Exam 2 Flashcards
The L4 nerve root supplies which of the following dermatomes?
A) Buttock, posterior and lateral thigh, lateral aspect of the leg, dorsum of the foot, medial half of the sole, and first, second and third toes
B) Medial buttock, lateral thigh, medial leg, dorsum of the foot, big toe
C) Back, upper butoock, anterior thigh and knee, medial lower leg
D) Back, front of thigh to knee
Medial buttock, lateral thigh, medial leg, dorsum of the foot, big toe
The sensory distribution of each nerve root is called the dermatome. Dermatome is defined as the area of skin supplied by a single nerve root. The area innervated by a nerve root is larger than that innervated by a peripheral nerve. The L4 nerve root corresponds to the dermatomal level of the medial buttock, lateral thigh, medial leg, dorsum of the foot, and the big toe.
Choice A. The dermatomal level supplied by the L5 nerve root corresponds to the buttock, posterior and lateral thigh, lateral aspect of the leg, dorsum of the foot, medial half of the sole, and the first, second and third toes.
Choice C. The dermatomal level supplied by the L3 nerve root corresponds to the back, upper buttock, anterior thigh and knee, and the medial lower leg.
Choice D. The dermatomal level supplied by the L2 nerve root corresponds to the back, and the front of thigh to knee.
An acute eruption of intensely itchy papules or wheals is called:
A) acne vulgaris
B) pityriasis rosea
C) psoriasis
D) urticaria
urticaria
Urticaria, another name for hives, is a skin rash triggered by certain foods, medications, allergies, and stress.
The plane that divides the body into front and back sections is called the __________.
A) coronal plane
B) midsagittal plane
C) sagittal plane
D) transverse plane
coronal plane
Sagittal plane - runs vertically through the body, separating it into right and left portions. They are not necessarily equal.
Median plane / Midsagittal plane - passes through the midline of the body, dividing it into equal right and left halves.
Transverse (horizontal) plane - runs parallel to the ground, dividing the body into superior and inferior portions.
Frontal (coronal) plane - runs vertically from right to left and divides the body into anterior and posterior parts.
Refusing to work with someone due to personal beliefs, race, religion, national origin, gender, disability, sexual orientation, or socioeconomic status is called:
A) harassment
B) bigotry
C) a power differential
D) self-disclosure
bigotry
Refusing to work with someone due to personal beliefs, race, religion, national origin, gender, disability, sexual orientation, or socioeconomic status is called bigotry.
Identify the muscle shown in the photo below.
A) Extensor pollicis brevis
B) Extensor pollicis longus
C) Extensor indicis
D) Abductor pollicis longus
Extensor pollicis brevis
The photo shows us the extensor pollicis brevis muscle which lies at the posterior surface of the forearm. From the name itself “pollicis,” this muscle acts on the thumb.
Origin: Posterior surface of distal end of shaft of radius
Insertion: Base of proximal phalanx of the thumb
Action: Extends the metacarpophalangeal joints of thumb
Innervation: Deep branch of radial nerve
- Clients with _____________ may have a difficult time lying prone.
A) head congestion
B) large chests or breasts
C) chest congestion
D) Both A and B
Both A and B
Female clients with large breasts or any client with head congestion may be uncomfortable in the prone position. Females may need additional bolsters or try side-lying position. Head congestion may be best suited in the seated position.
What is another name for pink eye?
A) conjunctivitis
B) rotavirus
C) Fifth disease
D) diphtheria
conjunctivitis
Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and eyelids (the conjunctiva). The eye will appear pink or red. Often the affected eye may have increased tears, drainage or be “stuck/matted shut” in the morning. It can affect one or both eyes. It often occurs with other viral cold symptoms, but can also be caused from bacteria. It is HIGHLY contagious. It can get on surfaces, such as face cradles, and spread very easily. Make needed referrals and reschedule massage after the symptoms have resolved.
If you have a cut or injury on your hand, during each massage you need to ____________ to prevent disease transmission.
A) use gloves
B) only use gloves if the client is HIV positive or has Hepatitis
C) use gloves only if your client has an open wound
D) take a week off work until it heals
use gloves
If you have a cut or injury on your hand, during each massage you need to use gloves during EVERY massage until the wound is healed.
You can assess a client’s passive range of motion by:
A) Instructing the client to move through their normal range of motion.
B) Resisting the client as they move through their normal range of motion.
C) Asking the client to move through their normal range of motion.
D) Moving the client to move through their normal range of motion yourself.
Moving the client to move through their normal range of motion yourself.
Active – AROM is when the practitioner allows a client to go through ROM alone.
Active Assistive – AAROM is when the practitioner assists a client through ROM.
Passive – PROM is when the practitioner moves a client through ROM. There is no effort from the client.
Active Resistive – ARROM is when the practitioner applies resistance during a client’s ROM.
A sprain is a stretching or tearing of a:
A) band of fascia
B) muscle
C) ligamen
t D) tendon
ligament
Strain and sprain are used interchangeably by clients, but they are different types of injuries.
A sprain is a stretching or tearing of ligaments while a strain is a stretching or tearing of a muscle tissue or tendon. Most commonly, the ankles are more prone to sprains while the hamstring muscle is more prone to strain.
What is not an official term for a bony landmark?
A) tubercle
B) trochanter
C) facet
D) bump
bump
A “bump” is not an official term for a bony landmark. All the other choices are official anatomical terms for various features of bones.
Choice A. A tubercle is a small, rounded projection from a bone.
Choice B. A trochanter is a large projection or tuberosity on the proximal femur.
Choice C. A facet is a flat to slightly concave/convex surface that articulates with other bones (example: vertebrae).
A type of massage that encourages body contouring, waste removal to lessen the appearance of cellulite.
A) Champissage
B) Aston Patterning
C) Facassage
D) Lypossage
Lypossage
Lypossage is a type of massage that encourages body contouring, waste removal to lessen the appearance of cellulite.
Champissage is also known as ‘Indian head massage’ and focuses on the head, neck and shoulders.
Aston patterning is a specific massage modality used to treat muscle pain.
