
D.Chronic mechanical low back pain
Explanation: Absolute contraindications to cervical HVLA include atlantoaxial instability (Down syndrome, rheumatoid arthritis with C1-C2 instability), acute cervical fracture, vertebrobasilar insufficiency, severe osteoporosis with bone fragility, malignancy at the treatment site, and acute infection.
6Which is the correct mechanism of muscle energy technique?
A.A high-velocity thrust through the restrictive barrier
B.Patient performs an isometric contraction (typically 3-5 seconds) against the operator's resistance at the restrictive barrier, then post-isometric relaxation allows engagement of new barrier
C.A passive hold at the point of comfort for 90 seconds
D.A high-amplitude springing motion through the available range
Explanation: Muscle energy is a direct, active technique. The operator places the patient at the restrictive barrier, the patient performs an isometric contraction (3-5 seconds) against operator resistance, then relaxes for 1-2 seconds while the operator re-engages the new barrier. Repeat 3-5 times.
7Which cranial bone is described as the 'keystone' of the cranial mechanism due to its central position and articulations with all other cranial bones except the mandible?
A.Occiput
B.Sphenoid
C.Temporal
D.Ethmoid
Explanation: The sphenoid is the keystone of the cranium - it articulates with all other cranial bones (frontal, parietal, temporal, occipital, ethmoid, vomer, palatines, zygomatic) except the mandible. The sphenobasilar synchondrosis (SBS) is the key articulation between sphenoid and occiput in cranial osteopathy.
8Which cranial technique involves gentle bilateral compression of the occipital squama just inferior to the lambdoidal sutures to encourage CSF fluctuation and parasympathetic balance?
A.V-spread
B.Compression of the fourth ventricle (CV4)
C.OA decompression
D.Frontal lift
Explanation: CV4 (compression of the fourth ventricle) is performed by placing the thenar eminences along the occipital squama just inferior to the lambdoidal sutures, then encouraging gentle compression to accentuate flexion (slow CSF fluctuation) and induce a 'still point.' Useful for general homeostasis, fever, headache, sympathetic dominance.
9Which lymphatic technique is performed at the start of any lymphatic treatment to release the thoracic inlet (Sibson's fascia)?
A.Pedal pump
B.Thoracic inlet release (Sibson's fascia release)
C.Splenic pump
D.Abdominal pump
Explanation: Thoracic inlet release is the first step in lymphatic treatment because the thoracic duct empties into venous circulation at the left subclavian-internal jugular junction. Releasing the thoracic inlet (Sibson's fascia from C7, T1, ribs 1 and 2) ensures unobstructed lymphatic drainage proximally.
10Which is the Chapman's anterior reflex point for the bronchi?
A.2nd intercostal space adjacent to the sternum
B.5th-6th intercostal space on the right
C.11th rib at the costochondral junction
D.Lateral pubic ramus
Explanation: The Chapman's anterior reflex point for the bronchi is in the 2nd intercostal space adjacent to the sternum. Other key Chapman's points: liver (5th-6th ICS right), thyroid (2nd ICS lateral to sternum), ovary (11th rib costochondral junction), uterus (lateral pubic ramus). Posterior Chapman's points are paraspinal at the same vertebral level.

About the AOBNMM NMM/OMM Exam

The AOBNMM Primary Certifying Examination is the AOA pathway for board certification in Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine (NMM/OMM). It comprises three components: a 3-hour Written Exam (150 case-based MCQs delivered remote-proctored), an Oral Exam (six cases over 50 minutes), and an in-person Practical Exam evaluating hands-on diagnostic and OMT skills. Candidates apply for each component separately at $600 per component.

Questions

100 scored questions

Time Limit

Written 3 hours (150 MCQs); Oral 50 minutes (6 cases); Practical 1 day in-person

Passing Score

Criterion-referenced scaled standard set by AOBNMM (typical AOA scale ~500/800)

Exam Fee

$600 per component x 3 = $1,800 total (American Osteopathic Board of Neuromusculoskeletal Medicine (AOBNMM))

AOBNMM NMM/OMM Exam Content Outline

15%

Palpatory Diagnosis and Somatic Dysfunction

TART criteria (Tissue texture change, Asymmetry, Restricted motion, Tenderness), Fryette's principles I (neutral, type I: sidebending and rotation oppose), II (non-neutral, type II: sidebending and rotation same side), III (motion in one plane affects other planes), regional palpatory landmarks, screening exam, and segmental motion testing.

20%

Direct OMT Techniques

HVLA (engages restrictive barrier, single thrust through barrier - cervical Type II, thoracic seated, lumbar Type II), muscle energy (isometric contraction 3-5 seconds at restrictive barrier, then post-isometric relaxation), articulatory technique (springing through ROM), Still technique (indirect-direct combined), facilitated positional release principles, contraindications (acute fracture, instability, Down syndrome cervical HVLA, RA, malignancy).

