Muscles: Origin, insertion, Action, Palpation, Trigger points

Flat, reddened patch of skin.

Macule

What is in flamed mucous membrane that lines abdominal cavity?

Peritonitis

What is the development of relationship based on mutual trust and Harmony?

Rapport

What is information for the therapist to use to develop treatment plan?

What is information for the therapist to use to develop treatment plan?

Condyloid and saddle joints allow for movement in two different planes along two axes of the body. This is known as a Condyloid and saddle joints are examples of _______________ joints.

biaxial

_____________ is elevation of medial edge of the foot so that the sole is turned inward (or medially)

inversion

What is forward head,erector spinea are elongated and weak,neck flexors weak,neck extensors are strong?

kyphotic-lordotic posture

When viewing standing posture you use?

plumb line

Myofascial pain tests and measures

posture Active ROM muscle length muscle strength

What is it when a male client requesting a female bodyworker?

Gender issues

What is friction with saline solution?

What is friction with saline solution?

What is a progressive skin condition that destroys motor neurons in the spinal cord?

Lou gerhig's disease

which organ does cystic fibrosis occur in?

Lungs

What is a chronic autoimmune disease and which antibodies attack various types of tissues throughout the body?

Lupus

The hip joint is also known as a _______________ joint.

multiaxial

The proximal articulation of the radius is an example of a _______________ joint.

pivot

The knee is an example of a _______________ joint.

pivotal hinge

What are some clinical indications for massage

-Circulatory disorders -edema -ischemic ulcers and varicose ulcers -Peripheral neurotics -Muscular trauma -Muscular tension -Scar tissue -Amputations -Tension headaches -Soft tissue inflammation -Arthritis

What are some uses for abdominal massage

-Stimulate bowel peristalsis -Friction massage over abdominal scar -Initiate bladder emptying

Noncontagious inflammation of the sebaceous glands in the skin; not contagious but avoid affected areas.

Acne

Example of hinge joint?

1. knee 2. interphalageal 3. elbow 4. all of these

Supinators of forearm: (Anterior/Palmar View)

10 biceps brachii 2) Supinator 3) Brachioradialis

It usually takes how long before massage activates the parasympathetic nervous system?

10 to 15 minutes

What part of the body ifs affected by peritonitis?

Abdomen

What is able to walk or not confined to a bed?

Ambulatory

The scope of practice of a massage therapist and observing that the muscles are tight, And gathering information to make informed decisions about the treatment?

Assessment

The shoulder joint is an example of a _________________?

Ball and socket joint

What is a client goals and time frame?

Care plan

Crohn's Disease (Regional Enteritis)

Chronic relapsing inflammatory disease of the intestianl tract; symptoms include intermittent diarrhea, colicky pain in lower abdomen, fatigue, low-grade fever. Indications: Painful condition; massage may be helpful in general stress and pain reduction. Contraindications: Refer client to physician immediately; with chronic conditions, work under physician's direct supervision.

What is abrupt restriction to joint movement?

Empty end feel

Contracture

Fixed resistance to passive stretching of muscles; usually the result of fibrosis or tissue ischemia. Indications; Massage and stretch. Contraindications: Do not stretch past fixed barrier

Signs of disease

Idiopathic

What is a direct physical effect?

Mechanical method

What is a full body steambath?

Russian bath

What uses hot air from 170 to 210°F with 10% to 20% humidity?

Sauna

Ringworm, athletes foot, fungal infection of the nails

Scaly and crusty cracking of the skin. Indications; keep area dry; do not use lubricants. Contraindications: Regional; do not use lubricants near the area because fungi thrive in a moist environment

What is a neurological state inwhich painful stimuli is moderated?

Slight analgesia

External application of heat for therapeutic purposes

Thermotherapy

An area of bruising

The study of disease

Which choices best describes scleroderma?

Thick skin and joint stiffness

How can a bladder infection go into the kidneys?

Through the ureters

What occurs when there is no physical restriction to movement other than pain expressed by the client?

abnormal end feel

Types of trigger points

active latent

Ulnar flexion is also knows as wrist _______________.

adduction

Reciprocal motion refers to___________________?

alternating motions in opposing directions.

Scalene muscles are _______________. ?

an accessory to inhalation

The anterior process on the scapular?

coracoid

Muscle spasm is?

hot area

What is tennis elbow,and can be caused by meat cutting?

lateral epicondylitis

The limit on the range of motion of an joint is?

normal end feel

What is the name of the largest foramen in the body?

obturator

The xiphoid process can be found______________?

on the sternum

A massage therapist that works on the tissues surrounding an adhesion, then works directly on the adhesion and then back to the surrounding tissues is demonstrating

regional local regional

Teres minor is an antagonist of the_______________________?

subscapularis

Myofascial pain is decreased by

short periods of rest slow steady stretch to the muscle, especially under a hot shower moist heat short periods of light activity myofascial therapy

The sternocliedomastiod muscle is associated with?

spasmodic torticollis

The muscle being treated in a therapeutic way is?

target muscle

Sternalis (Anterior View)

the sternalis occurs in 1 in 20 people. It is a band of fibers of varying length, width, and thickness that may occur unilaterally and bilaterally or be fused medially along the sternum.

Plantaris: (Posterior View of Knee)

the tendon of this muscle can be ruptured during violent ankle movements, especially dorsiflexion. It is a common injury to basketball players, sprinters, and ballet dancers. this tendon can be removed without causing any disability of the knee or ankle and is often used in reconstruction of tendons of the hand.

Deltoid(eus) (Anterolateral View)

the three portion may be seperated from one another , and in some instances the clavicular and acromial portions may be absent. this shoulder muscle is one of the prime injection sites, It is active during the rhythmic arm swinging movement invovled in walking.

What is nerve compressed syndrome and you use massage to lengthen the scalenes, SCM, pecs and neck extensors?

thoracic outlet syndrome

Refer symptoms to other areas of the body is?

trigger points

Upward Rotators of Scapula: (Posterior View)

1) Trapezius upper 2) Trapezius (lower ) 3) Serratus anterior

Extensors of Elbow: (Posterior View)

1) Triceps brachii 2) Anconeus

Which cranial nerve is directly affected in Bells Palsy?

7th

Muscular Dystrophy

A group of muscle disorders characterized by atrophy of skeletal muscle without nerve involvement. Indications: Massage is beneficial; work closely with supervising physician. Contraindications: General

Scalenus (Scalene) Anterior: (Anterior Lateral View):

A scalene minimus may occasionally be present between the first rib and the seventh cervical vertebra. there are multiple trigger points along the length of the muscle. The referred pain Pattern is along the upper and lower arm, lateral side of the hand, and just lateral to the midline in both the anterior and posterior upper thorax. Activation of it's trigger points shortens the anterior and middle scalene muscle, keeping the first rib pulled against the clavicle, causing neurovascular entrapment. Compression of the brachial plexus branches causes thoracic outlet syndrome. this is often misdiagnosed as carpal tunnel syndrome

What is the quality of accepting the consequences of one's actions?

Accountability

Clinic client participates

Active joint movement

Where is the origin of the rectus femoris?

Anterior Inferior iliac Spine (AIIS)

Phlebitis

Definition/Symptoms: inflammation of a vein; may be caused by a blood clot; symptoms include edema, stiffness, and pain; veins may streak red. Indications: N/A. Contraindications: Regional to general; see Deep Vein Thrombosis.

What is a PNF techniques in which the muscle spindles and golgi tendon organs are used to relax a hypertonic muscles?

Direct manipulation (DM)

Flexing the ankle dorsally so that the toes are moving toward the shin?

Dorsiflexion

What is an infectious disease that attacks many people at the same time?

Epidemic

What is coordinated movement?

Functional assessment

What is vibration?

High-frequency and movements, slight trembling other hand, reduces intensity of deep tissue techniques, trembling, Josling, shaking, and rocking

What is the term used for increased blood flow in tissue?

Hyperemia

Which condition would directly contribute to anterior pelvic tilt?

Hypotonic abdominals

Dyskinesia

Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movement and possibly pain. Indications: Massage is beneficial as part of physician directed treatment plan. Contraindications: General; refer client to physician for diagnosis and treatment plan.

Conjunctivitis (Pink eye)

Inflammation and infection of the mucous membranes of the eye. Indications: N/A. Contraindications: Regional; refer client to physician; may be contagious; avoid affected area.

Bursitis

Inflammation of a bursa. Indications:Massage may take pressure of the joint by relaxing and normalizing surrounding musculature; ice. Contraindications: Regional; avoid affected area: work above and below jointed area.

Which muscle is responsible for depression of the ribs?

Intercostal muscles located between each rib are mainly involved with breathing by either elevating the ribs during inspiration or depressing the ribs during expiration.

Flatulence

Intestinal gas. Indications: may be diet or stress related; massage may reduce stress. Contraindications: Refer client to physician if intestinal tract is painfully distended or to rule out severe underlying condition.

What is persistent chronic pain?

Intractable pain

Which of the following structures support the body while in the sitting position?

Ischial tuberosity

What is a movement at a constant speed through range of motion with mild resistance?

Isokinetic contraction

What is contraction without Joint movement?

Isometric contraction

What is a contraction with joint movement ?

Isotonic contraction

Lumbricales: (Plantar View Foot) This muscle is one of the second layers in the sole of the foot. Synergists: Flexor digitorum longus, flexor digitorum brevis, quratus plantae, plantar interossei Antagonists: Externsor digitorum longus, extensor digitorum brevis. Palpation: Deep muscle, cannot be palpated

Origin (proximal attachment) tendons of the flexor digitorum longus Insertion: (distal attachment) Dorsal surfaces of the distal phalanges Action: Flexes second through fifth toes at the metatarssophalangeal joint. Innervation First lumbricalis meidal planta nerve (L4, L5) second through fifth lumbricales; Lateral plantar nerve (S1, S2)

Rotatores: (Posterior View) these muscles are deep beneath the multifidus muscles and directly above the vertebrae. Synergists: intertransversarii interspinales, multifidus Antagonists: Rectus abdominis Palpation: deep muscles cannot be palpated

Origin: (Inferior Attachment) Transverse processes of each vertebrae Insertion: (superior Attachment) Short head: base of spinous process of next vertebrae above; long head: base of spinous process of second vertebra above Action: Extends and rotates the vertebral column Innervation: Dorsal rami of spinal nerves

A benign bone tumor?

Osteoma

Which of the following muscles adduct the hip?

Pectineus

____________________ of the scapula brings the medial border of the scapula closer to the

Protraction

What is an indirect response to touch?

Reflective methods

Severe form of chronic synovitis; stiffness and pain from thickening of synovium, may also affect heart, lungs, and skin. Caused by an autoimmune reaction, avoid affected joints when in acute stage.

Rheumatoid arthritis

The axial skeleton contains the following bones?

Rib, Sternum, Vertebrae, Ossicles

What type of joint is the first carpometacarpal joint?

Saddle

"Twisting" fracture in which the fracture line wraps around the bone.

Spiral fracture

What is hydrotherapy application using friction?

Sponging

Rectus Capitis Posterior Major:

The spasmodic contraction of four of the small cervical muscles set off the referred pain. (These muscle are: rectus capitis posterior major,rectus capitis posterior minor, obliquus capitis superior and obliquus capitis inferior important in the movement of the upper two cervical vertebrae.)

What is interpersonal, emotional, sexual, and intellectual?

Types of boundaries

What is caused by a. Pathogen that can grow after infected host cell?

Viral

What are some contraindications that may occur during massage

-Muscles go into spasm -New bruises -New swelling -Skin rash (may be allergic to media being used)

Describe general contraindications

-avoid massage altogether -ALL conditions approached with caution -uncooperative patients -if massage makes condition worse

Adductors of Thumb and Digits: (Palmar View)

1) Adductor pollicis Fingers 2) Palmar interossei

Flexors of Elbow: (Anterior View)

1) Biceps brachii 2) Brachialis 3) Pronator teres 4) Brachioradialis

Lateral Rotators of Knee (Posterior View)

1) Biceps femoris

Abductors of Wrist: (Anterior View)

1) Extensor cari radialis longus 2) Extensor carpi radialis brevis 3) Abduct pollicis longus 4) Flexor carpo radialis 5) Flexor pollicis longus

Flexors of hip (Anterior View)

1) Psoas major 2) Iliacus fascia latae 3) Tensor fascia latae 4) Retus femoris 5) Pectineus 6) Adductor brevis 7) Adductor longus 8) Adduct magnus 9) Sartorius 10) Gracilis 11) Gluteus medius 12) Gluteus minimus

Downward Rotators of Scapula: (Anterior View)

1) Rhomboideus minor 2) Rhomboideus major 3) Levator scapula 4) Pectoralis minor

Abductors of Humerus: ( Posterior View)

1) Suprapinatus 2) Deltoid (middle and posterior) 3) Infraspinatus

Extensors of Knee (Anterior View)

1) Tensor fascia latae 2) Vastus intermedius 3) Vastus lateralis 4) Rectus femoris 5) Vastus medialis

What are the 13 contraindications

1. Severe distress (general contraindication)- physically feel ill or nauseated 2. Acute inflammation-cardinal signs 3. Loss of structural integrity 4. Skin conditions-acne, rashes, boils 5. Decreased sensation-can't give feedback 6. Increased sensitivity to touch-avoid light superficial stroking if recipient is ticklish 7. Cardiovascular disorders 8. Spreading disease by circulation 9. Bleeding and bruising 10. Edema 11. Compromised immunity 12. Osteoporosis 13. Cancer

Aneurysm

Abnormal widening of the arterial wall; tends to form thrombi and also to burst; a pulsating bulge and pressure are felt with accompanying symptoms of pain. Indications: N/A. Contraindications: Regional; immediately refer client to physician; avoid direct heavy pressure into arterial vessels.

Muscles resisted or assisted by client, beneficial effect similar to exercise.

Active joint movement

A benign tumor of the glands.

Adenoma

The symphysis pubis is a _______________ joint?

Amphiarthrotic

What is a deviation from normal?

Anomaly

What is a scientific benefit of aromatherapy in relation to allopathic medicine?

Antimicrobial

Subluxation

Any deviation from the normal relationship in which the articular cartilage is touching any portion of its mating cartilage. Indications: Massage may help relive muscle spasm. Contraindications: Refer client to physician

What is Still's disease related to?

