100+ Free AOBNMM NMM/OMM Practice Questions
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Which OMT technique is appropriate for postoperative ileus to encourage GI motility?
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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?
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?
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?
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?
5Which is an ABSOLUTE contraindication to cervical HVLA?
6Which is the correct mechanism of muscle energy technique?
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?
8Which cranial technique involves gentle bilateral compression of the occipital squama just inferior to the lambdoidal sutures to encourage CSF fluctuation and parasympathetic balance?
9Which lymphatic technique is performed at the start of any lymphatic treatment to release the thoracic inlet (Sibson's fascia)?
10Which is the Chapman's anterior reflex point for the bronchi?
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
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.
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).
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.
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.
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.
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).
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).
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
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.