Facassage is a trademarked massage modality by Bonita Howes. It is a face toning massage and myofascial release for the face, scalp, neck, and shoulders incorporating hot and cold therapies.
What does the letter T in the acronym METH stand for?
A) Treatment
B) Traction
C) Training
D) Tapotement
Traction
METH is a newer acronym used by health professionals as an alternative to RICE.
M= Movement
E= Elevation
T= Traction
H= Heat
The ________________ stroke applies pressure to soft tissues to squeeze them together without any slip. The tissues can either be pressed against the underlying bone, or they can be manually squeezed together with the practitioner’s hands and fingers.
A) compression
B) petrissage
C) friction
D) vibration
compression
Compression (Pumping) strokes are a form of friction. The strokes are directed vertically down into the belly of the muscle towards the bone or other tissues. There is no slip or glide with compression strokes.
A client asks to extend her massage session and would like to give you an extra payment. You politely decline and explain to her that therapists follow a timely schedule for each client. In this scenario, you are practicing a _____ boundary trait.
A) Healthy
B) Rigid
C) Weak
D) Inflexible
Healthy
Boundary Traits and Styles Rigid/Inflexible/Impermeable/Thick People with rigid boundaries are closed off as if there is a wall around them. They are unable to let others get close to them, physically or emotionally. They have few close relationships, are extremely protective of personal information, and often seem detached from others.
Weak/Permeable/Porous/Thin People with soft or weak boundaries are essentially unprotected and allow unwanted attacks or abuse. They have difficulty defining and asserting their own rights and responsibilities. They have trouble saying “no”, tend to overshare, and often fear rejection if they do not comply with the demands of others.
Healthy/Flexible/Semi-permeable People with flexible or healthy boundaries choose what to let in and what to keep out. They are able to do this on a situation-specific and case-by-case basis. People with healthy boundaries are difficult to manipulate and often form healthy relationships. They are accepting with others say “no”, share personal information in an appropriate manner, and can communicate their personal needs and wants.
This disease is characterized by the slow deterioration of muscle function due to myelin sheath decay is:
A) epilepsy
B) multiple sclerosis
C) muscular dystrophy
D) meningitis
multiple sclerosis
Muscular dystrophy is a disease is characterized by the progressive atrophy of skeletal muscles without nerve involvement. Symptoms begin in childhood. In Multiple Sclerosis, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and body. Symptoms begin in adulthood.
All of the following are actions of this muscle, except:
A) Eversion at the subtalar joint
B) Plantarflexion of the ankle
C) Support of medial longitudinal arch
D) Support of lateral longitudinal arch
Eversion at the subtalar joint
This is the flexor digitorum longus muscle. It lis deep into the posterior surface of the lower leg.
Origin: Posterior surface of shaft of tibia Insertion: Bases of distal phalanges of lateral four toes (this does not include the great toe)
Action: Flexion of the distal phalanges of lateral four toes (distal interphalangeal joints or DIP); Plantarflexion of the ankle; Support for the medial and lateral longitudinal arches
Innervation: Tibial nerve
If a business sells products, or offers services that are taxed, a ____ must be obtained.
A) Doing Business As
B) Federal Tax Identification Number
C) Spa Establishment License
D) Sales Tax Permit
Sales Tax Permit
Some states requires a sales tax permit to be obtained if the business sells tangible products or offers taxable services.
The sural nerve can be found by palpating:
A) between the olecranon and the medial epicondyle of the humerus
B) the mid to lower part of the leg, where calf muscles join to the Achilles’ tendon
C) the lateral epicondyle of the femur
D) the medial epicondyle of the femur
the mid to lower part of the leg, where calf muscles join to the Achilles’ tendon
The sural nerve can be palpated on the lateral aspect of the leg and foot. Here is the best description of how to find it - Reach down to the outside of your ankle. Put your finger on the lateral malleolus and slide it down inferior the malleolus about a centimeter. It can also be palpated along the midline of the back of the lower leg where calf muscles join to the Achilles’ tendon.
The most you will have to pay for covered medical expenses in a plan year through deductible and coinsurance before your insurance plan begins to pay 100 percent of covered medical expenses.
A) copay
B) deductible
C) coinsurance
D) out of pocket maximum
out of pocket maximum
A deductible amount the insured must pay before policy benefits begin. A premium is money the insured pays to a health plan for a policy.
A co-pay is a fixed payment for a covered service.
Co-insurance is a portion of charges a person must pay, usually a percentage of the service. A fee schedule is a list of services or procedures indemnified by the insurance company and of the specific dollar amounts that will be paid for each service.
Out-of-Pocket Maximum is the most you will have to pay for covered medical expenses in a plan year through deductible and coinsurance before your insurance plan begins to pay 100 percent of covered medical expenses.
__________ is an abrupt restriction to a joint movement because pain.
A) An empty end feel
B) A soft end feel
C) A hard end feel
D) A squishy end feel
An empty end feel
Springy Block - During a PROM test a client withdrawals (rebounds) with some discomfort.
Empty - During a PROM test a client requests to stop and you are not able to assess the ROM.
Soft - During a PROM you notice a squishy, springy or yielding sensation.
Hard - During a PROM you notice a grinding sensation, or the feeling that two hard surfaces are articulating against each other.
Give the action of piriformis:
A) Adduct the thigh when the hip is flexed
B) Medially rotate the hip (coxal joint)
C) Flex the thigh/hip
D) Laterally rotate the hip
Laterally rotate the hip
The main action of the piriformis is lateral rotation of the hip/thigh. It can also ABduct the thigh the hip is flexed, not ADduct.
Which of the following is not a static stabilizer of the shoulder joint?
A) Inferior Glenohumeral ligament
B) Glenoid labrum
C) Glenoid fossa
D) Latissimus dorsi
Latissimus dorsi
The latissimus dorsi is a dynamic stabilizer of the shoulder joint. Static stabilizers include the glenoid, the labrum, the shoulder capsule, and glenohumeral ligaments.