Arthritis

What is it when therapist assist client and stretching until resistance is met?

Assisted static stretching

What has client relationships, professionalism, scope of practice/appropriate techniques, images/advertising claims?

Associated Bodywork and massage professionals

Scleroderma

Autoimmune disease that affects blood vessels and connective tissue of the skin; primary symptoms is hard, yellowish skin. Indications; N/A . Contraindications: Regional ,except in systemic cases, refer client to physician

Rheumatoid arthritis

Autoimmune inflammatory joint disease characterized by synovial inflammation that spreads to other tissues. Indications: stress responsive; massage can be helpful under medical supervision. Contraindications: General; work closely with physician.

You avoid what when extremely higher low blood pressure, lung disease, cardiac impairment, infectious skin condition, diabetes and kidney infection?

Avoid hydrotherapy

How often is it necessary for a Massage therapist to wash their hands?

Before and after each treatment

What is refusing to work on a client due to race, religion, size, or sexual orientation?

Bigotry or discrimination

What causes trigger points

Birth trauma, injury sustained in a fall or accident, poor posture, or overexertion

Deep Vein Thrombosis

Blood clot in deep veins; risk factor for pulmonary embolism (blood clot in the heart); often asymptomatic; symptoms may include swelling, edema, and pain described as aching and throbbing. Indications: N/A. Contraindications: Regional to general, depending on the severity of symptoms; always refer client to physician for unexplained pain; never massage over such areas.

Asking a client if there is any part of their body that they do not want massaged is a great way to find out the clients

Boundaries

Maintaining a therapeutic relationship with a client is very important. Which of the following should NOT be relied upon to preserve the relationship dynamic?

Boundaries

What is more than one fracture line, with several fragments resulting and much soft tissue damage?

Comminuted fracture

Atopic Dermatitis (Eczema)

Common inflammation of the skin marked by papules, vesicles, and crusts. Indications: symptom of an underlying condition: refer client to physician for diagnosis. Contraindications: regional: avoid affected area

What is the ability to communicate effectively, therapist ability to communicate with the client regarding goals, treatments, and outcomes?

Communicational skill

What is a break in the skin and torn soft tissues, where the bone protrudes through the skin?

Compound or open fracture

What produces a hyperemia or an increase in the amount of blood stored and muscle tissue?

Compression

What supports professional ethics by promoting a higher standard in the profession?

Continuing education

What is an agreement between the practitioner and the client that is often implied rather than explicit but what each will or will not do?

Contract

Axial skeleton contains these bones?

Cranium, facial, Sternum ,vertebrae

What is a progressivernflammatory condition that may affect any part of the G.I. tract?

Crohn's disease

What is the external application of cold for therapeutic purposes including ice massage?

Cryotherapy

What is it when giving chair massages at international airport for Foriegn tourists?

Cultural influences

What is lasting dilation and flushing of massaged area?

Deep stroking

What is socializing, group affiliation, friendship, dating, sexual activity, family, bartering, client/practitioner reversal, employment, interactions between students and school personnel?

Dual relationships

Erevtor Spinae Muscles:(Posterior View) Longissimus Cervicis Longissimuss Capitis Longissimus Thoracis

During full flexion, when bending over, the erector spinea muscles are relaxed. Upon standing upright, these muscles are initially inactive and extension is initiated by the hamstring muscles. As a result of this, lifting a load from the bent over positon can cause injury to these muscles. referred Pain: is up and down the spinal region and along the top of the iliac crest.

What is occurring when vasodilation increases the permeability of small vessels and fluid leaks into surrounding tissue?

Edema

What is a coordination or Synchronization to a rhythm?

Entrainment

One of the purposes of draping is to

Establish boundaries

What passes blood flow through superficial veins, increase permeability ability of capillary beds, and increased fluid and interstitial fluid?

Friction

What is body polishes, cold mittens, Drybrush massages, ice massages, salt clothes, and shampoos?

Frictions

What is a disease caused by molds or yeast?

Fungal

The influence of age on touch is most likely to be a consideration regarding what?

Geriatric massage

Which of the following muscles are synergists to the gluteals?

Hamstrings and piriformis

What is bone against bone?

Hard end feel

Trigger points may cause

Headaches neck and jaw pain, low back pain, tennis elbow, and carpal tunnel syndrome

A contagious bacterial disorder which has skin redness and vesicles around the nose, mouth, groin, hands and feet which burst and form crusts caused by staph; get a doctor's consent before massaging if doctor give's consent avoid affected areas.

Impetigo

Which of following is a concern for massaging a client with a diagnosis of enuresis?

Incontinence

Hypertonicity

Increased muscle tone. Indications: Massage and stretch. Contraindications: Recurrence without explanation; refer client to physician for diagnosis

Pancreatitis

Inflammation of the pancreas; may be present with diabetes and is aggravated by consumption of alcohol; one symptom is severe abdominal pain. Indications: Painful condition; massage may be helpful in general stress and pain reduction. Contraindications: refer client to physician immediately; with chronic conditions, work under physician's direct supervision.

Where would a Baker's cyst be located?

Knee

What area of the body would you find diverticulitis?

Large intestine

Scoliosis

Lateral curve of the vertebral column. Indications: Massage is beneficial as part of the treatment plan. Contraindications: Regional; in sever cases proceed after obtaining physician's recommendation.

What is tennis elbow, caused by repetitive extension of the wrist or pronation and supination of the forearm?

Lateral epicondylitis

Congestive heart Failure

Left heart failure; inability of the left ventricle to pump effectively; one symptom is increased fluid retention. Indications: massage is beneficial in helping diuretics remove excess fluid. Contraindications: General; must work under physician's supervision; client may have difficulty breathing in a supine position.

Degeneration and the necrosis of the head of femur?

Leg calve Perthes disease

The structure by which bone connects to another bone is a ________________?

Ligament

What type of massage is indicated for someone with hemophilia?

Light effleurage

What enhances lymphflow and reduces lymphedema?

Light massage

What is instantaneous temporary dilation of capillaries?

Light stroking

What causes contraction of blood vessels which tend to relax as movement continued?

Lights percussion

Lateral Flexors of Skull: (Lateral View)

Longus capitis Sternocleidmastoid (SCM) Splenius Lavator scapulae Middle scalene Posterior scalene Anterior scalene Trapszius

What has hyperextended lumbar spine,anterior tilt of the pelvis?

Lordotic posture

What is folders or pitchers elbow, caused by repetitive flexion of the wrist as in throwing?

Medial epicondylitis

What is guaranteeing that pain will be gone?

Misleading claims of creative abilities

What is another name for propioceptive neuromuscular facilitation, including reciprocal inhibition and post isometric relaxation, and assisted stretching technique that increases flexibility?

Muscle energy technique MET

Synergists:

Muscle that acts together with another muscle. Example: Biceps brachii and brachialis both causing flexion of the lower arm.

Group

Muscles

Pins and needles, numbness or burning sensations are an indication of which system malfunction? Nervous

Nervous

Which systems is directly affected by multiple sclerosis?

Nervous

What is a limited range of motion of the joint?

Normal end Feel

Externsor Carpi Radialis Brevis (Dorsal View)

Occasionally, a cystic swelling occurs on its tendon, causing a grape-size bump to appear on the wrist or back of the hand. Sometimes erroneously called a ganglion, it enlarges during flexion. the distal attachment of this muscle's tendon into the base of the third metacarpal bone is a common site.

Premenstrual Syndrome (PMS)

Occurs approximately one week before onset of period; symptoms include breast tenderness and swelling, fluid retention, headache, irritability, anxiety, depression, and poor concentration. Indications: massage is beneficial. Contraindications: Refer client to physician if symptoms are severe.

Longus Colli: ( Anterior View) Medial part

Origin (Inferior attachment) Anterior surface of the bodies of the first three thoracic and lower two cervical vertebrae insertion: (superior attachment) Anterior surface of the bodies of the bodies of the first two or three thoracic vertebrae.

Sternohyoid(eus): (Anterior View) the carotid sinus (importnat in blood pressure regulation) is found lateral to the sternohyoid between it and the SCM. Synergists: thyrohyoid, omohyoid Antagonists: Digastric, styohyoid, myohyoid, geniohyoid Palpation: palpate by placing fingers just lateral to trachea while swallowing. Innervation: Cervical spinal nerves C1-C3 through the ansa cervicalis (slender nerve root in cervical plexus)

Origin (inferior attachment) Medial end of clavicle and manubrium of sternum. Insertion: (superior attachment) Lower margin of body of hyoid bone. Action Depresses hyoid if it has been elevated, as in swallowing

Dorsal Interossei: (Lateral View Top Foot) 4 Trigger Points: are in the belly of each muscle Synergists: For flexion: lumbricales, flexor digitorum at the metatarsophalangeal joint Antagonists: to flexion; extensor digitorum longus, extensor digitorum brevis, to abduction plantar interossei Palpation: Deep muscle, cannot be palpated

Origin (proximal attachment) Adjacent sides of metatarsal bones Insertion: (distal attachment) First medial side of proximal phalanx of second toe: second, third, and fourth: lateral sides os the base of proximal phalanges of the second, third, and fourth toes. Action: Abducts toes and flexes proximal phalanges at the metatarsophalangeals Innervation: Lateral plantar nerve (S1, S2)

iliacus (Anterior View) 1 Trigger Point: is near the inner border of the ilium behind the anterior inferior iliac spine. Referred pain: Is the entire lumbar area and front of thigh. Synergists: Psoas major, adductor group, rectus femoris Antagonists: Gluteus maximus, hamstring muscles Palpation: Palpate into the iliac fossa with fingertips while thigh is flexed at hip joint. most of iliacus is not palpable.

Origin (superior attachment) Upper two thirds of iliac fossa, ala of the sacrum, anterior inferior iliac spine and iliac crest Insertion: (inferior attachment) With psoas major, lesser trochanter of femur Action: flexes thigh at hip joint; laterally rotates thigh Innervation: Muscular branches of femoral nerve (L2-L4)

Spinalis Cervicis: (Posterior View) Synergists: Longissimus, semi spinalis, iliocostalis grup Antagonists: Scalenes group, rectus abdominis

Origin: ( inferior attachment) Insertion: (superior Attachment) Spinous processes of second and third cervical vertebrae. (C2, C3) Innervation: dorsal rami of lower cervical and thoracic spinal nerves.

IIiocostalis thoracis: ( Posterior View) 2 Trigger points: on the belly of the muscle Synergists: Longissimus, semispinalis, spinalis group, quadratus lumborum Antagonist: Rectus abdominus

Origin: (Inferior attachment) Angles of lower six ribs medial to the iliocostalis lumborum. Insertion: (superior attachment) Superior border at the angles of the upper six ribs Innervation: Dorsal rami of the thoracic spinal nerves

Semispinalis Cervicis: (Posterior View) Synerginsts: Longissimus, iliocostalis, Spinalis group Antagonists: Rectus Abdominis

Origin: (inferior attachment) transverse processes of upper six thoracic (T1-T6) and articular processes of lower four cervical vertebrae (C4-C7) Insertion: (superior attachment) Spinous process of second through fifth cervical vertabrae (C2-C5) Action: Extends and rotates vertebrae column Innervation: Dorsal rami of lower three cervical spinal nerves (C4-C7)

Quadratus Femoris: (Posterior View) This is the most inferior of the rotators of the hip. Synergists: Superior gemellus, inferior gemellus, piriformis, internal obturator, external obturator Antagonist: Gluetus minimus Palpation: Palpate between ishial tuberosity and intertrochanteric crest of femur during active lateral rotation of thigh.

Origin: (posterior attachment) Upper part of the lateral border of the ischial tuberosity Insertion (distal attachment) Trochanteric crest of femur Action: Laterally rotates the thigh at the hip joint Innervation Branch from sacral plexus (L5, S1)

Pronator Teres (Anterior View) this muscle forms the medial border of the antecubital fossa 1 Trigger point is in the belly of the muscle near elbow attachment. trigger point activation can cause this muscle to squeeze the median nerve, resulting in numbness associated with carpal tunnel syndrome. Referred pain: is the radial side of the forearm into the wrist and thumb. Synergists: Pronator quadratus Antagonists: Supinator Palpation: Palpate on medial side of foreman just medial to insertion of biceps brachii during resisted pronation.

Origin: (proximal attachment) hummeral head: just above the medial epicondyle of the humerus: Ulnar head: medial side of the coronois process of the ulna Insertion: (distal attachment) Middle of lateral surface of radius Action: Pronates the forearm and assists in flexing the elbow Innervation: Median nerve (C6, C7)

Vastus Intermedius: (Anterior View) this muscle is the smallest and deepest of the quadriceps femoris group. It is covered by the rectus femoris and lies between the two vastus muscles 1 Trigger point is near the proximal attachment. Referred Pain: is the deep anterior thigh Synergists: Other three quafriceps femoris muscles, sartorius Antagonists: Hamstring muscles Palpation: deep muscle; cannot readily be palpated

Origin: (proximal attachment) Anterior and lateral surfaces of th eproximal two thirds of the body of the femur Insertion: (distal attachment) Deep surface the tendon of the rectus femoris and vastus muscle ; patella and through the patella ligament to the tibial tuberosity Action: Extends the knee at the joint innervation: femoral nerve (L2-L4)

Flexor Carpi Radialis: (Anterior View) 1 Trigger point is in the belly of the muscle. Synergists: Flexor carpi ulnaris, palmaris longus Antagonists: Extensor ulnaris Palpation: palpate tendon on anterior surface of wrist in line with second metacarpal.

