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OMM 4 Final Exam Review – 300 Questions – Counterstrain, HVLA, Cranial, Chapman Points Q&A 2026

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This document is a comprehensive OMM (Osteopathic Manipulative Medicine) final exam review containing approximately 300 high-yield questions and correct answers focused on osteopathic principles, diagnosis, and treatment techniques. It covers essential topics such as sacral diagnosis (e.g., seated flexion test, spring test relationships), counterstrain tenderpoints, muscle energy techniques, myofascial release (MFR), and high-velocity low-amplitude (HVLA) principles. Early sections (pages 1–3) emphasize sacral mechanics, carpal tunnel management in pregnancy, and thoracic inlet techniques, while subsequent sections expand into detailed tenderpoint locations and treatments for multiple body regions. The document provides in-depth coverage of core OMM concepts including spinal mechanics (Type I vs Type II dysfunctions), cranial strain patterns (torsions, sidebending rotations, vertical and lateral strains), viscerosomatic reflexes, and Chapman points. It also integrates clinical applications such as lymphatic drainage techniques, pregnancy-related OMT considerations, and musculoskeletal dysfunction patterns. Additional sections focus on orthopedic testing (e.g., Spurling, Adson, McMurray), joint biomechanics, nerve entrapments, and conditions like scoliosis, spinal stenosis, and cauda equina syndrome. The structured Q&A format reinforces active recall and clinical reasoning, making it highly effective for board-style preparation. This resource is highly relevant for courses such as Osteopathic Manipulative Medicine (OMM I–IV), Musculoskeletal Medicine, and Clinical Skills training. It is ideal for osteopathic medical students preparing for COMLEX Level 1 and Level 2-CE, as well as OMM practical and written final exams. It is also useful for students in clinical rotations, physician assistant (PA) programs with OMT exposure, and healthcare professionals seeking to reinforce osteopathic techniques and principles. The content aligns closely with widely used textbooks such as Foundations of Osteopathic Medicine and Savarese OMT Review, making it a valuable supplementary resource for mastering OMM techniques, improving diagnostic accuracy, and achieving strong performance on board and practical exams. Keywords: OMM, osteopathic manipulative medicine, counterstrain, HVLA, muscle energy, myofascial release, cranial techniques, chapman points, sacral dysfunction, viscerosomatic reflexes, lymphatic drainage, spinal mechanics, orthopedic tests, COMLEX preparation

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OMM 4 Final 2026 Exam
Questions and Correct Answers |
New Update



If the spring/sphinx test are negative (flexion), the deep sulcus is on the

____ side as the seated flexion test - 🧠 ANSWER ✔✔SAME


If the spring/sphinx is positive (extension), the deep sulcus is on the ____

side of the seated flexion test - 🧠 ANSWER ✔✔OPPOSITE

,What is the MFR technique for gastrocnemius? - 🧠 ANSWER ✔✔1. with

patient supine, sit at the foot of the table on the side of dysfunction

2. place both hands side by side under the gastrocnemius with the weight

of the leg resting on your fingertips

3. apply an upward force (posterior to anterior) with your fingers into the

muscle, then pull inferiorly, using the weight of the leg to compress the area

4. maintain the pressure for 30-60 seconds or until release is palpated


Carpal Tunnel is common in what trimester? - 🧠 ANSWER ✔✔2nd


Does carpal tunnel resolve after pregnancy? - 🧠 ANSWER ✔✔yes it usually

resolves right after delivery


What is the treatment for carpal tunnel? - 🧠 ANSWER ✔✔1. elevaluate and

treat C5-C7, T1-T7, and upper extremity for somatic dysfunction

2. check for radioulnar, ulno-humeral, and interosseous somatic

dysfunction

3. MFR, ST, ME

4. direct carpal relase of plamar aponeurosis / transverse carpal ligament

,What are common symptoms of carpal tunnel? - 🧠 ANSWER

✔✔numbness, tingling, pain at night that spares the 5th digit


Describe the process of performing thoracic inlet/outlet seated - 🧠

ANSWER ✔✔1. stand behind the seated pateint


2. place your plams over the shoulders at the cerivicothoracic junction

3. place your tumbs over the posterior first rib and place the 2nd and 3rd

digits superior and ifnerior to the clavicle at the sternocalivucular joints

4. asseess motion inferior and superior, right and left, and torsional to

determine postion of ease or restriction

5. gently stack the tissues in all three planes of motion into the positon of

ease or into the barrier

6. hold for 30-60 seconds or until release is palpated


Describe a Type 1 somatic dysfunction - 🧠 ANSWER ✔✔motion: neutral


rotation and sidebending are opposite directions


Describe type 2 somatic dysfunction - 🧠 ANSWER ✔✔motion: flexion or

extension

rotation/sidebending are in the same direction

COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED

, AC4 counter strain location and treatment? - 🧠 ANSWER ✔✔Location:

located posterior to the SCM

Treatment Position: Flex, side bend AWAY, rotate AWAY


AC8 counterstrain location and treatment - 🧠 ANSWER ✔✔Location:

sternal attachment of SCM

Treatment: flex, side bend AWAY, rotate AWAY


AC1 counterstrain location and treatment - 🧠 ANSWER ✔✔Location:

posterior aspect of ascending ramus of mandible

Treatment: Rotate AWAY


AC7 counterstrrain location and treatment - 🧠 ANSWER ✔✔Location:

clavicular attachment of SCM

Treatment: flex, side bend TOWARD, rotate AWAY

medial meniscus/ MCL tenderpoint and treatment - 🧠 ANSWER

✔✔Tenderpoint


anterior medial aspect of the meniscus on the joint line




Treatment

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