Your client presents with tight hamstrings. As a part of the knee flexor group, how would you palpate for the the semimembranosus and semitendinosus?
A) Let the client lie in prone and resist knee flexion. Palpate the posterior medial knee and thigh.
B) Let the client lie in prone and resist knee flexion. Palpate proximal to the posterior lateral knee and thigh.
C) Let the client lie in prone and resist hip extension with knee flexion.
D) Let the client lie in prone and resist hip and knee extension.
Let the client lie in prone and resist knee flexion. Palpate the posterior medial knee and thigh.
Choice A refers to the palpation of the medial hamstrings- the semimembranosus and semitendinosus.
Choice B refers to the Biceps Femoris is also known as the lateral hamstring because of its lateral location on the posterior thigh. It acts as a hip extensor as well as a strong flexor of the knee. To palpate for the Biceps Femoris, have your client lie in a prone position and resist his knee flexion or knee flexion with tibial lateral rotation. The muscle may be palpated anywhere along the posterolateral thigh running from the ischial tuberosity to the fibular head.
Choice C assesses the strength of your Gluteus Maximus while
Choice D assesses the strength of your hamstrings.
The muscle shown in the photo is the _____.
A) Pectineus
B) Adductor brevis
C) Iliacus
D) Psoas minor
Pectineus
This is the pectineus muscle which lies at the anterior/ front compartment of the thigh.
Origin: Superior ramus of pubis
Insertion: Upper end of linea aspera of the femoral shaft
Action: Flexion and adduction of hip
Innervation: Femoral nerve
___________________ is the system of rules (based on values, morals, and standards of accepted conduct) that guide correct behavior.
A) Roles and Boundaries
B) Ethics
C) Professionalism
D) Applied Kinesiology
Ethics
Ethics is the determination between what is right and what is wrong, or a set of moral principles.
A code of ethics is a summary of a set of adopted guidelines for a specific group, such as massage therapists.
Ethics help determine our boundaries.
Boundaries are defined as limits between acceptable and unacceptable behavior.
_________ is any sexual-oriented behavior that occurs in the professional setting.
A) Prostitution
B) Sensual massage
C) Sexual Misconduct
D) Therapeutic massage
Sexual Misconduct
Sexual Misconduct is any sexual behavior that occurs in the professional setting. The sexual behavior is without consent or by force, intimidation, coercion, or manipulation. Prostitution is the practice of engaging in sexual relations in exchange for payment or some other benefit.
What is the action of this muscle?
A) Shoulder shrugging
B) Elevation of second rib
C) Elevation of ribs 1-2
D) Head extension
Elevation of second rib
This is the scalenus posterior or the posterior scalene, a part of the muscles of the neck.
Origin: Transverse processes of lower cervical vertebrae
Insertion: Second rib
Action: Elevation of second rib. Lateral flexion and rotation of the cervical part of the vertebral column.
Innervation: Anterior rami of cervical nerves
______________ are tissues that are not contractile (such as nerves, ligaments, and bones).
A) Contractile tissues
B) Inert tissues
C) End feel tissues
D) Capsular patterns
Inert tissues
Contractile tissues are the fibrous tissues that have tension placed on them during muscular contractions (muscles and tendons). Inert are tissues that are not contractile (such as nerves, ligaments, bursae, and bones).
A patient comes into your clinic following a flexor tendon repair. What technique will you use for her scars?
A) Deep friction massage
B) Superficial friction. massage
C) Effleurage
D) Tapotement
Deep friction massage
Deep friction massage can be used for adhesions and scars. Superficial friction massage is useful for warming the skin and superficial layers of the soft tissues only.
An injury in which a ligament is partially torn is called?
A) A sprain
B) Gout
C) Myalgia
D) A strain
A sprain
A sprain is a stretching or tearing of ligaments. Ligaments the tough bands of fibrous tissue that connect one bone to another in your joints.
A strain is an injury to muscle tissue. Strain and sprain are used interchangeably by clients, but they are different types of injuries.
This muscle inserts into the _____.
A) Temporal bone
B) Floor of temporal fossa
C) Zygomatic arch
D) Epicranial aponeurosis
Epicranial aponeurosis
This is the occipital belly of the Occipitofrontalis muscle, a muscle of the scalp.
Origin: Highest nuchal line of occipital bone
Insertion: Epicranial aponeurosis
Action: Moves scalp on skull and raises the eyebrows
Innervation: Facial nerve
A swollen and weakened wall in the side of an aorta in danger of bursting is known as
A) aneurysm
B) hemorrhoid
C) stroke
D) embolism
aneurysm
An aneurysm is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. They can occur anywhere, but are most common in the brain, aorta, abdomen, or heart.
A client comes in with a topical prescription from their doctor. They ask you to measure out a pea-size amount and rub it on an area on their back. What is the best course of action?
A) Document the date and time of administration, the drug name and dose, and site in the client’s charts
B) Where gloves when administering the prescription
C) Explain to the client that administering medication is not within your permitted scope of practice
D) Both A and B are correct
Explain to the client that administering medication is not within your permitted scope of practice
Administration of medication is outside the scope of practice for massage. Explain to the client that it is not within your permitted scope of practice.
A client is 8 weeks post-op from a hysterectomy. Which is the most common concern for post-op clients seeking massage?
A) cerebrovascular accident
B) thrombus
C) anemia
D) fluid loss
thrombus
A thrombus, or blood clot, is the most common concern for a massage session. The possibility of blood clot should be ruled out with all post-op massage clients before a massage can takes place.
The _____ serves as the proximal attachment for this muscle:
A) Ischial tuberosity
B) Superior ramus of pubis
C) Inferior ramus of pubis
D) Intertrochanteric line
Ischial tuberosity
This is the quadratus femoris, a deep muscle located at the posterior surface of the hip.
Origin: Lateral border of the ischial tuberosity
Insertion: Intertrochanteric crest
Action: Hip lateral/ external rotation and adduction. Stabilizes the femoral head in the acetabulum.
Innervation: Nerve to Quadratus femoris (L4-S1)
What class of lever is best used for balance and stability?