Origin: (proximal attachment) Medial epicondyle of the humerus Insertion (distal attachment) Base of second and third metacarpal bones Action: flexes wrist and abduct hand Synergists: Flexor carpi ulnaris, palmaris longus Antagonists: Extensor carpi radialis longus, extensor carpi radialis brevis extensor ulnaris Innervation median nerve (C6, C7)

Adductor Hallucis (Plantar view Foot) This muscle is one of the third layer muscles in the sole of the foot. It helps to maintain the transverse arch of the foot. The transverse head may also insert on the big toe. 3 Trigger Points: are found in the belly of the transverse head, in the belly and near the insertion of the bblique head. Referred Pain: is to the ball of the foot. the transverse head may be absent. Antagonists: Lateral plantar nerve (S1, S2) Palpation: Deep muscle, cannot be palpate

Origin: (proximal attachment) Oblique head; bases of second, third, and fourth metatatrasal bones and sheath of fibularis longus tendon; Transverse head. ligamants of the metataratophalangeal joints of the third, fourth, and fifth toes Insertions: (distal attachment) Lateral side of base of proximal phalanx of the big toe. Action: Adducts the big toe Innervation: Lateral plantar nerve (S1, S2)

Abductor Digiti Minimi: (Palmar View) The hypothenar eminence (base of the little finge) is less prominent than the thenar eminence (base of the thumb. Trigger Point: Is in the belly of the muscle Referred Pain: is into the little finger. Synergists: flexor digiti minimibrevis, opponens digiti minimi Antagonist: Palmar interossei Palpation: palpate on ulnar border of fifth metacarpal during active abduction of little finger.

Origin: (proximal attachment) Pisiform bone and the tendon of the flexor carpi ulnaris Insertion: (distal attachment) Medial side of base of proximal phalanx of the fifth finger Action: Abducts the fifth finger Innervation: Ulnar nerve (C8, T1)

Brachioradialis (Lateral View) The brachioradialis is used to stabilize the elbow during rapid flexion and extension while in midposition, such as in hammering. 1 Trigger point: is in the belly of the muscle. Referred pain: is from the wrist and base of the thumb in the web space between the thumb and index finger to the lateral epicondyle of the humerus Synergists: Brachialis, biceps brachii Antagonists: Triceps brachii, anconeus Palpation: Palpate on upper forearm during resisted elbow flexion.

Origin: (proximal attachment) Proximal two-thirds of the lateral supracondylar ridge of humerus Insertion: ( distal attachment) Lateral side of the base of the styloid process of radius Action: flexes the elbow: assists in pronation and supination of the forearm to the midposition Innervation: Radial nerve (C5, C6)

Opponens Digiti Minimi: (Palmar view) This muscle helps to cup the palm of the hand. It lies deep to the abductor digiti minimi and flexor digiti minimi. Synergists: Flexor digiti minimi brevis, abductor digiti minimi Antagonist Dorsal interossei Palpation: Deep muscle, cannot be readily palpated.

Origin: (proximal attachment) anterior surface of flexor retinaculum and hook of hamte Insertion: (distal attachment) Whole length of the medial border of the fifth metacarpal bone. Action: rotates fifth metacarpal bone into opposition with thumb,draws it forward, and assists in flexing carpometacarpal joint of fifth finger Innervation: Ulnar berve (C8, T1)

Flexor Digitorum Brevis (Plantar View) 2 Trigger Point: are in the belly of the muscle as it divides into slips onto the second through fifth toes. Referred Pain: is to the top of the foot and just behind the toes. together these muscles help support the arches of the foot. The slip to the little toe may be reduce or absent. Synergists: Flexor digitorum longus Antagonist: Extensor digitorum longus Palpation: palpate medially on plantar surface of foot when toes are flexed.

Origin: (proximal attachment) tuberosity of the calcaneous and plantar apononeurosis insertion: ( distal attachment) sides of middle phalanges of the second through fifth toes Action: Flexes digitorum longus Innervation: Medial plantar nerve (S1-s3)

Abductor Digiti Minimi: (Plantar View Foot) 2 Trigger point are near the origin and in the belly of the muscle; Referred Pain: is to the fifth toe and lateral side of foot. Synergists: Flxor digiti minimi Antagonists: plantar interossei Palpation: Palpate along lateral border of little toe when toe is actively abducted.

Origin: (proximal attachment) tuberosity of the calcaneous and the plantar aponeurosis. Insertion (distal attachment) Lateral side of proximal phalanx of the fifth toe Action: Abducts the fifth toe, and flexes it at the metatarsophalangeal Innervation: Lateral plantar nerve (S1, S2)

Gemellus Inferior: (Posterior View) Synergists: suprior gemellus, qudratus femoris, internal obturator, external oburtator, piriformis Antagonist: gluteus minimus Palpation: deep muscle, cannot be palpated.

Origin: (proximal attachment) upper margin of ichial tuberosity Insertion (distal attachment) with tendon of obturator internus into upper border of greater trochanter. Innervation: nerve from sacral plexus (L5-S2)

An active muscles that benefit greatly from massage because?

Oxygen and nutrients are delivered

Dysmenorrhea

Painful menstruation; may be caused by endometriosis—abnormal growth and distribution of uterine lining—symptoms include heavy periods and clotting. Indications: massage is beneficial for stress reduction and pain. Contraindications: Refer client to physician for diagnosis.

What is a widespread epidemic?

Pandemic

Urticaria (Hives)

Red, raised lesions caused by leakage of fluid from the skin and blood vessels; primary symptom is severe itching. Indications: Do not use scented products; hives may have an emotional component. Contraindications: Regional; avoid affected area.

Atonicity

Reduced ability to inability of the muscle to contract. Indications: Massage to tone; relaxation of opposing muscle groups. Contraindications: Regional; refer client to physician for diagnosis befor proceeding

Would you do if a client needs a treatment outside the scope of practice?

Refer the client to another professional

What is the results of pressure or movement on one part of the body having an effect in another part, stimulation of the nervous and endocrine systems, muscle relaxation, increased mental clarity, pain reduction, normalizing system function?

Reflective of effect massage

If a caller asked if the massage includes sex or a client asked to be touch in a sexual manner or for a happy ending you should?

Remain professional and explain the services

What is professionals being clear about what is expected for clients?

Rights as professional

What is a bath with salt?

Saline bath

What is NOT likely to be a mode of HIV transmission?

Saliva

A malignant tumor arising in tissue other than epithelial tissue.

Sarcoma

Which of the following muscles is a hip abductor?

Sartorius

What is a good position for a client when preforming on site corporate massage?

Seated position

Gentle stroking, light friction petrissage, holding pressure-ischemic compression

Sedative massage technique

Syncope

Sudden loss of strength; fainting ; may be caused by a cardiac spasm resulting from closure of coronary arteries. Indications: N/A. Contraindications: General; immediately refer client to physician.

Convulsion

Sudden, involuntary series of muscle contractions, sometimes called seizure. Indications: N/A. Contraindications: Refer client to physician immediately

Postpolio Syndrome

Symptoms of fatigue and general muscle weakness that appear years after resolution of poliomyelitis. Indications: Massage is beneficial as part of a physician directed treatment plan. Contraindications: General

What connects muscle to bone?

Tendons is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension

What is an inflammation of the tendon sheath?

Tenosynovitis

Piriformis: (Anterior View)

Tension in this muscle may cause entrapment of the sciatic nerve that nromally passes under the pirformis but which, in some individuals, may pass through the muscle. Tension in the piriformis can cause a twist at the sacroiliac joint, causing a tilted sacrum and making it appear as if one leg is shorter. Tightening of the piriformis makes crossing the legs at the knee difficult. Occasionally, the sciatic nerve may go through the piriformis.

Client holds the left arm position against therapist's inferior/caudal pressure. You test what?

Test the left arm flexors

If a client reveals that they are guilty of child abuse, the law may require that the client should be what?

The client should be reported to child welfare authorities

Which of the following would be an appropriate disclosure to a client?

The fact that the massage professional has a cold

If a minor asks therapist to make an exception and give a massage without permission from a parent or legal guardian the therapist said what?

The therapist should not give the massage

Vastus Lateralis: (Anterior View)

This is the most lateral of the quadriceps femoris group. It forms the lateral aspect of the thigh and is a common sit for intramuscular injections. Striking the patella ligament causes the characteristic knee jerk reflex test. It is a common condition in runners and may also be caused by a blow to the patella or exteme flexing of the knee joint as in squatting or kneeling.

Latissmus Dori: (Posterior View)

This muscle may occasionally arise in part from the inferior angle of the scapula. This muscle is important in bringing the arm down in a power stroke as in hammering, swimming (crawling stroke), and rowing.

The only saddle joint of the body is found in the ________________?

Thumb

What is the important of maintaining S.O.A.P notes for each client session?

To monitor the progress of the client

Is tilting of head, caused by spasm in SCM muscle?

Torticollis

What is the reaction to repeat exposure to stimuli that can explain the automatic reaction to massage?

Toughening/hardening

What is it when a client has feelings towards the therapist, for example, the client gives the therapist a gift that show affection?

Transference

What is a physical injury or when caused by external force or violence?

Trauma

What are some medications information you need to know for massage

Types of medications that require caution include, but are not limited to, those that: *alter sensation *affect the blood and circulation *compromise tissue integrity *alter mood -Check with the MD first

What is name - dropping clients, telling a spouse details about the partner session, discussing a massage with a client and a public place such as a grocery store?

Violations of confidentiality

Poliomyelitis

Viral infection of the nerves that control skeletal muscles. Indications: Massage is beneficial as part of a physician-directed treatment plan. Contraindications: General

Herpes Zoster (Shingles)

Viral infection that usually affects the skin of a single dermatome; produces red, swollen plaque that ruptures and crusts. Indications: Condition is painful; general massage may ease pain. Contraindications: Regional; avoid affected area; may need to refer client to physician

What is when the client is sitting in the tub and receiving jets of water against the skin?

Whirlpool

You avoid what when there's inflammation, edema and acute stage of injury?

You avoid what when there's inflammation, edema and acute stage of injury?

What do you need to remember about arthritis and massage

You need to use caution with rheumatoid -it is not indicated during acute phase especially over acutely inflamed joints -caution during sub acute phase -helps patient prepare for ROM activity -The depth of massage is inversely proportional to degree of inflammation present -same for degenerative (osteoarthritis)

A massage therapist who is providing an intake to uncover the treatment desires of the client is performing

a needs assessment

Myofascial pain and Active ROM

active contraction of the muscle in the shortened position may cause pain muscle shortening associated with an active trigger point can cause a limitation in range of motion in the joints over which this muscle acts

A patient with myofascial pain trigger points may report

acute muscle trauma repetitive stress/microtrauma biomechanics stress on a cold muscle lack of exercise prolonged poor posture nutritional deficiencies excessive caffeine or nicotine intake sleep disturbances articular dysfunction in nearby joints surgical scars tissue under tension as commonly found after spinal surgery or hip replacement stress constitutional illness

Myofascial pain and muscle length:

attempts at passively elongating the muscle will cause pain in the muscle at less than normal length

What coordinates activities with work equipment?

ergonomics

Placing weight on the inner edge of the foot is an example of _______________.

eversion

compression test

firm pressure is applied to a muscle during a movement that typically causes pain in that particular muscle the result of applying the pressure is that the pain is relieved or significantly diminished

What has strong neck extensors, weak anterior vertebral neck flexors?

forward head position

The type of joint found in the spine is_____________?

gliding

Energy crisis hypothesis

oldest explanation for the existence of trigger points states that increased demand on a muscle, macro trauma, or repeated micro trauma leads to increased calcium release from the sarcoplasmic reticulum Increased calcium release leads to prolonged shortening of the sarcomeres shortening causes a decreased intramuscular circulation lack of oxygen supply results in a local depletion of the entry-rich phosphate ATP. muscle cells are unable to initiate the active process of actomyosin relaxation resulting in a trigger point and its associated taut band of muscle fibers

On a rare occasion a client will be unhappy or dissatisfied with an experience with a therapist. In this case, a therapist should have a _______________ to address the client's issues.

recourse policy

When assessing flexion of the knee,resistance is applied to the end of the?

tibia

local twitch response definition

transient visible or palpable contraction or dimpling of the muscle or skin as the tense muscle fibers of the trigger point contract when pressure is applied

Hinge and pivot joints are examples of _______________ joints.

uniaxial

flat palpation

used for paraspinal muscles doesn't move her fingers on the skin, but rather moves the skin and the fingers across the muscle fibers will typically feel a cord-like band of muscle fibers which will produce a snapping feeling when moving the fingers and skin back and forth across the fibers

pincer palpation

used for trigger point palpation in the sternocleidomastoid, pectoralis major, and latissimus dorsi the examiner squeezes the fibers between the fingers with a back and forth rolling motion to locate the taut band

What is acceleration/deceleration injury to the head a neck?

whiplash

Adductors of Humerus: (Anterior View)

1) Deltoid (anterior) 2) Coracobrachialis 3) Pectoralis major 4) teres major 5) Latissimus dorsi

Flexors of humerus: (Anterior View)

1) Deltoid (anterior) 2) Petoralis major (clavicular head) 3) Coracobrachialis 4) Biceps brachii

Medial Rotators of humerus: (Posterior View)

1) Deltoid Anterior 2) Pectoralis major 3) Subscapularis 4) Teres major 5) Latissimus dorsi

Abductor of the Thumb and digits: (Dorsal View)

1) Dorsal interossie 2) Abductor difiti minimi Thumb 3) Abductor pollicis brevis 4) Abductor pollicis longus

Extensors of Wrist: (Posterior/ Dorsal)

1) Extensor carpi radialis longus 2) Extensor carpi radialis brevis 3) Extendsor carpi ulnaris 4) Extensor digitorum

Adductors of wrist: (Anterior/ Palmar View)

1) Extensor carpi ulnaris 2) Flecor carpi ulnaris

Dorsiflexors of Ankle: ( anterior View)

1) Extensor digitorum longus 2) fibularis tertius 3) Tibialis anterior 4) Externsor Hallucis longus

Extension-Opposition of Thumb and digits: (Dorsal View)

1) Extensor pollicis longus tendon 2) Extensor pollicis brevis tendon Fingers 3) Dorsal interossei 4) Extensor digitorum tendon 5) Extenso digiti minimi tendon 6) Extensor indics 7) Deep to extensor digitorum lumbricales

Evertors of Foot: (Lateral view)

1) Fibularis longus 2) Fibularis brevis 3) Extensor digitorum longus 4) Fibularis tertius

Flexors of Wrist: ( Anterior/ Palm View Superficial)

1) Flexor carpi radialis 2) Palmaris longus 3) Flexor capi ulnaris 4) Flexor digitorum superficialis 5) Flexor digitorum profundus

Which of the following joint classifications would be described as slightly moveable?