20%

Indirect OMT Techniques

Counterstrain (90-second hold at point of comfort, monitor tender point, slow return), Jones tender points (anterior cervical, posterior cervical, anterior/posterior thoracic, lumbar, sacral, pelvic, rib), facilitated positional release (FPR - 3-5 seconds at point of ease), balanced ligamentous tension (BLT - balance ligamentous tensions, respiratory cooperation), myofascial release (direct and indirect, fascial unwinding), still indirect technique.

10%

Cranial Osteopathy and Lymphatic Techniques

Primary respiratory mechanism (PRM): 5 phenomena - inherent motility of CNS, fluctuation of CSF, mobility of intracranial/intraspinal membranes (reciprocal tension membrane), articular mobility of cranial bones, involuntary mobility of sacrum between ilia. CV4 (compression of fourth ventricle), V-spread (sutural release), OA decompression. Lymphatic: thoracic inlet release, thoracic pump, pedal pump, abdominal/splenic pump, mesenteric release.

15%

Regional Applications

Cervical: OA (Type II only - motion testing in flexion/extension), AA (rotation only), C2-C7 (Type II per Fryette). Thoracic: T1-T4 atypical, T5-T12 typical (rule of 3s for spinous-transverse process relationship). Lumbar: Type I and Type II. Sacrum: 4 sacral diagnoses (R on R, L on L, R on L, L on R) involving oblique axes; sacral torsions diagnosed by sphinx test. Pelvis: 5 innominate dysfunctions (anterior/posterior rotation, superior/inferior shear, in-flare/out-flare). Ribs: inhalation (rib 'up'), exhalation (rib 'down'), structural (anterior/posterior). Extremities: shoulder, elbow, wrist, hip, knee, ankle, foot.

10%

OMM in Primary Care and Specialty Practice

Acute mechanical LBP (muscle energy, HVLA per indications), chronic LBP (multimodal OMT + exercise + psychosocial), tension/cervicogenic headache (suboccipital release, cervical ME), pneumonia/COPD/asthma (rib raising, thoracic pump, lymphatic), postoperative ileus (mesenteric release, sacral release), postpartum (pelvic balancing, sacral techniques), pediatric (cranial molding, plagiocephaly, otitis media via mandibular drainage), obstetric (pelvic balancing, sacral techniques), sports medicine (extremity OMT, return-to-play).

5%

Viscerosomatic Reflexes and Autonomic Integration

Sympathetic innervation T1-L2: head/neck T1-T4, heart T1-T5, lungs T2-T7, upper GI T5-T9, lower GI T10-T11, kidney T10-T11, adrenal T10, ureter T10-L1, bladder T11-L2, uterus T10-L2, ovary T10. Parasympathetic: vagus (CN X) for heart, lungs, GI to splenic flexure; S2-S4 for descending colon, pelvic organs. Chapman's anterior reflex points (e.g., bronchi - 2nd ICS, thyroid - 2nd ICS lateral; ovary - 11th rib; liver - 5th-6th ICS right; pyloric stenosis - 6th ICS right).

5%

Osteopathic Principles and Tenets

Four tenets: (1) body is a unit (body-mind-spirit); (2) body is capable of self-regulation, self-healing, health maintenance; (3) structure and function are reciprocally interrelated; (4) rational treatment is based on these principles. A.T. Still founded osteopathy in 1874. Integration with evidence-based medicine, scope of NMM/OMM practice, ethics, and patient-centered care.

How to Pass the AOBNMM NMM/OMM Exam

What You Need to Know

  • Passing score: Criterion-referenced scaled standard set by AOBNMM (typical AOA scale ~500/800)
  • Exam length: 100 questions
  • Time limit: Written 3 hours (150 MCQs); Oral 50 minutes (6 cases); Practical 1 day in-person
  • Exam fee: $600 per component x 3 = $1,800 total