A) Class 1
B) Class 2
C) Class 3
D) Class 4
Class 2
Class 1 - Balance and Stability
Class 2 - Power
Class 3 - Speed
There is not a Class 4 lever.
What structure would be least likely injured if the tibia is dislocated directly posterior?
A) Tibial nerve
B) Popliteal Artery
C) Common Peroneal Nerve
D) Ant. Cruciate Ligament
Common Peroneal Nerve
The common peroneal nerve travels over the lateral knee. It is the least likely to be injured. The other structures are either within the knee or directly posterior.
A client experiences pain while abducting the shoulder. The muscle most likely involved would be:
A) Pectoralis Major
B) Rhomboid Major
C) Deltoids
D) Infraspinatus
Deltoids
The deltoid is the only muscle listed that aids in abduction of the arm/humerus.
Ribs 1-7 are known as ________________.
A) floating ribs
B) false ribs
C) true ribs
D) sternal
true ribs
Ribs 1-7 are known as true ribs because they attach directly to the sternum.
Ribs 8-10 are known as false ribs because they attach to the sternum via costal cartilage.
Ribs eleven and twelve are known as floating ribs because they do not attache to the sternum or coastal cartilage.
You have two clients that are also sisters. One starts telling you a story about a vacation that they took together a couple weeks ago. You already heard this story. You should:
A) stop her and tell her that you heard the story.
B) let her continue and act as if you never heard the story.
C) let her finish, and tell your next client what happened.
D) tell the story to your spouse that evening.
let her continue and act as if you never heard the story.
You have two clients that are also sisters. One starts telling you a story about a vacation that they took together a couple weeks ago. You already heard this story. You should let her continue and act as if you never heard the story. This protects the confidentiality of your first client.
A back and forth movement where the hands are on opposite sides of the limb and work in opposing directions:
A) Tapping
B) Wringing
C) Tschampa
D) Trager
Wringing
Wringing strokes are a back and forth movement where the hands are on opposite sides of the limb and work in opposing directions. Wringing is a massage technique in the category of petrissage movements.
What is another name for the 5th Chakra?
A) Heart
B) Throat
C) Sacral
D) Solar Plexus
Throat
1st - Root Chakra
2nd - Sacral Chakra
3rd - Solar Plexus Chakra
4th - Heart Chakra
5th - Throat Chakra
6th - Brow Chakra
7th - Crown Chakra
Mrs. Snowy comes into your clinic complaining of muscle pain on both of her upper back and neck. During assessment, you noted tender knots on both of her upper trapezius. Pressure on these knots only referred the pain to more distal areas. She has no problems moving her back and both upper extremities. She is a bank accountant who works more than 8 hours a day in front of the computer. You suspect that Mrs. Snowy has:
A) Myofascial pain syndrome
B) Torn upper trapezius muscles
C) Depression
D) Torn rotator cuff muscles
Myofascial pain syndrome
Mrs. Snowy is exhibiting signs and symptoms consistent with myofascial pain syndrome. It is a chronic pain condition caused by muscle injuries, overuse, or stress-related muscle tension. It results in pain and tender knots called “trigger points.”
When you put pressure on these trigger points, pain may be referred to areas distant from the original knots. The upper trapezius is a common location for these tender points.
A sign of _____________ is when the practitioner is angry about the lack of progress a client is making.
A) Countertransference
B) Self-Disclosure
C) Transference
D) Polarity
Countertransference
Transference vs. Countertransference
Transference occurs when the client makes the professional relationship personal. The client transfers onto a current relationship thoughts or feelings that originated in a different, past relationship.
Countertransference goes in the opposite direction of transference. The therapist, or professional, transfers onto the client their own issues from the past. It also occurs when the professional is unable to separate the therapeutic relationship from their personal feelings surrounding the client.
Bartering transactions and gratuities are _______________.
A) taxable
B) not taxable
C) illegal in the massage field
D) deductible
taxable
All income, including tips, needs to be reported on taxes. This includes city, state and federal taxes. All cash and barter transactions should always be reported as income.
Trochlear Nerve (IV)
A) Sound
B) Facial expressions and taste buds
C) Eye Movement
D) Smell
Eye Movement
I. Olfactory – Sense of smell
II. Optic – Vision
III. Oculomotor – Eyelids, Pupil Size
IV. Trochlear – Eye Movement, Proprioception
V. Trigeminal – Chewing, Face Sensation
VI. Abducens – Eye Movement
VII. Facial – Facial Expressions, Taste
VIII. Vestibulo-Cochlear – Balance, Hearing
IX. Glosso-Pharyngeal – Tasting, Swallowing, Blood Pressure and Respiration
X. Vagus – Speech, Swallowing, The Heart, Some Visceral Organs
XI. Accessory – Head Movement, Voice Production
XII. Hypoglossal – Tongue Movement
Which of the following is associated with the fight or flight response?
A) Decreased Release of Glucose
B) Decreased Blood Pressure
C) Decreased Bladder Control
D) Decreased Heart Rate
Decreased Bladder Control
During sympathetic (fight or flight) activation: The bronchioles dilate to increase gas exchange. Extra oxygen is needed for increased physical activity and dealing with perceived threats. The heartrate and blood pressure increase.
Pupils dilate possibly for better vision - reason mostly unknown. Glucose is released for additional energy needs. Peristalsis is put on hold with all other digestive activities. In a dangerous situation, the bladder is not going to waste energy on bladder control. That is why some people may urinate during scary situations.
Which type of insurance protects massage professionals from claims made against the massage services they provide?
A) Professional Liability Insurance
B) Property Insurance
C) Disability Insurance
D) Health or Medical Insurance
Professional Liability Insurance
Professional Liability, or malpractice, insurance protects massage professionals from claims made against them by clients that believe they were injured from their massage.
The primary stress hormone in the body that massage (theoretically) can help decrease is _________.
A) Cortizone
B) Cortisol
C) Corticoid
D) Liposomes
Cortisol
The primary stress hormone in the body that massage (theoretically) can help decrease is cortisol. Cortisol is produced in the adrenal cortex of the adrenal gland.