Amphiarthrosis

What is the examination of tissues removed from cadavers or living people for the purpose of studying disease?

Anatomic pathology

a wet cloth with water run from it that is applied to the skin surface is what?

Compression

Thoracic Outlet Syndrome

Compression of brachial nerve plexus; primary symptom is pain that radiates to the shoulder and arm. Indications: Massage is beneficial as part of the treatment

Trigeminal neuralgia (Tic Douloureux)

Compression or degeneration of the fifth cranial nerve; primary symptom is recurring episodes of stabbing pain in face. Indications: Avoid entire area of trigeminal nerve innervation; massage may trigger pain response. Contraindication: Regional

Swelling, reducing spasiticity, prevent injury to tissue

Conditions for which Cold can be applied

Stretch week muscles, and Impaired circulation, arthritis, and increasing extensibility of collagen tissue

Conditions for which Heat Could be applied

What is keeping information private, respect for clients right to privacy

Confidentiality

What is in the professional therapeutic relationship?

Confidentiality, scope of practice, client centered actions and words, consistency, informed consent and right of refusal, contract, rights of professionals

What is a disease present at birth?

Congenital

Reduces cortisol levels, increases serotonin and dopamine levels, increases secretion of endorphins and enkaphalins, reduces pain?

Effects of massage on the nervous and endocrine system

What part of the body is directly affected when a client has conjunctivitis?

Eyes

What happens with with fascia over time?

Fascia can become more fibrotic when traumatized or overused, and it tends to web after periods of immobility, causing collagen molecules to tether together, leading to fibrosis. The longer someone has the problem, the more it spider webs throughout the body

Which of the following should be a part of a massage therapists policy statement?

Fee schedule

Which of the following should be done before working with a new client that is covered by insurance? Fill out the intake form

Fill out the intake form

Benign fatty tumor?

Lipoma

What is an important interviewing technique?

Listening

Carbuncle

Mass of connected boils. Indication: Massage may increase systemic circulation and may assist healing. Contraindication: Refer client to physician; regional; avoid affected area.

Lower Back Pain

May be of many varieties: muscular, nerve entrapment, or disk problem. Indications: Massage can be beneficial as part of the treatment plan. Contraindications: Regional; important to refer client to physician to rule out serious conditions of the spine or viscera

What is the result of the application of physical force says that as bending compression, stretching,sharing, broadening, and vibration of tissues, the venous return, lymph flow, and breaking adhesions?

Mechanical effects of massage

What is out of the professional therapeutic relationship?

Medical advice, social needs, personal needs, spiritual advice, psychological counseling, other business deals

Latent trigger point

doesn't produce spontaneous pain. Pain occurs only on the application of external pressure present with muscle shortening and can cause muscle weakness or restrict joint movement can turn into active trigger points

What is observing a client's gravitational line,balance,and symmetry in various positions?

Posture assessment

A massage therapist has created a great side business of selling supplements and therapy aides to her clients. What ethical advantage is the massage therapist using to increase profits?

Power differential

What is the relationship when an experienced therapist with a PhD performs a massage on a new therapist, or when a recently licensed therapist works under the supervision of a more experienced professional?

Power differential

What is final adjustments, massage or canceling without proper training?

Practicing Beyond scope of practice

What is outside the scope of practice?

Prescribing treatment

What symptom would be expected in a client diagnosed with cataplexy?

Temporary muscle weakness

Which muscle is a synergist to medial rotation of the hip?

Tensor fascia latae

Moving the left hand from in front of the right hip to the front of the left shoulder is an example of _______________.

diagonal abduction

Motor endplate hypothesis

dysfunction of the motor endplate or neuromuscular junction could also produce trigger points there may be a small increase in activity near the motor endplate zone of muscles that contain active trigger points

The up phase of a wide arm push-up creates which type of contraction of the bicep muscle?

eccentric contraction is one where the muscle lengthens under force.

Hypotheses on trigger point pathogenesis

energy crisis hypothesis motor endplate hypothesis radiculopathic model for myofascial pain

What is a hole or rip in the abdominal wall?

Hernia

The sternum from superior to inferior?

manubrium, body, xiphoid

What are some exceptions to contraindications

-Malignancies: in late stages of terminal cancer message may be used for pain relief. -Edema: if due to cardiac insufficiency massage may aide in return of fluid, but only if MD asks for it to be done. (it is possible to overload the heart with fluid.)

*What are some indications for massage

-Pain -Relieving muscle tension or spasm -Increasing flexibility and range of motion -Reducing muscular pain -Edema -Lymphedema -Scar tissue

When is abdominal massage contraindicated:

-Pregnancy -Peritonitis -Hernias -Inflammatory abdominal lesions

Lateral Rotators of Hip: (Posterior View)

1) Gluteus maximus 2) Gluteus medius 3) Gluteus minimius 4) Piriformis 5) Gemellus superior 6) Quadratus femoris 7) gemellus inferior 8) Obturator externus 9) Iliacus 10) Obturator internus 11) Psoas major 12) Sartorius

Extensors of Hip: (Posterior View)

1) Gluteus medius 2) Gluteus maximus 3) Biceps femoris 4) Semitendinosus 5) Adductor magnus 6) Semimembranosus

Abductors of Hip: (Posterior & Anterior View)

1) Gluteus medius 2) Gluteus minimus 3) Gluteus maximus Anterior View 4) Tensor fascia latae 5) Sartorius

Medial Rotatos of Hip: (Posterior View)

1) Gluteus medius 2) Gluteus minimus 3) Tensor fasicia latea

Medial Rotators of Knee: (Posterior Veiw)

1) Gracilis 2) Semitendinosus 3) Sartorius 4) Popliteus

Flexors of knee (Posterior View)

1) Gracilis 2) Semitendinosus 3) Semimembranouosus 4) Gastrocnemius 5) Sartorius 6) biceps Femoris 7) Plantaris 8) Popliteus

Lateral Rotators of Humerus: (Posterior View)

1) Infraspinatus 2) Deltoid (Posterior_ 3) Teres minor

Elevators of Scapula: (Posterior View)

1) Lavator scapula 2) Trapezius 3) Rhomboiseus mionor 4) Rhomboideus major

Adductors of hip (Anterior View)

1) Pectineus 2) Adductor brevis 3) Adductor longus 4) Gracilis 5) Adductor magnus

Extensors of Humerus: (Posterior View)

1) Pectoralis major (sternal head 2) Deltoid (posterior) 3) Triceps brachii (long head) 4) Teres major 5) Latissimus dorsi

Protractors of Scapula: (Anterior View)

1) Pectoralis minor 2) Serratus anterior

Depressors of scapula: (Posterior View)

1) Pectoralis minor 2) Serratus anterior 3) Pectoralis major 4) Trapezius

Plantar flexors of Ankle: (Posterior View)

1) Plantaris 2) Gastrocnemius 3) Flexor hallucis longus 4) Fibularis longus 5) fibularis brevis 6) Flexor digitorum longus 7) Soleus 8) Tibialis posterior

Pronators of Forearm: (Anterior View)

1) Pronator teres 2) Brachioradialis 3) Pronator quadratus

Retractors of Scapula: (Posterior View)

1) Rhomboideus minor 2) Trapezius 3) Rhomboideus major

Qnterior flexior Flexors of Skull: (Posterior View)

1) Sternocleidomastoid 2) Rectus capitis anterior 3) Longus capitis 4) Longus colli 5) Middle scalene 6) Anterior scalene

Invertors of Foot (Poterior view)

1) Tibialis Posterior 2) flexor digitorum longus 3) Flexor halluscis 4) Tibialis anterior

Extensors of Neck: (Poterior View)

1) Trapezius Tendon 6) Rectus capitis posterior .........................................................minor 2) Semispinalis capitis 7) Obliquus capitis ...........................................................superior 3) Splenius capitis 8) Rectus capitis posterior ...................................................major 4) Trapezius (cut) 9)Semispinalis capitis ...........................................................(cut) 5) Splenisus vervicis 10) Longissimus capitis

Rotatars of Neck: (Posterior View)

1) upper tendon of trapezius 2) Semispinalis 3) Splenius capitis 4) Sternocleidomastoid (SCM 5) upper trapezius 6) Splenius Cervicis 7) Rectus capitis posterior major 8) Obliquus capitus superior 9) Semispinalis (cut) 10) Levator scapulae

Breast Cancer

Abnormal, malignant tissue growth on or in the breast; most common cause of cancer in women; encourage monthly breast self-examination and regular checkups. Indications: be aware of changes in tissue around axillary region. Contraindications: If changes are noted, refer client to physician; early diagnosis is important.

Trigger points are primary cause of pain what percentage of the time?

75%

Spasmodic Torticollis

A contracted state of the cervical muscles that causes pain and rotation of the head. Indications: Massage is beneficial. Contraindications: Regional; refer client to physician for diagnosis to rule out serious disease

Fibrillation

A small, local contraction of muscle that is invisible under the skin; results from spontaneous, synchronous activation of single muscle cells. Indications: massage, direct pressure. Contraindications: If continuous, refer client to physician for diagnosis.

Lordosis

Abnormal increased concavity in the curvature of the lumbar spine. indications: Massage is beneficial as part of the treatment plan. Contraindications: Regional; in severe cases proceed after obtaining physician's recommendation.

Kyphosis

Abnormal increased convexity of the thoracic spine. Indications: Massage is beneficial as part of the treatment plan. Contraindications: regional; in severe cases proceed after obtaining physician's recommendation.

If you ask a client to turn his head to the side so you can see how much range of motion he has, this is considered what type of movement?

Active- range of motion (or AROM) Patient performs the exercise to move the joint without any assistance to the muscles surrounding the joint.

The term to describe a condition with an intense sudden onset and short duration.

Acute

Urinary Tract Infection

Acute pyelonephritis— inflammation of the kidney and pelvis; usually occurs in women with abrupt onset of fever, chills, malaise, and back pain, also tenderness on palpation over the costovertebral region; cystitis—affects men and women, usually caused by transmission of bacteria through the urethra because of improper cleansing after bowel movement; may cause pain in lower abdomen above pubic bone and low back ache. Indications: N/A. Contraindications: Refer client to physician for diagnosis and treatment.

Herpex Simplex

Acute viral disease marked by groups of watery blisters on or near mucous membranes. Indications: recurrence is related to stress: massage may reduce stress levels. Contraindications: Contagious; regional; avoid the affected area

What is unethical behavior from therapist and a professional relationship?

Any sexual acts, activities, behaviors, talks, relations, or intercourse

Ice pack, ice plastic bag, wrapped in towel or Styrofoam cup

Application of ice

Which of the following is a violation of confidentiality?

Approaching and speaking to a client in a restaurant

What is an endangerment site?

Areas of the body where delicate structures are less protected and, therefore, may be more easily damaged when receiving message

Raynaud's Syndrome

Arteriospastic condition caused by vasospasms of the small cutaneous and subcutaneous arteries and arterioles; usually activated by cold but can be emotionally triggered; symptoms include skin pallor and pain. Indications: Care must be taken to avoid triggering the symptoms; interview client carefully; massage may be beneficial for stress reduction. Contraindications: refer client to physician for specific underlying diagnosis; condition may be symptomatic of serious disorder.

Where on the SOAP chart, is short term goals based on activities or daily living recorded?

Assessment

What is a broad category of hydrotherapy application that involves partial or complete immersion in water?

Bath

Noncontagious inflammation of the skin and deeper tissues. Cause: widespread bacterial infection (Staph) get doctor's consent before performing massage.

Cellulitis

A loss of muscle mass and strength due to immobility is referred to as_________.

Atrophy

Rheumatoid arthritis, lupus, chronic fatigue syndrome and Sjogren's syndrome are all examples of ________ diseases.

Autoimmune

You avoid what when there is circulatory problems, and cold applications are not used prolonged periods because of depressing effect?

Avoid ice and cold

Where are some endangerment site

Axillary, belly, popliteal area, kidneys

What is caused by tiny cells that secrete toxins, eat body cells, or form colonies?

Bacterial

Osteomyelitis

Bacterial infection of the bone; symptoms include deep pain and fever. Indications: N/A. Contraindications: General; immediately refer client to physician; difficult to diagnose and treat.

Halitosis

Bad breath; may indicate digestive problems or sinus infection. Indications: N/A. Contraindications: Refer client to physician for specific diagnosis.

Joint with the greatest range of movement?

Ball-and-socket

What is bobbling or bouncing during the stretch, not recommended due to possibility of muscle strain or chair?

Ballistic stretching

Hemophilia

Blood clotting disorder; primary symptom is spontaneous bleeding resulting from an inability to form clots. Indications: Extremely light energy type of massage given only under physician's direction. Contraindications: General; work only under physician's supervision.

What is scrubbing the body with a brush dipped warm, soapy water?

Body shampoo

If a male client has a female body worker, as he is laying down on the table, she begins the session and her breasts touches the client. who would be at fault?

Body worker

Get doctor's approval before performing bodywork. If approved massage proximal and distal to the site of injury but not on the fracture until 6 to 8 weeks after injury.

Bone fractures and massage

Which nerve plexus is involved in thoracic outlet syndrome?

Brachial

What is likely to be a mode of HIV transmission?

Breast milk

Another name for amphiarthrosis is __________________?

Cartilage Joint

Massage movement towards the heart is characterized as: ?

Centripetal

Sleep Apnea

Cessation of breathing during sleep. Indications: Stress may be a factor; massage is beneficial in reducing stress. Contraindications. Regional

Angina Pectoris

Chest pain caused by inadequate oxygen to the heart (usually because of blocked coronary arteries) Indications: massage is beneficial as part of a lifestyle change. Contraindications: General: massage is performed under physician's supervision.

Cirrhosis of the Liver

Chronic disease that replaces liver tissue with connective tissue; major cause is alcohol consumption; early symtoms include gas, change in bowel habits, slight weight loss, nausea in the morning, and a dull, heavy ache in the right upper quadrant of the abdomen; advanced symptoms include jaundice, peripheral edema, bleeding, and red palms. Indications: massage is beneficial in stress reduction and drug withdrawal. Contraindications: Refer client to physician for diagnosis; work under physician's supervision.