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

AOBNMM NMM/OMM Study Tips from Top Performers

1Drill Fryette's principles to instant recall: Type I (neutral, sidebending and rotation oppose - 'group curves' usually >=3 segments in thoracic/lumbar), Type II (non-neutral - flexed or extended; sidebending and rotation to the same side - typically single-segment dysfunctions), Type III (motion introduced in one plane reduces motion in other planes). Cervical: OA is Type II only (motion in F/E with rotation opposite of sidebending), AA is rotation-dominant (50% of cervical rotation), C2-C7 are Type II per Fryette.
2Memorize counterstrain rules: 90-second passive hold at the point of comfort/ease with continuous tender-point monitoring, slow passive return to neutral. Recognize the most common Jones tender points: anterior cervical at the lateral mass, posterior cervical along the spinous and transverse processes, anterior chest wall (rib counterstrain), psoas (lower abdomen), piriformis (sciatic notch), iliacus, and PL5 (lumbar 5 posterior tender at the medial PSIS).
3Master sacral diagnosis: forward torsions (R on R, L on L) - 'like on like' axis - more common, posterior surface rotates POSTERIORLY on the named oblique axis; backward torsions (R on L, L on R) - 'unlike on unlike' axis - less common, posterior surface rotates anteriorly. Use sphinx (extension) test: deep sulcus deepens on rotated side in forward torsion (no change in backward torsion).
4Learn rib dysfunctions: inhalation (rib 'up' or 'stuck up') - moves with inhalation, restricted with exhalation; exhalation (rib 'down' or 'stuck down') - moves with exhalation, restricted with inhalation; pump-handle (ribs 1-5) - sagittal-plane motion; bucket-handle (ribs 6-10) - frontal-plane motion; caliper (ribs 11-12) - rotational/floating. Key group ribs: 1 (with respiratory diaphragm; treat with first rib mobilization), 11/12 (often via myofascial release and lymphatic).
5Drill Chapman's reflex point landmarks: anterior bronchi (2nd ICS sternal border), thyroid (2nd ICS lateral to sternum), arms (humeral end of clavicle), liver (5th-6th ICS right), gallbladder (6th ICS right - posterior at T6 right), adrenals (intertransverse process T11-T12), kidney (anterior 12th rib tip), bladder (periumbilical), ovary (11th rib at the costochondral junction), uterus (lateral pubic ramus). Posterior Chapman's points are paraspinal at the same vertebral level as the corresponding visceral innervation.

Frequently Asked Questions

Who is eligible for the AOBNMM Primary Certifying Examination?

Candidates must be DO graduates who have satisfactorily completed an ACGME-accredited (formerly AOA-approved) NMM/OMM residency. An unrestricted US medical license and program director attestation of clinical competence are required. NMM/OMM is a DO-unique specialty.

How is the AOBNMM exam structured?

AOBNMM certification has three components: (1) Written Exam: 150 case-based single-best-answer MCQs in 3 hours, delivered via remote proctored online platform; (2) Oral Exam: six clinical cases in two 25-minute sessions (50 minutes total), also remote proctored; (3) Practical Exam: one-day in-person hands-on evaluation of palpatory diagnosis and OMT skills. Candidates apply for each component separately.

What does the AOBNMM exam cost?

Each component (Written, Oral, Practical) is $600, totaling $1,800 for initial certification. Candidates apply separately for each component and submit corresponding fees. Continuous certification through the OCC framework includes annual longitudinal assessment via the AOA Learning Portal.

What topics are tested on the AOBNMM Written Exam?

The blueprint covers palpatory diagnosis (TART, Fryette's principles), direct OMT techniques (HVLA, muscle energy, articulatory, Still), indirect OMT (counterstrain, FPR, BLT, MFR), cranial osteopathy and lymphatic techniques (CV4, V-spread, OA decompression, thoracic/pedal pumps), regional applications (cervical/thoracic/lumbar/sacrum/pelvis/ribs/extremities), OMM in primary care, viscerosomatic reflexes, Chapman's points, and osteopathic principles.

How long should I study for the AOBNMM exam?

Most NMM/OMM residency graduates report 300-500 hours of dedicated preparation. A typical plan allocates ~30% to OMT techniques and indications/contraindications, ~25% to regional applications and Fryette's principles, ~15% to Chapman's and viscerosomatic reflexes, ~15% to cranial and lymphatic techniques, and ~15% to clinical scenarios and integrative application.

What is the pass rate for the AOBNMM exam?

AOBNMM publishes annual pass-rate statistics on its certification site. First-attempt pass rates for US-trained NMM/OMM residency graduates have historically ranged about 80-90% across the Written, Oral, and Practical components. Performance on the Practical Exam depends heavily on hands-on skill and palpatory acuity.

How does the Practical Exam work?

The Practical Exam is the only in-person component and takes place in the fall of each year. Candidates demonstrate palpatory diagnosis, OMT technique execution (HVLA, muscle energy, counterstrain, BLT, MFR, cranial, lymphatic), and treatment planning on standardized patients or models. Examiners assess accuracy of diagnosis, appropriate technique selection, correct execution, and patient safety.

What is OCC for NMM/OMM diplomates?

After initial certification, AOBNMM diplomates maintain certification through the AOA Osteopathic Continuous Certification (OCC) framework. This includes CME, periodic practice performance assessment, professionalism, and annual longitudinal assessment via the AOA Learning Portal (replacing the traditional 10-year recertification exam). Specific OCC component fees and schedules are published on the AOBNMM site.