Which of the following body positions may be interpreted by a client as a sign of aggressiveness on the part of the therapist?
A) Standing with an open body position
B) Seated while leaning slightly forward
C) Standing with hands-on hips
D) Seated behind a desk with legs crossed
Standing with hands-on hips
One sign of non-verbal, aggressive behavior would be standing with your hands-on your hips or head.
There are twelve (12) ______________ vertebrae in the typical human skeleton.
A) sacral
B) thoracic
C) lumbar
D) cervical
thoracic
There are a total of 33 vertebrae in the vertebral column (that is if you count the coccygeal vertebrae as 4).
Cervical: 7 vertebrae (C1–C7)
Thoracic: 12 vertebrae (T1–T12)
Lumbar: 5 vertebrae (L1–L5)
Sacral: 5 (fused) vertebrae (S1–S5)
Coccygeal: 4 (varies between 3–5) (fused) vertebrae (aka -Tailbone)
Which of these would be used to aide in the healing of localized inflammation?
A) Cryotherapy
B) Hot Stone massage
C) Fomentation
D) Heat Therapy
Cryotherapy
Fomentation, hot stone, and heat therapy all add warmth to the skin and further vasodilate the tissues. Cryotherapy to help to reduce swelling in the area.
Which modalities are often associated with a sense of mystery and doubt? They often use a light touch, or off the body applications.
A) Oriental/Eastern
B) Energy
C) Deep Tissue
D) Neuromuscular
Energy
Energy-based modalities often use a light touch, or no touching at all. Currently, energy modalities have not been proven to be effective in scientific research studies.
Information you receive from palpation should be recorded in which part of the SOAP charts?
A) S
B) O
C) A
D) P
O
Subjective
What did the client say? The subjective component includes a summary of what the client says. Their perception of the pain and how it affects their daily living should be included. Notes from other health care providers the client has seen can also be documented here.
Objective
What does the massage practitioner feel or see? The objective component includes the massage professionals observations of the client and the results of physical evaluations. Note swelling, skin color or temperature, weakness or muscle tone here. Palpation and gait assessment findings should be noted in this section.
Assessment
What did the massage practitioner do? The assessment component includes a summary of notes after treatment is conducted It should indicate whether or not progress made during the session. What is the pain scale number after treatment? Were there changes in range of motion or posture? You should document long and short-term goals and expected functional outcomes.
Planning
What is next? The planning component includes suggestions and reminders for future sessions. You may also include home care suggestions for the client.
After taking a 12-hour continuing education course, a massage therapist advertises they are now “certified shiatsu practitioner.” What is this an example of?
A) Bigotry
B) Financial Impropriety
C) Misrepresentation of educational status
D) Exploiting the power differential
Misrepresentation of educational status
A short CE course does not give one the permission to advertise as thoroughly trained in a modality. This is a misrepresentation of educational status.
A ____________occurs from a muscle and ligament imbalance around the toe joint which causes the middle joint of the toe to bend and become stuck in this position. It typically occurs in the proximal interphalangeal joint of the second, third, or fourth toes.
A) bunion
B) hammertoe
C) genu recurvatum
D) pes planus
hammertoe
A hammertoe occurs from a muscle and ligament imbalance around the toe joint which causes the middle joint of the toe to bend and become stuck in this position.
Pes planus is flat feet. Genu recurvatum is a hyperextension of knee joint.
A bunion is a deformity of the joint between the big toe and 1st metatarsal. It is also known as a hallux abducto valgus.
Meaning “on the opposite side”:
A) Sinistral
B) Contralateral
C) Ipsilateral
D) Dextral
Contralateral
Ipsilateral means the same side of the body and contralateral is the opposite side of the body.
Dextral refers to the right site of the body and Sinistral means left.
Volar and Palmar are the palm side of the hand.
___________ is a condition characterized by a straightening of the cervical curve.
A) Dowager’s hump
B) Swan-neck deformity
C) Military neck
D) Torticollis
Military neck
Military neck is a condition characterized by a straightening of the cervical curve.
Torticollis is characterized by turning or tipping of the head.
Dowager’s hump is an abnormal outward curvature of the thoracic vertebrae.
Swan-neck deformity is an abnormal flexion of the base of the finger.
With RICE therapy/treatment this step allows for the healing process to begin and prevents further injury.
A) Rest
B) Ice
C) Compression
D) Elevation
Rest
METH and MEAT is a newer acronym used by health professionals as an alternative to RICE.
M= Movement
E= Elevation
T= Traction
H= Heat
M= Movement
E= Elevation
A= analgesics
T= Treatment
R= Rest
I= Ice
C= Compression
E= Elevation
A written acknowledgment for cash received is a
A) Balance Sheet
B) Invoice
C) Receipt
D) Bank Statement
Receipt
Balance sheet - A financial statement that reports assets, liabilities, and owner’s equity on a specific date.
Bank statement - A report of deposits, withdrawals, and bank statements sent to a depositor by a bank.
Receipt - A business form giving written acknowledgment for cash received.
Sales invoice - An invoice used as a document for recording a sale on an account.
In nonpathological states, excessive ROM in a joint is referred to as:
A) Locking
B) Giving way
C) Anatomical instability
D) Hypermobility
Hypermobility
In nonpathological states, laxity or hypermobility refers to an excessive ROM in a joint. Laxity implies that the client has excessive range of motion but can control movement in that range and no pathology is present. It is a function of the ligaments and joint capsule resistance. This differs from flexibility, which is the range of motion available in one or more joints and is a function of contractile tissue resistance primarily as well as ligament and joint capsule resistance.
Choice A. Locking may mean that the joint cannot be fully extended, as is the case with a meniscal tear in the knee, or it may mean that it does not extend one time and does not flex the next time (pseudolocking), as in the case of loose body moving within the joint. Locking may mean that the joint cannot be put through a full ROM because of muscle spasm or the movement was too fast; sometimes referred to as spasm locking.