Psoriasis

Chronic inflammation of the skin; probably genetic; symptoms include scaly plaque and excessive growth rate of epithelial cells. Indications: May be stress-induced; massage reduces stress. Contraindications: Regional; avoid affected area

Lupus Erythermatosus

Chronic inflammatory disease that affects many body tissues; common symptoms is a red rash on the face. Indications: Massage may be beneficial under physician's close supervision. Contraindications: general; systemic disease

Ankylosing Spondylitis

Chronic inflammatory disease; can be progressive; usually involves the sacroiliac joint and spinal articulations; cause is unknown, appears to be genetic; if progressive, calcification of the joints and articular surfaces occurs; begins with feelings of fatigue and intermittent low back pain

What is on a 24 hour clock?

Circadian rhythms

What is the client can stop treatment at any time, a client to refuse any part of treatment even if permission has been given previously?

Client right of refusal

. What is laboratory medicine?

Clinic pathology

What is commonly accepted guidelines or principles of combat that govern professional conduct?

Code of ethics

A bone broken in several places (shattered).

Comminuted Fracture

Hydrotherapy application that combines heat and cold, benefits include alternating vasoconstriction and vasodilation, and beneficial for chronic muscle spasms

Contrast methods

Head injury

Contusion (bump on the head); laceration (cut or break in the skin); subdural and apidural injury may produce disorientation, nausea, and uneven pupil dilatation. Indications; Immediately refer client to physician if any of the signs listed above are noted. Contraindications; general; all traumatic injuries must be evaluated by a physician.

Functional assessment

Coronal plane

What is decreased as one of the effects of massage -

Cortisol

What is the feelings of a therapist towards the clients, example when a therapist gets angry because the client is talking to much or complaining about Personal problems?

Countertransference

Myocardial Infarction (MI)

Death of cardiac muscle cells, usually from inadequate blood supply, often from coronary thrombosis or coronary artery disease; symptoms include severe pain in the chest or left arm, difficulty breathing and weakness. Indications: During rehabilitation, massage can be beneficial when supervised by physician. Contraindications: General; refer client to physician immediately.

Reduces inflammation, reduces swelling, vasoconstriction initially induced, secondary affective increase the local circulation, initial feeling uncomfortable cold, total numbness

Effects of cold and ice

Increases blood flow, increased metabolism, reduces pain, increases range of motion, and decreases stiffness

Effects of heat

Malnutrition

Deficiency of calories in general and often in protein; malnutrition may be caused by increased nutrient demand on the body without sufficient food intake—severe burns, illnes, or lack of food, especially protein— symptoms include flaking skin, brittle hair, hairloss, slow-healing sores, bruising, susceptibility to infection, and fatigue; more common in children and the elderly and with drug and alcohol abuse; be aware of eating disorders. Note: Malnutrition also can be caused by insufficient or improper digestion and absorption of food. Indications: With anorexia or bulimia, massage may be beneficial for stress reduction. Contraindications: Refer client to physician for diagnosis and treatment plan.

Transient Ischemic Attack (TIA)

Definition/symptoms; Episodes of neurologic dysfunction that usually are of short duration (a few minutes ) but may persist for 24 hours; reversible; symptom pattern is the same with each attack, because the same vessel is involved; small strokes, seizures, migraine symptoms, postural hypotension, and strokes Allen syndrome may be misdiagnosed as TIAs. Indications: Massage may be beneficial under physician's supervision. COntraindications: Refer client to physician for diagnosis.

Osteoarthritis

Degeneration joint disease of the articular cartilage; age and joint damage are risk factors. Indications: massage is beneficial. Contraindications: Regional; avoid area of inflammation

What is a deteriorating disease involving the breakdown of tissues?

Degenerative

What is the bone and the skull being driven in ward?

Depressed fracture

What is assigning a name or label to group of signs or symptoms, a diagnosis is outside scope of practice, and can be made by primary caregiver?

Diagnosis

Which of the following describes the joint classification of the glenohumeral joint?

Diarthrosis

What is an application of oscillating magnetic fields to tissue?

Diathermy

What is a sharing of personal information with permission?

Disclosure

Temporomandibular Joint (TMJ) Dysfunction

Disorder in functioning of the TMJ; pain and muscle contraction. Indications: Massage is beneficial; work closely with dentist and physician. Contraindications: regional; if painful.

Trigger points may cause symptoms of

Dizziness, earaches, nausea, heartburn, false heart pain, heart arrhythmia, genital pain, and numbness in the hands and feet.

Which of the following is the number one ethical standard of providing massage therapy?

Do NO harm

Reduces superficial keloid formation, stimulates sweat and oil gland activity, friction and stroking movement heightened blood circulation, slight raining and warming of the skin, nutrition to skin is improved

Effects of massage on skin

__________________where the toes are brought closer to the shin. This flexion decreases the angle between the dorsum of the foot and the leg. An example includes the position of the foot when walking on the heels.

Dorsiflexion

What dilates blood vessels, increase red blood cell count, increase stroke volume, decreases heart rate and pulse rate, reduces ischemia, stimulates the release histamine for vasodilation and acetychlorine.

Effect of massage on the cardiovascular system

Petrissage or kneading and compression create a pumping action, forces Venous blood and lymph out word, brings fresh supply of blood to muscles, aids and removal of metabolic waste, helps nourish tissue friction massage reduces adhesion and excessive scar improves posture allows more flexability.

Effective massage on the muscular system

What is sympathetic action of stress, mostly reflective effects, parasympathetic patterns and conservation withdrawal, entrainment, body mind effect, and placebo effect?

Effects of massage that can be processed through the ANS

What results in a decreased ability to exhale with the diaphragm and intercostal's not able to work efficiently?

Emphysema

What is a change in quality of movement of the first sign of resistance?

End feel

What is guiding principles for distinguishing between right and wrong?

Ethics

What is the study of all factors involved in causing a disease?

Etiology

What is asking a professional for advice during the treatment?

Exploding power differential

This has flexed or straight lumbar spine,forward head,posterior pelvic tilt,hamstrings short and strong?

Flat back posture

Contagious inflammation of a hair follicle caused by staph or other bacterial infection. Avoid affected area and refer to doctor.

Folliculitis

What are hot packs?

Fomentations

Diverticulosis

Formation of small pockets in the large intestine, caused by herniation of the mucosa; if pockets become inflamed, conditions is called diverticulitis; symptoms include gas, diarrhea, and pain. Indications: Diet may need adjustment to include more fiber. Contraindications: Refer client to physician if pain or symptoms persist.

Neuropathy

Functional disturbance or pathologic change in the peripheral nervous system; symptoms include numbness, burning, and tingling pain. Indications: Massage is beneficial under medical supervision; may calm hypersensitive nerves. Contraindications: General; work under physician's direction.

What is observing the body movements or walking?

Gait assessment

Cholelihiasis and Cholecystitis

Gallstones formed as a result of inflammation; primary symptom is severe pain in upper abdomen radiating to back and right shoulder. Indications: N/A. Contraindications: Immediately refer client to physician

Which muscle is a synergist to lateral rotation of the hip?

Gemellus inferior

Fibromyalgia

General disruption in connective tissue muscle component; symptoms include tender point activity; vague symptoms of pain and fatigue. Indications: massage may be beneficial; work with physician. Contraindications: General; refer client to physician for diagnosis; do not use therapeutic inflammation methods

Peripheral Neuropathy

General functional disturbances and pathologic changes in the peripheral nervous system caused by diabetic neuropathy, ischemic neuropathy, or traumatic neuropathy; symptoms include numbness, burning and pain. Indications: massage is beneficial as part of the treatment plan. Contraindications: Regional; refer client to physician for specific diagnosis.

What is an annular deformity of a collapsed vertebrae?

Gibbus

What is effleurage

Gliding, nurse drafts, deep effleurage, feather stripping, best for applying lubrication, beneficial or Dema, reduces high blood pressure and date for beginning and ending massage.

Which is an inflammatory joint condition caused by deposits of uric acid crystals?

Gout

An incomplete break in a bone.

Greenstick fracture

Transversospinalis (Posterior View)

Group of muscles: Semiispinalis Capitis semispinails Cervicles Semispinalis Thoracis

Erector Spinae Muscles (Posterior View) IIiocostallis cervicis IIiocostalis Thoracis IIiocostalis Lumborum

Group of muscles: The erector spinae muscles are a group of three sets of muscles: the iliocostalis, longissimus, and spinalis, Together they extend and laterally flex the vertbral column. In the lumbar region they lie deep to the lumbodorsal fasica (thoracolumbar and in the thoracic region they are deep to the trapezuis and rhomboideus muscles. Back strain is a common erector spinae problem in people participating in sports and those who lift muscles. Back strain is a common erector spinae problem in people participating in sports and those who lift heavy weights without proper back support. Back strain indicates some degree of streching, tearing, of muscles fibers or ligiments resulting form excessive extension or rotation of the vertebral column, especially in the lumbar region. Referred pain: can be projected to the front of the body and to the internal organs.

Take a complete medical history, consult a physician, develop a treatment plan

Guidelines for massaging person with cancer

What is health insurance portability and accessibility act, enacted in 1996, involves security and privacy of health care issues, specific guidelines that relate to privacy?

HIPPA

Arteriosclerosis and Atherosclerosis

Hardening of the arteries; a type of coronary hear disease; symptoms may be mild to severe; may be mistaken for other problems. Indications: massage is beneficial as part of a lifestyle change. Contraindications: General: perform massage under physician's supervision.

What is a complete state of well-being?

Health

Impetigo

Highly contagious bacterial skin infection that occurs most often in children; begins as a reddish discoloration and develops into vesicles with a yellow crust Indication: Massage may increase systemic circulation and assist healing Contraindication: Regional; refer client to physician; avoid affected area

The knee and elbow are an example of a ____________ joint?

Hinge

What type of joint is the talocrural joint?

Hinge

Hot or cold massage application using hot or cold water

Hydrotherapy

Trigger point definition

Hyper-irritable site within a muscle and /or its tendon and other closely associated connective tissue, compression of a trigger point results in distribution of pain in an area (a referred pain pattern) Usually somewhat distant from the location of the trigger point.

A person who is complaining of feeling cranky and nervous, having frequent headaches, sleeping trouble, shaking or trembling, tingly or numbness in skin and unclear thinking could be suffering from which of the following conditions?

Hypoglycemic

What is when the client is sitting in a tub?

Immersion bath

Mononucleosis

Induced by Epstein-Barr virus; symptoms include fever, fatigue, and swollen glands. Indications: massage is beneficial as part of the treatment plan; care must be taken with contagious conditions. General; refer client to physician for specific diagnosis.

Bell's Palsy

Infection of the seventh cranial nerve; primary symptom is paralysis of facial features, including the eyelids and mouth. Indications: relaxation massage may facilitate healing. Contraindications: regional; refer client to physician

What is capable of being transmitted with or without contact?

Infectious

Tenosynovitis

Inflammation of a tendon sheath, usually from repetitive movement. Indications: massage may relieve muscle hypertension and assist healing of area; ice. Contraindications: Regional; avoid affected area; work above and below the area

Folliculitis

Inflammation of the hair follicles Indication: massage may increase systemic circulation and assist healing Contraindication: Regional; Refer client to physician,; avoid affected area

Appendicitis

Inflammation of the mucosal lining of the appendix, caused by trapped food or fecal matter; more common in individuals under age 25; symptoms include mild periumbilical pain, nausea, vomiting, increasing pain in the lower right quadrant, muscle spasm, and rebound tenderness. Indications: N/A. Contraindications: Immediately refer client to physician.

Acne

Inflammation of the skin affecting the sebaceous gland ducts. Massage increases systemic circulation; may assist healing. Contraindication: Regional; avoid affected area; do not use ointments that clog pores

Cellulitis

Inflammation of the subcutaneous tissue with redness and swelling. Indication: Avoid. Contraindication: Regional; may be associated with erysipelas, a contagious condition; refer client to physician

Pelvic Inflammatory Disease

Inflammation of the uterus, fallopian tubes, ovaries, and surrounding tissue; infection often is introduced by intercourse; symptoms include pain and tenderness in the lower abdomen, backache, pain during intercourse, heavy periods, and vaginal discharge. Indications N/A. Contraindications: Refer client to physician for diagnosis.

Contact Dermatitis

Inflammation that occurs in response to contact with an external agent. Indications: use unscented lubricants (scents often cause allergic reactions. Contraindications; regional, avoid the affected area.

Colitis

Inflammatory condition of the large intestine; one type (irritable bowel syndrome) is brought on by stress. Indications: painful condition; massage may be helpful in general stress and pain reduction. Contraindications: Immediately refer client to physician; work with chornic conditions under direct supervision of physician.

What is an agreement to participate in activity after the purpose has been explained, a protection process for the consumer?

Informed consent

What is working on a minor without parent told knowledge, treating the injury without permission?

Informed consent violations

Cystic Fibrosis

Inherited disorder that disrupts cell transport and causes exocrine glands to produce thick secretions; thick pancreatic secretions may block the pancreatic duct. Indications: Massage is beneficial with specific training to loosen mucus with percussive techniques. Contraindications: General; work under direct care of physician

Myofascial release

Injuries, stress, overuse, dehydration and poor posture contribute to restrictions in the layers due to bonding of fascia.

What is the loss of function of wrist and fingers?

Injury to ulnar nerve

iliacus (Anterior View)

It can mimic menstrual pain and appendicitis. The combine iliacus/psoas (iliopsoas) muscle and the adductor group of thigh muscle are the muscles usually in volved in the injury called a pulled groin or a groin strain, since the attachments of these muscles are in the inguinal (groin) region at the junction of the abdomen and thigh. Sport involving quick starts, such as short-distance racing, basketball, football, and soccer, often produce tearing within the muscle and at it's attachment.

Why is proper draping an important part of good, professional ethics?

It ensures your client's privacy and comfort

Tensor Fasciae Latae: (Lateral view)

It is one of sevreal muscles (iliacus, rectus femoris, sartorius) implicated in a high pointer injury, which may involve both a bruise on the bone of the iliac crest as well as tearing or avulsion of the attachments of these muscles to the iliac crest.

How does continuing education support professional ethics?