Choice B. Giving way is often caused by reflex inhibition or weakness of the muscles, so that the patient feels that the limb will buckle if weight is placed on it or because pain will be too great. Inhibition may be caused by anticipated pain or instability.
Choice C. Anatomical instability is also called clinical or gross instability, or pathological hypermobility. It is described as an excessive or gross physiological movement in a joint where the client becomes apprehensive at the end of the ROM because a subluxation or dislocation is imminent.
During a massage session, a client starts becoming furious and attacks the therapist with hurtful remarks. The therapist then, accepts the remarks and proceeded with therapy. In this scenario, the therapist exhibits the following boundary trait:
A) Semi-permeable
B) Rigid
C) Impermeable
D) Permeable
Permeable
Boundary Traits and Styles
Rigid/Inflexible/Impermeable/Thick People
with rigid boundaries are closed off as if there is a wall around them. They are unable to let others get close to them, physically or emotionally. They have few close relationships, are extremely protective of personal information, and often seem detached from others.
Weak/Permeable/Porous/Thin People
with soft or weak boundaries are essentially unprotected and allow unwanted attacks or abuse. They have difficulty defining and asserting their own rights and responsibilities. They have trouble saying “no”, tend to overshare, and often fear rejection if they do not comply with the demands of others.
Healthy/Flexible/Semi-permeable People
with flexible or healthy boundaries choose what to let in and what to keep out. They are able to do this on a situation-specific and case-by-case basis. People with healthy boundaries are difficult to manipulate and often form healthy relationships. They are accepting with others say “no”, share personal information in an appropriate manner, and can communicate their personal needs and wants.
A stroke that pulls tissue up and away from its current position.
A) Percussion
B) Petrissage
C) Compression
D) Vibration
Petrissage
Petrissage comes from the French word ‘pétrir’, which means “to knead”. These strokes, which may be rhythmic, often include lifting and squeezing the muscles. These movements address the deeper layers of tissue and also help increase circulation to the area. Strokes and pressure are directed toward the heart.
The displacement of two bones in a joint.
A) Sprain
B) Fracture
C) Dislocation
D) Strain
Dislocation
Dislocations are joint injuries that force bones out of normal position temporarily. Bones are not fractured. A subluxation is a term used mainly in the chiropractic field to refer to a slight misalignment of the vertebrae.
A sprain is a stretching or tearing of ligaments. Ligaments the tough bands of fibrous tissue that connect one bone to another in your joints.
A strain is an injury to muscle tissue.
All of the following are examples of PHI, except:
A) the client’s insurance identification number
B) the client’s address
C) the massage clinic’s address
D) the client’s date of birth
the massage clinic’s address
Protected Health Information (PHI) does not include the massage clinic address. PHI is individually identifiable health information (Name, phone number, insurance number, DOB, SSN, email, health information, etc)
The symmetric stance, or _____________ stance, consists of both feet shoulder width apart and placed as if on a line with the toes forward. Knees are slightly bent and work is directly in front of you. It is an ideal stance for petrissage strokes.
A) Warrior
B) Horse
C) Lunge
D) Both a and b are correct
Both a and b are correct
Bow Stance Archer, bow, asymmetric or lunge position is used when applying massage techniques that move from one point to the next along the client’s body.
Example: effleurage, or when greater pressure is needed. Both feet should be shoulder-width apart. One foot should be in front of the other with the back foot is laterally rotated. Weight is primarily on the practitioner’s back foot. This helps provide leverage for strokes that require a lot of pressure.
Horse Stance Warrior, horse, straight, or symmetric stance is used to perform massage techniques that traverse relatively short distances, such as pétrissage and most friction strokes. The practitioner should place their feet just outside hip distance with toes pointing forward.
A fraudulent signature is known as a(n) __________________.
A) tax evasion
B) endorsement
C) forgery
D) counterfeiting
forgery
A fraudulent signature is known as a forgery. Forging money (cash) or currency is called counterfeiting. Signing the back of the check is called endorsing. Tax evasion is misrepresenting your income or deductions to pay less taxes.
After using ice for 72 hours on a strain or sprain, you should massage ___________ the injury to speed up healing.
A) directly on
B) proximal to
C) distal to
D) lateral and medial to
proximal to
After using ice for 72 hours on a strain or sprain, you should massage proximal the injury to speed up healing.
This refers to massage strokes that move one layer of tissue over another.
A) Kneading
B) Gliding
C) Friction
D) Percussion
Friction
Friction strokes move one layer of tissue over another. Types of friction includes: circular, transverse or cross-fiber. Other types include rolling, chucking, and wringing.
_______________ governs the privacy and security of protected health information (PHI).
A) AMTA
B) NCBTMB
C) FSMTB
D) HIPAA
HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. HIPAA created national standards to protect an individual’s medical records and other Protected Health Information (PHI).
HIPAA information can be found on the government’s HIPAA website. What does HIPAA do? It gives patients more control over their health information. It sets boundaries on the use and release of health It establishes appropriate safeguards that health care providers and others must achieve to protect the privacy of health information.
You suspect that your client has impetigo. What should you do?
A) Clean the affected area with alcohol and massage the area.
B) Avoid the area and proceed with the massage.
C) Explain to the client what they need to do to treat the area.
D) Explain what you suspect and politely reschedule the massage. Suggest the client see their doctor for treatment.
Explain what you suspect and politely reschedule the massage.
Suggest the client see their doctor for treatment. Impetigo is highly contagious. It systemically contraindicates massage until the symptoms have completely resolved.
The science of preparing and using medications, as well as the effects from the medications.
A) Herbology
B) Pathology
C) Pharmacology
D) Physiology
Pharmacology
Pharmacology is the branch of medicine concerned with the uses and effects of drugs and medications.
__________ is a type of medication widely used to decrease pain and reduce inflammation.
A) Antibiotic
B) NSAID
C) Heparin
D) Albuterol
NSAID
Three common Nonsteroidal Anti-Inflammatory Drugs, or NSAIDs, are aspirin, ibuprofen, and naproxen They are used for pain relief and inflammation.
Identify the muscle shown in the photo below:
A) Longus colli
B) Rectus capitis anterior
C) Longus cervicis
D) Platysma
Longus colli
The photo shows us the longus colli, a deep cervical flexor muscle. It is divided into three portions- superior oblique, inferior oblique, and vertical portions.
Origin: Superior oblique portion originates from transverse processes of C3-C5. Inferior oblique portion originates from bodies of T1 and T2. Vertical portion arises from bodies of C5-C7 and T1-T3.
Insertion: Superior oblique inserts to the tubercle on the anterior arch of atlas. Inferior oblique into the transverse processes of C5-C6. Vertical portion into the bodies of C2-C4.
Action: Cervical flexion, ipsilateral lateral/ side flexion and some rotation
Innervation: C2-C6
All of the following are movements that occur in the horizontal plane, except:
A) Pronation
B) Internal rotation
C) Supination
D) Adduction
Adduction
The horizontal plane or XZ plane separates the body into upper and lower parts. In this plane, rotational movements occur. This includes internal/medial rotation, external/lateral rotation, supination and pronation. Adduction and abduction are movements that occur in the frontal plane, not in the horizontal plane.
When should gloves be used during a massage?
A) When there is direct contact with body fluids
B) When there is direct contact with mucous membranes
C) When there is direct contact with non-intact skin
D) All of the above
All of the above
Gloves are used during a massage when there is direct contact with: potential infectious body fluids mucous membranes non-intact skin I have had a message from student that said “We should never be in contact with body fluids! That is outside our scope of practice.” Think about intraoral massage for TMJ or jaw pain.
That is most certainly inside the scope of practice for many massage therapists and saliva is a body fluid and can transmit blood-borne diseases, if blood is present.
Which of the below is not part of helping a client reach informed consent?
A) Listening carefully to client questions and statements.
B) Avoiding medical jargon when describing treatments.
C) Being aware of religious or cultural differences that may affect their understanding of the massage session and plan.
D) Carefully describing the diagnosis the massage therapist has made.
Carefully describing the diagnosis the massage therapist has made.
Massage therapists may not diagnose any conditions. It is not under the scope of practice of massage in any state.
Fulling is a form of:
A) Effleurage
B) Petrissage
C) Tapotement
D) Friction
Petrissage
Fulling is a superficial petrissage stroke. The practitioner uses their thumbs and first fingers. It is similar to a pinching movement. This is the definition in “The Art of Massage” by Kellogg. Some authors define fulling as more of a broadening, lifting, and compressing movement, but still as a form of petrissage.
Which of the below is considered good body mechanics?
A) Having table high enough to keep shoulders in a shrugged position.
B) Hyperextended (Locked) knees
C) Standing directly on top of (or over) your work, instead of behind the work
D) None of the above are considered good body mechanics
None of the above are considered good body mechanics
In general, joints should be kept lined up, or “stacked”, but never locked. Wrists should never be hyperflexed or hyperextended.
Here are a few general rules: • Back straight – Keep a neutral spine. • Keep knees bent. • Keep wrists relaxed and in a neutral position. • Stay behind each massage stroke. • Power should come from the core/pelvis and legs. • Keep elbows close to the body.
An asthenic body type is also called as:
A) Ectomorphic
B) Endomorphic
C) Mesomorphic
D) Pyknic
Ectomorphic
Generally, there are 3 body types:
Ectomorphic or Asthenic- thin body build; characterized by prominence of the structures developed from embryonic ectoderm
Mesomorphic or Athletic- muscular or sturdy body build; characterized by prominence of the structures developed from embryonic mesoderm
Endoderm or Pyknic- fat or heavy body build; characterized bu prominence of the structures developed from the embryonic endoderm
During the consultation procedures and policies should be explained. Which IS NOT part of the policies and procedures during the consultation? Stating _______________.
A) qualifications of the therapist
B) fees
C) cancellation policies
D) the ancient history of their massage modality
the ancient history of their massage modality
Screening on the phone allows the massage practitioner to obtain pertinent information about a massage client. The practitioner can find out if massage is appropriate for them and if their modality is best suited for the potential client’s problems. It can also help massage practitioners eliminate appointments with people seeking non-therapeutic massage services and unnecessary exposure to risks. It is also a time to share about the policies of the massage practice. The practitioner should disclose their qualifications, fees, and cancellation policies.
The ancient history of their massage modality is not pertinent information about the practice and procedures.
To value client trust and understand that public trust in our profession is based on our actions and behavior.
A) Fidelity
B) Beneficence
C) Societal Trust
D) Veracity
Societal Trust
Veracity is the principle that one should tell the truth. Beneficence is the act of doing or promoting good. Fidelity is the principle that one should keep one’s promises. Societal trust is understanding that our clients and general public trust us because of our position and profession.
Which of the following is MOST accurate regarding massage professionals recommending supplements to their clients?
A) The massage professional should only recommend those supplements covered under his or her professional liability insurance.
B) Unless the massage professional has other credentials, such as an RD or M.D., he or she does not possess the qualifications to legally recommend or prescribe supplements.
C) The massage professional should become educated about the specific supplements before making any recommendations.
D) Due to potential complications from taking supplements with other medications, massage therapists should recommend only plant-based supplements.
Unless the massage professional has other credentials, such as an RD or M.D., he or she does not possess the qualifications to legally recommend or prescribe supplements.
Unless the massage professional has other credentials (dietitian/RDN/RD or doctor/MD/DO), he or she does not possess the qualifications to legally and ethically recommend or prescribe supplements.
The probable course and outcome of a disease or condition is called the:
A) Diagnosis
B) Referral
C) Treatment plan
D) Prognosis
Prognosis
The identification of an illness or problem is called a diagnosis. The prognosis is the probable course and outcome of a disease or condition.
Unilateral contraction of the left side of these muscles will produce _____.
A) Trunk lateral flexion to the right and rotation to the left
B) Trunk lateral flexion to the left and rotation to the right
C) Trunk flexion and rotation to the left
D) Trunk flexion and rotation to the right
Trunk lateral flexion to the left and rotation to the right
The photo shows us the multifidus muscles. These are deep and small muscles yet, are very important for stabilization of the spine.