It promotes a higher standard in our profession

An excess of potassium in the blood (hyperkalemia) is a result of which improperly functioning organ?

Kidney

What is overdeveloped thoracic curve?

Kyphosis

What is refusing to adapt office for clients with physical challenges?

Lack of accessibility

Osteoporosis

Loss of minerals and collagen from bone matrix, resulting in reduced volume and strength of skeletal bone. Indications: Gentle massage is beneficial; use care and caution. Contraindications: General

Testicular Cancer

Malignant growth in the testicle; usually a slow-growing lump. Indications: N/A. Contraindications: Refer client to physician immediately if he mentions such a symptom.

Gouty arthritis

Metabolic condition in which sodium urate crystals trigger a chronic inflammatory process. Indications: dietary adjustment necessary. Contraindications: Regional: avoid area of inflammation

Diabetes Mellitus

Metabolic disorder; body loses the ability to oxidize carbohydrates because of faulty pancreatic activity, especially of the islets of Langerhans, which affects insulin production; symptoms include thirst, hunger, and acidosis; sever symptoms include difficulty breathing and changes in blood chemistry that lead to coma. Indications: massage is given under supervision of the primary care physician; it is beneficial for circulation enhancement and stress reduction; exercise also is beneficial. Contraindications: General; work only under physician's supervision.

What is gravity line in the back view standing posture?

Midsagittal plane

What is the results of the interplay of body, mind, and emotions and health and disease processes, anxiety reduction and relaxation response?

Mind - body effects of massage

During a treatment, a generous client complains of being too hot and would really prefer to remove all draping. How should the massage therapist respond to this situation?

Minimize cover while draping the private areas

What is implying that attending a workshop is the same as an advanced degree?

Misrepresentation of educational status

The ratio of people who are diseased to those who are well.

Morbidity

What contains guidelines for sexual combat, guidance on client files and sharing information, business practices, professionalism, legal and ethical requirements, roles and boundaries, and business practices?

NCBTMB Standards of practice

Tumors; abnormal tissue that grows more rapidly then normal.

Neoplasm

Parkinson's Disease

Nervous disorder characterized by abnormally low levels of the neurotransmitter dopamine, resulting in involuntary trembling and muscle rigidity. Indications: Massage is beneficial as part of a physician directed treatment plan. Contraindications: General.

Where on the SOAP chart, therapist visual observations, such as observation of muscle guarding?

Objective

Longus Colli: (Anterior View) Superior Obilique part

Origin ( Inferior attachment) Tranverse process of the third, fourth, and fifth cervical certebrae insertion (superior attachment) Anterior arch of atlas.

Gracilis: (Anterior View) the Gracilis is a long slender, superficial muscle of the medial thigh. 2 Trigger point: are found in the belly of the muscle and near the origin. Referred Pain: is deep into th egroin into th emedial thigh, and downward to the knee and shin. because it is a relatively weak member of the thigh adductor group, the gracilis, together with its nerves and blood vessels has been transplanted to replace a damaged muscle. synergists: Adductor muscles Antagonists: tensor fascia latae, gluteal muscles. Palpation: Palpate muscle on the upper medial side of the thigh during active hip adduction; palpate its tendon on medial side of knee medial to tendon of the semitendinosus.

Origin (Proximal Attachment) Inferior ramus and body of pubis Insertion: (distal attachment) Medial surface of tibia just inferior to its medial condyle Action: Adducts thigh at hip joint and flexes leg at knee joint: flexes hip and assists in medial rotation Innervation: Obturator nerve (L3-L4)

Interspinales (Posterior View) Synergists: Mutifidus, rotatores, semispinalis, erector spinae groups Antagonist: Rectus abdominis Palpation deep Muscles; cannot be readily palpated.

Origin (inferior Attatchment) Cervical region: spinous processes of thirdj to seventh cervical verterae (C3-C7) throacic region: spinous processes of second to twelfth throcic vertbrae (T2-T12); Lumbar region: spinous processes of second to fifth lumbar. Insertion: (superior attachment) Spinous process of next superior vertebra to the vertbra of origi. Action: Extends the vertebral column Innervation: Posterior primary rami of spinal palpated.

Rectus Capitis Posterior Minor: 1 Trigger point: is in the belly of the muscle. Synergists: Rectus capitis, posterior major, obliquus capitius superior, longissimus capitis, semispinalis capitis. Antagonists: rectus capitis anterior, longus colli, longus capitius. Palpation: deep muscle cannot be readily palpated.

Origin (inferior attachment) Posterior tubercle of atlas Insertion: (superior attachment) Median portion of inferior nuchal line of occipital bone. Action: Extends the head Innervation: Dorsal ramus of first cervical (suboccipital) Nerve (C1)

Longus Colli: (Anterior View) Inferior Oblique part Action: all three parts Flex the neck. The superior oblique portion bends it laterally; inferior oblique portion rotates it to the opposite side. Synergists Scalenes muscles SCM, Longus capitis, platysma Anatagonists: Rectus capitis posterior superior and inferior obliquus capitis superior longissimus capitis, semispinalis capitis. Palpation: Deep muscle cannot be readily palpated.

Origin (inferior attachment_ Anterior surface of the bodies of the first two or three thoracic vertebrae. insertion (superior attachment ) Transverse processes of the fifth and sixth cervical vertebrae Innervation C2-C7

Gluteus Minimus: (Lateral View) this is the smallesty and deepest of the gluteal muscles. the three muscles together prevent the pelvis from dropping toward the opposite side during walking. It also keeps the pelvis level when standing on one foot. 3 trigger points: is in the belly of the muscle. Referred Pain: is the lower lateral buttock down the lateral aspect of the thigh, lower leg to the ankle Synergists: Gluteus medius, tensor fasciae latae Antagonists: Adductor group, pectineus, gracilis Palpation: deep muscle; cannot readily be palapted.

Origin (proximal Attachment) Outer surface of the ilium between the middle and inferior gluteal lines Insertion (distal attachment) Anterior border of the greater trochanter Action: Abducts the femur at the hip joint and medially rotate the thigh: flexes hip. Innervation: Superior gluteal nerve (L4-s1)

Palmar Interossei: (Palmar View) Synergists: flexor digitorum superficialis, flexor digitorum profundusm flexor digiti minimi Antagonists: Dorsal interossie, abductor digiti minimi, lumbricales Palpation: deep muscle, cannot readily be palpated.

Origin (proximal attachment) First medial side of base of first metacarpal bone, second, third, and fourth; anterior surface of th esecond, fourth, and fifth metacarpal bones Insertion: (distal attachment) First medial side of base of proximal phalanx of thumb; second: medial side of base of proximal phalanx of index finger; thrid and fourth; lateral side of proximal phalanges of ring finger and fifth finger. Action Adducts fingers toward center of third finger at metacarpophalangeal joints and assists in flexion of fingers at the same joints. Innervation Deep branch of ulnar nerve. (C7-T1)

Pectineus (Anterior View) 1 Trigger points: is in the the belly of the muscles Referred Pain: is deep in the groin area. Synergists: Other adductor muscles, gracilis Antagonists: Tensor fascia latae, gluteus minimus, glureus medius Palpation: Palpate above adductor longus during active thigh adduction.

Origin (proximal attachment) Pectineal line on superior ramus of pubis Insertion (distal attachment) from lesser trochanter to linea aspera of femur Action: Flexes femur at hip and assist in adduction of femur at hip. Innervation: Femoral nerve (L2-L4)

Subscapularis (Anterior View) this "rotator cuff' muscle is often implicated in "frozen shoulder syndrome" 3 Trigger points: are found near the attachment of the humerus and in the belly. Referred pain: is to the neck of the shoulders and down the arm to the wrist. the bursa located beneath the muscle is called the subscapular bursa. Synergists: Teres major, pectoralis major, lattissimus dorsi Antagonists: Posterior deltoid teres minor, infraspinatus Palpation: cannot be readily palpated because of its position.

Origin (proximal/medial) Subscapular fossa of the scapula Insertion: (distal/lateral) Lesser tubercle of the humeraus and the ventral part of the capsule of the shoulder joint. Action: medially rotates and stabilizes the head of the humerus in the glendoid cavity Innervation: Upper and lower subscapular nerves (C5, C6)

Subcostales: (Posterior View) these muscles are deep to the internal intercostals. the subcostals aid the internal intercostals to decrease the size of the thoracic cavity, thus aiding in forced expiration. synergists: Internal intercostals, diaphragm Antagonists: External intercostals, diaphragm Palpation: deep muscles: cannot be palpated

Origin (superior attachment) Inner surface of surface of each rib near it Angles. Insertion: (Inferior attachment) Medially on the inner surface of the second or third rib below. Action: Draws ventral part of ribs downward Innervation: Internecostals, diaphragm

Psoas Major: (Anterior View) this muscle together with iliacus makes up the iliopsoas. 2 Trigger points: are near both points of attachment. A tight posas major muscle causes a tilt at hip, increasing the lumbar curvature, causing lordosis. Referred pain: is the lumbar area. In some people a psoas minor muscle may occur medially to the psoas major, either unilaterally or bilaterally. It may arise from either the body of T12 or L1 and the disk between them and may insert on the iliac fascia, inguinal ligament, or on th eneck or lesser trochanter of the femur. Synergists: Iliacus, adductor group, rectus femoris, psoas minor (if present) Antagonists gluteus maximus, hamstring muscles Palpation: Palpate deeply between umbilicu and anterior superior iliac spine with thigh flexed at hip joint.

Origin (superior attachment) Transverse processes of all lumbar vertebrae, bodies of last thoracic and all lumbal vertbrae, bodies, of last thoracic and all lumbar bertbrae, and intervertbral disc of each lumbar vertebrae Insertion: (inferior Attachment) Lesser trachanchter of femur Action Flexes thigh at the hip joint and flexes vertebral column Innervation: Ventral rami of (L1-L3)

Intertransversarii: (Posterior View) Synergists: interspinales, rotatores, multifidus groups. Antagonists: Same muscles on opposite side Palpation: Deep muscles cannot be readily palpated

Origin: ( Inferior attachment) transverse processes of all vertebrae from lumbar to axis. Insertion: (superior attachment) Transverse process of nest superior vertebrae. Action: Laterally flexes vertebral column Innervation: Ventral and dorsal rami of spinal nerves.

Fibularis (Peroneus) Brevis (Lateral View Leg) the action of the foot "evertors" is helpful when walking or running on uneven surface. 1 Trigger point: is in the belly of the muscle. Referred pain: is the lateral malleolus to the lateral side of the foot. Synergists: for plantar flexion: finularis longus: gastrocnemius, soleus; for eversion; fibularis longus, fibularis tertius. Antagonists: To plantar flexion: tibialis anterior, extensor digitorum longus; to eversion; tibialis anterior, tibialis posterior Palpation: Palpate tendon on lateral dorsal surface of foot near proximal end fifth metatarsal.

Origin: ( Proximal Attachment) Lower two-thirds of lateral surface of the fibula Insertion (distal attachment) Lateral side of the base of the fifth metatarsal bone. Action: Plantar flexes; fibularis longus, gastrocnemius, soleus: For eversion; Fibularis longus, fibularis tertius. Innervation: Superficial fibular nerve (L4-S1)

Tibialis Anterior: (Anterior View Leg) 1 Trigger Point: for this muscle is in its belly. Referred Pain: is down the shin to the ankle and into the big toe. Synergists: Externsor hallucis longus, extensor digitorum longus. Antagonists: Gastrocnemius, soleus, fibularis longus Palpation: Palpate muscle on anterior surface of tibia during active dorsiflexion of foot; palpate its tendon on medial side of anterior surface of ankle.

Origin: ( Proximal attachment) Lateral condyle and proximal one-half of the lateral surface of the tibia and the interosseous membrane Insertion: (distal Attachment) Medial plantar surface of the first cuneiform bone and the base of the first metatarsal bone Action: Dorsiflexes the foot at the ankle joint and invert the foot. Innervation: Deep fibular nerve (L4-S1)

intercostales Interni (Nal): Antrior View) the muscle fibers here are angled obliquely away form the costal cartilages. The contraction of these muscles decrease the size of the thoracic cavity and aids in forced expiration. Synergists: Serratus posterior inferior, quadratus lumborum antangonists: External intercostals, scalenes Palpation: Palpate between costal carilages.

Origin: ( Superior attachment) Ridge of inner surface of rib and corresponding costal carilage. Insertion: (inferior attachment) Superior border of rib below Action: depresses the rib cage and draws ribs together Synergists: Serratus posterior inferior, quadratus lumborum Antagonists: External intercostals, scalenes Innervation:Intercostal nerves (T1-T11

Platysma: (Anterior View) This muscle that tenses the neck when shaving. 3 Trigger points: are in the lower third of the muscle. Activation of trigger points can cause a "Prickling" sensation in the cheeks, chin, and throat. Referred pain: is to the chin. Synergists at TMJ: disgastric, mylohoid, geniohyoid Antagonists: at TMJ: temporalis, masseter, medial pterygoid Palpation: With hand on anterior neck, forcefully contract platysma by depressing and drawing lower lip laterally.

Origin: ( inferior attachment): subcutaneous fascia covering the pectoralis major and the deltoid. Insertion: (superior attachment): lower margin of mandiable, and subcutaneous fascia and muscle of jaw and mouth. Action Tenses skin of neck: draws down the lower lip and angle of mouth; helps depress mandible. Innervation: Cervical branch of facial nerve (VII)

Soleus: (Posterior View of foot) 3 Trigger point: are near both the origin and insertion. (Most heel and Achilles tendon pain comes from trigger points in the Soleus. Referred Pain: is down the entire calf to the heel and sole of the foot into the toes. Synergists: Gastrocnemius, plantaris, tibialis posterior, fibularis tertius Antagonists: Tibialis anterior, extensor digitorum longus, fibularis tertius Palpation: Palpate lateral side of lower leg below belly of gastrocnemius during active plantar flexion.

Origin: ( proximal attachment) Upper one-fourth of posterior surface of the fibula, soleal line, and upper shaft of tibia Insertion (distal attachment) With the gastrocnemius, via the Achilles tendon to the calcaneous Action: plantar flexes the ankle and stabilizes the leg over the foot Innervation: Tibial nerve (S1, S2)

Quadratus Lumborum (Anterior Veiw) The superior attachment may extend to the eleventh rib and also to L5. 4 Trigger points are found laterally near the rib or iliac attachment. referred pain is found in the gluteal and groin area and also in the sacroiliac joint and the great trochanter. If the trigger point are active, a cough or sneeze can cause sever pain in the lower back. Synergists: Erector spinae group, serratus posterior inferior, subcostalis, internal intercostals, transversus thoracis Antagonists: Ventral rami of the twelfth thoracic (T12) and upper three lumbar spinal nerves (L1-L3) Palpation: In supine position, palpate deep in lumbar region above iliac crest during active elevation of hip.

Origin: (Infereior Atachment) iliolumbar Ligament and the posterior portion of the iliac crest insertion: ( superior attachment) Inferior border of last rib and the transverse processes of the first four lumber vertebrae (L1-L4) Action: flexes Lumbar region of vertebral column laterally to the same side, both muscles together stabilize and extend the lumbar vertebrae and assit forced experiation. Innervation: Ventral rami of the twelfth thoracic (T12) and upper three lumbar spinal nerves (L1-L3)

Longissmus Thoracis: (Posterior View) 2 trigger points: belly of the muscle first one between the 10 and 11th rib. Second one between the first and second lumbar region. Synergists: Iilocstalis, semispinalis, spinalis groups Antagonist: Rectus abdominis Palpation: Palpate erector spinaemuscles as a group lateral to spinous process of the vertebrae.

Origin: (Inferior attachment) Aponeurosis and transverse processes of lumbar and lower thoracic vertbrae. Insertion: (superior attachment) Transverse processes of all thoracic vertebrae and between tubercles and angles of lower of lower ten ribs. Action: extends and laterally flexes vertebral column Innervation: Dorsal rami of thoracic and lumbar spinal nerves

Semispinalis Capitis: (Posterior View) 4 Trigger points Referred pain is to the rear of the head and band encircling the head from the occipital to the eye. Synergists: Longissimus, ilipcostalis, spinalis group Anatgonists: Rectus abdominis

Origin: (Inferior attachment) Transverse process of the upper six thoracic (T1-T6) and seventh cervical (C7) and articular processes of the fourth through six cervical vertebrae (C4-C6); its origin varies Insertion: (superior attatchment) between the superior and inferior nuchal lines of the occipital Action: Extends and rotates the head to the opposite side Innervation: Dorsal rami of the first six cervical soinal nerves (C1-C6_)

Spinalis Capitis Capitis: (Posterior View) Synergists: Longissimus, semipinalis, iliocastalis group Antagonist: Scalenes group, retcus abdominis

Origin: (Inferior attachment) Transverse process of upper seven thoracic. (T1-T7) Insertion: (superior attachment) Between superior and inferior nuchal line of the occipital bone Innervation" Dorsal rami of lower cervical and thoracic spinal nerves.

Extensor Digitorum Brevis and Extensor Hallucis Brevis: (Lateral View) 2 Trigger Point: are located toward the origin end of these short toe extensors. referred pain: occurs right around these muscles on the outter side of the top of the foot. synergists: Extensor diritorum longus, extensor hallucis longus. Antagonists: flexor digitorum muscles, flexor hallucis muscles Palpation: Palpate distal and anterior to medial malleolus during extension of toes.

Origin: (Proximal Attachment) Anterior and lateral surfaces of the calcaneous, lateral talocalcaneal ligament, and inferior extensor retinaculum Insertion (Proximal attachment) Dorsal surface of the base of the proximal phalax of the bog toe and the lateal sides of the tendon of the extensor digitorum longus of the second, third, and fourth toes Action: Extend the metatasalphalangeal joint of the big toe, and extends the interphalangeal and metatarsophalangeal joints of the second through fourth toes. Innervation: Deep fibular nerve (L5-S2)

Palmaris Longu: (Anterior View) the tendon of the palmaris longus is above the antebrachial fasia of the wrist and can be seen if one cups the hand and flexes the wrist. the muscle is absent in about one fourth of the population. 1 Trigger Point: is in the belly of the muscle. Trigger pint activated can cause a pricking sensation in the palm of the hand Referred pain: is to the wrist and hand Synergists: flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis Antagonists: Extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum Palpation: palpate in midline of anterior surface of wrist when wrist is flexed against resistance and thumb is abduct.

Origin: (Proximal Attachment) Medial epicondyle of the humerus through the common flexor tendon Insertion: (Distal attachment) Front of flexor retinaculum and apex of the palmar aponeurosis Action: Flexes the wrist and tenses the palmar fasica flexor digitorum superficalis Innervation: Median nerve (C6, C8)

Femoris (Anterior Rectus View) 2 Trigger point: are near its attachments. Referred Pain: is the entire anterior thigh with a concentration at the knee. synergists: Other three quadriceps femoris muscles, psoas, sartorius Antagonists: Hamstring muscles Palpation: Palpate on anterior surface of thigh during active knee extension.

Origin: (Proximal attachment) Anterior head: anterior inferior iliac spine: Posterior head: upper margin of the acetabulum Insertion (Distal Attachment) Pattella and by the patella ligament to the tibial tuberosity Action: Extends the leg at the knee and flexes the thigh at the hip joint Innervation: Femoral nerve (L2-L4)

Flexor hallucis Longus: ( Posterior Veiw Leg) This muscle is important in pushing, off the surface in walking, running, and jumping. 1 Trigger Point: is in the belly of the muscle. Referred pain: is down the posterior leg to the heel and the sole of the foot. Synergist: Flexor hallucis brevis Antagonist: Extensor hallucis longus. Palpation: Palpate tendon just medial to Achilles tendon and on plantar surface of big toe.

Origin: (Proximal attachment) Lower two-third of posterior surface of the fibula and the interosseous membrane. Insertion: (Distal attachment) Plantar aspect of the base of the distal phalanx of the big towe Action: Flexes the big toe, plantar flexes the ankle joint, and inverts the foot. Innervation: Tibial nerve (L5,- S2)

Flexor Pollicis Longus: (Anterior View) Additional superior attachment may be from the medial epicondyle and either the medial or lateral side of the coronoid process of the ulna. 1 Trigger Point: is in th ebelly of the muscle Referred pain: is to the thumb Synergists: Flexor pollicis brevis longus, extendor pollicis brevis, abductor pollicis Antagonists: Extensor Pollicis Longus, extensor pollicis brevis, abductor pollicis longus Palpation: Palpate tendon on anterior surface of proximal phalanx of thumb during active flexion.

Origin: (Proximal attachment) Middle of anterior shaft of the radius and interosseous membrane Insertion: (distal attachment) Palmar surface of the base of the distal phalanx of the thumb Action: flexes the thumb; assists in abduction of wrist. Innervation: Extensor interosseous branch of the median nerve (C8-T1)

Adductor Brevis (Posterior Veiw) The adductor brevis is found deep to the adductor longus 1 Trigger point: is in its belly. referred pain pattern is deep in the groin to the medial knee and on to the shin synergists Other adductor muscles, pectineus, gracilis Antagonists tensor fasciae latae, gluteus minimus, gluteus medius Palpation deep muscle; cannot be readily palpated.

Origin: (Proximal attachment) Outer surface of inferior ramus of pubis Insertion (distal attachment) upper onethird of medial lip of the linea aspera of th efemur Action: Adducts the thigh. Assists in flexion an dmedial rotation. Innervation: Obturator nerve (L3, L4)

Aductor Hallucis (Plantar view Foot) The musclle of the sole of the foot can be divided into four layers from most superficial to deepest. the most superficial layer includes this muscle and the flexor digitorum brevis and the abductor digiti minimi 2 Trigger point: are in the belly of the muscle referred Pain: is to the inside of the heel and sole of the foot. Nerve entrapment can cause numbness in toes. this muscle may have muscle of tendon "slips' to the base of the first phalanx of the second and third toe. Synergists: Flexor hallucis longus, flexor hallucis brevis Antagonists: Extensor hallucis longus, extensor hallucis brevis, adductor hallucis Palpation: Palpate along medial border of big toe when toe is actively abducted.

Origin: (Proximal attachment) Tuberosity of calcaneous, flexor retinaculum, and plantar aponeurosis Insertion: (distal attachment) Medial side of base of proximal phalanx of big toe. Action: Abduct the big toe and assists in flexion at the metatarsophalangeal joint of the big toe. Innervation: medial plantar nerve (S1-S3)

Latissmus Dori: (Posterior View) 3 Trigger points: are in the belly of the muscle near the rib attachment. when trigger point is activated the full muscle stretch needed to move the arm upward and forward can be inhibited. Referred pain: is below the scapula and into the ulnar side of the arm and the abdominal oblique area. it also acts as an accessory muscle respiration. Synergists: Rhomboids, pectoralis major, teres major. Antagonists: Deltoid, supraspinatus Palpation: Palpate along lateral side of rib cage during active extension of the humerus.

Origin: (indirectly attachment) through lumbodorsal fasica into spinous process of lower six thoracic and lumbar vertebrae (T7-L5) lower three to four ribs, and iliac crest. Insertion: in floor of intertubercular groove of humerus. Action: Extends, adducts and medially rotates the arm; draws the shoulder downward and backward. Innervation: Thoracodorsal nerve (C6-C8)

Rectus Abdominis: (Anterior view) These are the "abes" Tendinous bands divide each rectus into four bellies. Each muscle is enclosed in a sheath formed from the aponeurosis of the lateral abdominal muscles. This muscle contracts strongly during "situps" or when a person is lying in a supine position and raises the legs several inches from the floor. Trigger Point are located in each belly near the linea alba. Referred Pain: is to the middle of the back and lower quadrant of the abdomen. Synergists: External obliques, internal obliques, pyamidalis. Antagonists: Erector spinae muscles Palpation: Palpate on the anterior medial surface of abdomen during active flexion of trunk.

Origin: (inferior Attachment) Crest pubis and pubic symphysis. Insertion: (superior attachment) Cartliage of fifth, sixth, and seventh rib and xiphoid process of sternum. Action: Flexes the vertebral column and compresses the abdominal cavity Innervation: Anterior primary rami of the surface of abdomen during active flexion of trunk

IIliocostalis Cervicis: (Posterior View) Synergists; Longissimus, semispinalis, spinalis groups, quadratus lumborum antagonist: rectus abdominis

Origin: (inferior Attachment) angles of the third through sixth ribs. insertion: (superior attachment) Posterior tubercles of the transverse process of the fourth through seventh cervical vertrea column. Innervation: dorsal rami of the lower cervical and thoracic spinal nerves.

Rectus Capitis Anterior: rectus capitis lateralis stablize the neck while coughing and sneezing. Synergists: SCM, Longus colli, Longus capitis Antagonists: Rectus capitis, poterior major, and minor, obliquus capitis superior, semispinalis capitis Palpation: Deep muscle; cannot be readily palpated.

Origin: (inferior attachment) Anterior base of transverse process of atlas. Insertion: (superior attachment) Occipitial bone anterior to the foramen magnum Action Flexes head. Innervation: C1, C2

Splenius Capitis: (Posterior View) The inferior attachment may only go to the third thoracic vertebra. the word spelnius means bandage. The splenius muscle seem to wrap around the deeper neck muscles. 1 Trigger point: for the muscle is in the belly close to the head. Referred pain: is to the top of the head and the eye region. Synergists: Splenius cervicis, semispinalis capitis, superior portion of trapezius. Antagonist: SCM Palpation: Palpate both splenius muscles between posterior edge of SCM and anterior edge of upper trapezius as head neck are rotating.

Origin: (inferior attachment) Fascia and spinous process of seventh cervical and first four thoracic vertebrae (C7-T4) Insertion: (superior attachment) Lateral one third of the superior nuchal line and the mastoid process of the temporal bone. Action: Extends and hyperextends the head; contraction of only one side laterally flexes and rotates the head and neck. Innervation: dorsal rami of the middle cervical nerve (C4-C6)

Sternothyroid(eus): (Anterior View) Antagonist: Thyroid Palpation: Cannot be palpated seperately. Innervation: Ansa cervicalis (C1-C3)

Origin: (inferior attachment) Posterior surface of manubrium of sternum. Insertion (superior attachment) Oblique line on lamina of thyroid cartilage. Action: Depresses larynx

Obliquus Capitis Inferior: (Posterior View) 1 Trigger point: is in the belly of the muscle. Referred pain: is to the back of the head and ear. Synergists: Longissimus capitis, rectus capitis posterior major Anatagnists: Longus colli, SCM Palpation: Deep Muscles can not be readily palpated.

Origin: (inferior attachment) Spinous and upper lamina of axis Insertion: ( superior attachment) Transverse process of the atlas Action: Rotates head. Innervation: Dorsal ramus of the first cervical (suboccipital nerve (C1)

Rectus Capitis Posterior Major: Referred pain: Commonly associated with a tension headache. 1 Trigger Points: is in the vbelly of the muscle. Synergists: Rectus capitis posterior minor, obliquus capitis superior, longissimus capitis, semispinalis capitis. Antagonists: rectus capitis anterior, longus colli, longus capitis

Origin: (inferior attachment) Spinous process of axis Insertion: (superior attachment) Lateral portion of inferior Action: extends head and rotates it toward the same side. Innervation Dorsal ramus of the suboccipital nerve (C1) Palpation: deep Muscle: cannot be readily palpated.

Spinalis Thoracis: (Posterior View) Synergists: Longissumus, semispinais, Iliocostalis group Antagonist: Scalenes Group, rectus Abdominis Palpation: Palpate erector spinae muscles as a group lateral to spinous processes.

Origin: (inferior attachment) Spinous processes of the lower two throacic and upper two lumbar vertebrae (T11-L2) Insertion: (superior attachment) Spinious process of upper eight thoracic vertebrae (T1-T8) Action: Extends the vertebrae column

Sternocleidomastoid (SCM): ( Lateral View) 5 Trigger points: along the entire length of the bottom heads of the muscle. Referred pain: is head, face, especially in the occidental region, ear, and forehead. Synergists: Scalene group Antagonists: upper division of the erector spine group Palpation: palpate with hand on anterolateral neck as head is turned and neck flexed

Origin: (inferior attachment) Sternal head: manubrium of sternum Clavicular head: superior border of medial third of clavicle Insertion: (superior attachment) Mastoid process of temporal and lateral half of superior nuchal line. Innervation: Spinal part of accessory nerve (XI) and branches of cervical spinal nerves (C2-C4)

Obliquus Capitis Superior: (Posterior View) 1 Trigger point: is in the belly of the muscle. Referred pain: is to the back and top of the head. Synergists: Rectus capitis anterior, longus capitis, longus colli Palpation: Deep muscle; cannot be readily palpated.