Origin: Posterior surface of sacrum, posterior superior iliac spine, mamillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae, and articular processes of C4-C6
Insertion: Spinous processes of vertebrae except C1, and 2-4 bones above origin
Action: Unilateral contraction produces ipsilateral lateral flexion and contralateral rotation of the spine. Bilateral contraction produces extension of the spine. Also included in the core group of muscles, the multifidus are also very important for lumbar and overall spinal stabilization.
Innervation: Dorsal rami of spinal nerves
The direction of ________________ is down and back and forth in a fast oscillating manner.
A) friction
B) compression
C) vibration
D) kneading
vibration
Vibration strokes are characteristically fast and in an oscillating manner. Movement generally comes from the hands and wrists. Vibration includes trembling, jostling, rhythmic shaking or rocking.
A question that requires only a yes or no response is what type of question?
A) Closed-ended question
B) Open-ended question
C) Feedback question
D) Reflective question
Closed-ended question
Reflective listen is when the practitioner Repeats or reiterates what a client just said. This conveys your comprehension of what they just told you and reduces errors.
Open-ended questions require a descriptive answer rather than “yes” or “no” answers (close-ended). An open-ended questions would be - Tell me about your job. Communication without words is non-verbal communication. This can be posture or body language. Leading questions are questions the practitioner asks the client to help the client recall missing or forgotten details, but generally should be avoided. A leading question would be to someone that has arthritis - Does cold weather make it worse? a better question would be - Have you noticed anything that makes your pain worse?
A smaller group that represents a population of interest in a research project.
A) Sample
B) Pilot study
C) Case report
D) Abstract
Sample
The results are a section of a research article that analyzes the data gathered. An abstract is a statement that summarizes a research project. A case report is a study that describes an outcome from treatment of one patient/client. A population is the entire of a group of interest in a research project.
A sample is a smaller group that represents a population of interest in a research project. A pilot study is done to test or check out procedures, measures, or potential treatments in anticipation of a larger experimental study. It has been scaled down to conserve resources.
What is another name for the 2nd Chakra?
A) Crown
B) Root
C) Sacral
D) Both B and C
Sacral
1st - Root Chakra
2nd - Sacral Chakra
3rd - Solar Plexus Chakra
4th - Heart Chakra
5th - Throat Chakra
6th - Brow Chakra
7th - Crown Chakra
_____ inflammation occurs in many parts of the body.
A) Systematic
B) Systemic
C) Localization
D) Localized
Systemic
The inflammatory response is a natural phenomenon where the body first attempts to protect itself. Inflammation can be categorized into 2- localized and systemic.
From the name itself, localized inflammation refers to inflammation that is confined to a specific area only.
This has 5 characteristics- heat, redness, swelling, pain, and loss of function. On the other hand, systemic inflammation occurs not just in one part of the body and can be widespread. In addition to the 5 characteristics, systemic inflammation also involves 3 other features- the production and release of neutrophils by the bone marrow, stimulation of fever through pyrogens, and loss of large amounts of fluid when systemic inflammation is so severe.
When massaging the anterior neck, what structure(s) should be avoided?
A) carotid artery
B) internal jugular vein
C) vagus nerve
D) all of the above
all of the above
Anterior Triangle of the Neck Bordered by the SCM, mandible, and trachea Contains the jugular vein, carotid artery, and the vagus nerve
Most widely recognized and accepted physiological effect of massage.
A) increased circulation of blood
B) emotional relaxation
C) better skin appearance
D) decreased circulation of blood
increased circulation of blood
An emotional, or somatoemotional, release is an emotional response occurring during a massage. This may be a sigh, giggle or may involve periods crying.
The metacarpophalangeal joints are classified as?
A) Plane
B) Hinge
C) Condyloid
D) Saddle
Condyloid
MCP joints are biaxial joints that allow flexion/extension and abduction/adduction. This movement makes is a condyloid joint.
A client being treated in a massage therapy clinic explains that he has felt nauseous since having his methotrexate medication level altered. The most appropriate massage therapy action is to:
A) explain to the client that nausea is very common when altering medication levels and to give their body time to adjust
B) request that the client contact their physician’s office to discuss the situation before the massage takes place
C) ask the client to stop taking the prescribed medication
D) suggest client return to taking the previously prescribed medication dosage and see if that resolves the nausea
request that the client contact their physician’s office to discuss the situation before the massage takes place
Methotrexate (MXT) is used to treat certain types of cancer, autoimmune diseases (RA) and ectopic pregnancies. Request that the client contact their physician’s office to discuss this issue as it is outside your scope to discuss medication changes.
Disinfecting agents include all of the following, except:
A) Bleach
B) Rubbing alcohol
C) Water
D) Ammonia
Water
Water alone does not have disinfecting properties for sanitation purposes.
COPD is an abbreviation for:
A) chronic obstructive pulmonary disease
B) chronic obstructive pancreatic duct disorder
C) chronic obstruction pleural disease
D) cardiopulmonary disease
chronic obstructive pulmonary disease
COPD, chronic obstructive pulmonary disease, is a progressive lung disease that causes breathing problems. The main cause of this disease is smoking.
Origin of Teres Major:
A) Ulna
B) Radius
C) Scapula
D) Humerus
Scapula
ORIGIN
Inferior angle of the scapula.
INSERTION
Medial lip of the bicipital of the humerus.
ACTION
Extends, medially rotates and adducts humerus.
Applying a small amount of a product to the inner bend of the elbow followed by checking for an allergic reaction is called a _______________________.
A) derma test
B) patch test
C) grid test
D) anaphylaxis test
patch test
Applying a small amount of a product to the inner bend of the elbow followed by checking for an allergic reaction is called a patch test. This can help rule out allergies and sensitivities to topical products.
The most important practice in the prevention of the spread of disease is __________.
A) latex gloves
B) sterilization
C) Handwashing
D) gowns and masks
Handwashing
The most important practice in the prevention of the spread of disease is HANDWASHING.