Origin: (inferior attachment) Superior surface of transverse process of atlas. Insertion: (superior attachment) Occipital bone between inferior and superior nuchal lines. Action: Extends the head. Innervation: dorsal ramus of the first cervical (suboccipital) nerve (C1)

Semispinalis Thoracis: (Posterior View) Synergists: Longissimus, iliocostalis, spinalis Group Antagonists: Rectus abdominis Palpation: Deep muscle cannot be readily palpated.

Origin: (inferior attachment) Transverse process of the lower thoracic vertebrae insertion: (superior Attachment) Spinous processes of the lower two cervical and upper four thoracic vertebrae (C6-T4) Action Extends and rotates vertebral column Innervation: Dorsal rami of upper six thoracic spinal nerves (T1-T6)

Longiddimus Cervicis: (Posterior View) Synergists: liocostalis , semispinalis, spinalis groups. Antagonist: rectus abdominis

Origin: (inferior attachment) Transverse process of upper five thoracic vertebrae (T1-t5) Insertion: (superior Attachment) posterior tubercles of the transverse process of the second through sixth cervical vertebrae (C2-C6) innercation: Dorsal rami of thoracic spinal

Splenius Cervicis: (Posterior View) The superior atachment may only be the first two cervical vertebra (C1-C2). 2 Trigger point: are in the belly of the muscle and near the insertion. Referred pain: is to the back of the head. synergists: Splenius capitis anterior SCM. Antagonists: Rectus capitis anterior, SCM Palpation: Palpate with the splenius capitis

Origin: (inferior attachment) spinous processes of the third through sixth thoracic vertebrae (T3-T6) Insertion: (superior attachment) Posterior tubercles of the transverse processes of the first three cervical vertebrae (C1-C3) Action: Extends and hyperextends the neck, contraction of only one side laterally flexes and rotates the neck and head. Innervation: Dorsal rami of the lower cervical nerves (C4-C8)

Painful infection of bone tissue and bone marrow/sometimes pus filled abscesses form; caused by staph or strep infective resulting from a bone fracture, surgery or wound. DO NOT massage!

Osteomyelitis

Rhomboid(eus) Major (Posterior View) the rhomboideus major and minor also function in pullin the scapula toward the body wall in a movement called "medial tilt" 3 Trigger Point: are found at the attachment point near the scapula border. Referred pain: is to the vertebral border of the scapula. Synergists: Trapezius, levator scapulae, rhomboid minor, latissimus dorsi Antagonists: Pectoralis major pectoralis minor Palpation: Palpate along vertebral border during active retraction and adduction scapula.

Origin: (medial attachment) Spinious process of the second through fifth thoracic vertebrae (T2-T5) Insertion (lateral attachment) Medial border of scapula between the spine and the inferior angle. Action: Adducts, retracts, elevates and rotates the scapula so that the glenoid cavity faces downward and stabilizes the scapula. Innervation: Doral scapular nerve (C5)

Trapezius: (Posterior View) This is the large triangular-shaped muscle covering the upper back. 6 Trigger points: are in the belly of the muscle and near its points of attachment to the scapula. Referred pain: are in the neck to the ear and the temple and also in the subscapular area. Synergists: Levator scapulae, SCM, rhomboid major and minor. Antagonists: Serratus anterior, latissimus dorsim pectoralis major. Palpation: palpate its difficult regions during elevation, retraction and depression of scapula.

Origin: (medialattachment) Medial third of superior nuchal line, external occipital protuberance, ligamentum nuchae, spinous process of the seventh cervical, and all thoracic vertebrae. Insertion: (lateral attachment) Lateral third of clavicle, acromion process and spine of scapula. Action: stablizes raises, retracts, and rotates the scapula. The superior fibers elevate, the middle fibers retract, and the inferior fibers depress the scapula. together the upper and lower fibers rotate the arm. Innervation: accessory (XI) and ventral rami of C3, C4

Flexor Hallucis Brevis: (Plantar View Foot) This muscle is one of the third layer muscle on the sole of the foot. 2 Trigger point: are located in the belly of the muscle slip. Referred Pain: is to the big toe. Synergists: Flexor digitorum longus, flexor digitorum brevis, quadratus plantae, plantar interossei Antagonists: Extensor digitorum longus, extensor digitorum brevis Palpation: Deep muscle cannot be palpated.

Origin: (proxiaml attachment) Tendons of the flexor digitorum longus Insertion: Distal attachment) Dorsal surfaces of the distal phalanges Action: Flexes second through fifth toes at the meatarsophangeal joint Innervation: First lumbricalis: medial plantar nerve (L4, L5) Second through fifth lumbricales; Lateral plantar nerve (S1, S2)

Abductor Pollicis Brevis: (Palmer View) This form the bulk of the muscle on the radial side of the palm during active thumb abduction. 1 Trigger point: is in the belly of the muscle. Referred pain: is the wrist into the thumb. Any lesion that reduces the size of the capal tunnel (flexor retainculum) may cause compression of the median nerve. This causes weakness in the abductor pollicis brevis and opponens pollicis muscles, causing difficulty in performing fine movements with the thumb. Synergists: abductor Pollicis longus, externsor pollicis brevis Anagonists: Flexor pollicis longus, adductor pollicis, opponens pollicis. Palpation: Palpate the bulky muscle on radial side of palm during active thumb abduction.

Origin: (proximal Attachment) Flexor retinaculum, tubercle of trapezium bone and tubercle of the scaphoid bone Insertion: (distal attachment) Radial side of the base of the proximal phalanx of the thumb. Action: Abducts the thumb and assists in opposition of the thumb. Innervation: Median nerve (C8, T1)

Semimembranosus: (Posterior View) This most medial member of the hamstring group is deep to the semitendinosus. 3 Trigger point: are in its belly and near its insertion Referred Pain: is the back of the thigh to behind the knee and down the back of the leg to mid-calf. Variation in the number of bellies and insertions may occur as wall as the muscles reduction or absence. It may attach to the medial meniscus of the Knee, facilitating movement of the meniscus during flexion. Synergists: Other hamstring muscles, gracilis , gastrocnemius, sartrius Antagonists: Four quadriceps femoris muscles. Palpation: Palpate on posterior medial thigh during active knee flexion.

Origin: (proximal Attachment) Ischial tuberosity insertion (distal attachment) Posterior part of the medial condyle of tibia Action: flexes and slightly medially rotated leg at knee joint and extends thigh at hip. Innervation: Tibial portion of sciatic nerve (L5-S2)

Flexor Hallucis Brevis: (Plantar View Foot) This muscle is one of the third layer muscle on the sole of the foot. 2 Trigger points: are located in the belly od each muscle slip Referred Pain: is to the big toe Synergists: Flexoe hallucis longus Antagonists: Extensor hallucis extensor hallucis brevis Palpation Deep muscle; can not bee palpated.

Origin: (proximal atachment) Plantar surface of cuboid and lateral cuneiform bones Insertion: (distal attachment) Medial part: medial side of the base of the proximal phalanx of the big toe Lateral part; lateral side of the base of the proximal phalanx of the big toe. Action: flexes the metatarsophangeal joint of the big toe Innervation: Medial plantar nerve (S1-S3)

Plantaris: (Posterior View of Knee) this is a small muscle is absent in some people. It varies greatly in size. 1 Trigger point is in the belly of the muscle behind the knee. Referred Pain: is behind the knee and into the calf. synergists: Soleus, gastrocnemius, tibialis posterior, fibularis longus, fibularis brevis Antagonists: Tibialis anterior, extensor digitorum longus, fibularis terius Palpation: Deep muscle; cannot be readily palpated.

Origin: (proximal attachment) Insertion: (distal attachment) posterior surface of calcaneus; may be part of Achilles tendon or separate. Action: Plantar flexes the foot. Innervation: Tibial nerve (L4-S1)

Supinator: (Anterior View) 1 Trigger point: is near the radius in the antecubital space Referred pain: is from the lateral epicondyle to the dorsal web of the thumb. It mimics tennis elbow. The radial nerve passes between the superficial and deep layers of this muscle. Synergists: Biceps brachii, accessory supinator Antagonists: Pronator quadratus, pronator teres Palpation: Palpate distal to lateral epicondyle of humerus on posterior lateral side of forearm during resisted supination of forearm. deep muscle; difficult to palpate.

Origin: (proximal attachment) Lateral epicondyle of humerus annual and radial collateral ligaments, and supinator crest of ulna. Insertion: (distal Attachment) Lateral surface of the upper one-third crest of ulna Action: Supinates the forearm. Biceps brachii, accessory supinator Innervation: Radial nerve (C6)

Hyperthyroidism

Overproduction of thyroid hormone; can be caused by a tumor or by problems with the self-regulatory mechanism in the pituitary gland; symptoms include anxiety, bulging eyes, high metabolic rate, and nervousness. Indications: massage is beneficial for relaxing the client. Contraindications: General; work within physician's recommendations

Tensor Fasciae Latae: (Lateral view) This muscle braces the knee when walking. 1 trigger Point: is in the belly of the muscle near its proximal attachment. referred Pain: is localized in the hip and down th elateral side of the leg the knee. Synergists: Forabduction of thigh : gluteus medius, gluteus minimus, for flexion at hip: glutues maximus Antagonists: to abduction of thigh: adductor group, gracilis, pectineus; to flexion at hip; biceps femoris semitendinosus , semimembranosus. Palpation: palpate below superior anterior iliac spine at level of greater trochanter during hip abduction and flexion.

Origin: (proximal attachment) Anterior aspect of the outer lip of the iliac crest and the anterior superior iliac spine Insertion (distal attachment) middle and proximal thirds of the thigh along the iliotibial tract the iliotibial band insert on the lateral epicondyle of tibia. Action: Assists in abduction, medial rotation, and flexion of thigh. Makes the iliotibial tract tuat stabilizer of the hip. Innervation: Superior gluteal nerve (L4-S1)

Adductor Longus: (Posterior View) this is the most anterior of the adductor muscles. The adduct Longus forms the medial border of the femoral triangle. Trigger point point is in the belly of the muscle. Referred pain: is in the groin area downward to the knee and shin Its pain is also felt deep in the hip joint. Synergists: Other adductor muscles pectineus, gracilis Antagonists: tensot fasciae latae, gluteus mnimus, gluteus medius Palpation: Palpate in medial aspect of groin during active adduction of femur at hip.

Origin: (proximal attachment) Anterior body of pubis Insertion: (distal attachment) Medial onethird of medial lip of linea aspera of femur Action: Adducts and flexes thigh; assists in medial rotation Innervation: tensor fasciae latae, gluteus minimus, gluteus medius

Pectoralis Minor: (Anterior View) 2 Trigger points: are near the inerstion at the ribs and at the coracoid process. Referred pain: is the front of the chest and down the ulnar side of the arm and mimics the symptoms of angina Entrapment of the brachial plexus and subclavian artery between the pectoralis minor and rib cage causes pectoralis minor syndrome when when the muscle is tight. Synergists: Pectoralis major, serratus anterior. Antagonists: rhomboideus major and minor lower trapeziuis. Palpation: With arm behind and lifted away from back causing extension at shoulder, palpate just inferior to coracoid process.

Origin: (proximal attachment) Anterior surface of the third through fifth rib. Insertion: (distal attachment) Coraciod process of the scapula. Action: with ribs fixed, it draws the scapula forward and downward; with scapula fixed, it draws the rib cage superiorly. Innervation: Medial pectoral nerve (C8, T1)

Satorius: (Anterior View) 3 Trigger points: are in three or four places in th elong belly of the muscle. referred Pain: is the entire anterior thigh with concentration at the knee. rarely it is divded into two, inferiorly or completely along its length. Synergist: Hamstring muscles, gracilis Antgonists: Gluteal muscles, adductor muscles, tensor fasciae latae Palpation: Palpate along its length starting at anterior superior iliac spine during active flexion, abduction and lateral rotation of hip.

Origin: (proximal attachment) Antrior superior iliac spine and upper half of iliac notch insertion: (distal attachment Proximal part of the medial aspect of th etibia Action: Flexes, Laterally rotates, and abducts the hip joint; also flexes the torso toward the leg, and flexes and assists in medial rotation of th eknee Innervation: Femoral nerve (L2; L3)

Flexor Digiti Minimi Brevis ( Plantar View Foot) Occasional this muscle also arises from the cuboid, allowing opposition of the little toe. 1 Trigger Point: is located in the belly of the muscle. Referred pain: is to the base of the fifth toe and to the base of the big toe. Synergists: Abductor digiti minimi plantar Antagonists: Extensor digitorum longus Palpation: Deep muscle, cannot be palpated

Origin: (proximal attachment) Base of the fifth metatarsal bone and sheath of the fibularis longus tendon Insertion: (distal attachment) Lateral side of base of the proximal phalanx of the fifth toe Action: Flexes the proximal digiti minimi plantar interossei Innervation: Lateral plantar nerve (S1, S2)

Gluteus Medius: (Lateral View) 3 Trigger point: are along the musculotendinous junction at the iliac crest. Referred pain: is to the lower back and posterior and lateral areas of buttock. Synergists: Gluteus minimus tensor fasiciae latae Anatgonists: adductor group, gracilis, pectineus Palpation: Palpate on lateral aspect of hip between liliac crest and greater trochanter during active abduction.

Origin: (proximal attachment) Between anterior and posterior gluteal lines on lateral surface of ilium Insertion: (distal attachment) lateral surface of the greater trochanter of the femur Action: Abducts the hip joint and medially rotates the thigh; extends and flexes hip Innervation: Superior gluteal nerve (L5, S1)

Extensor Digitorum: (Dorsal View) 1 Trigger point: is in the belly of the muscle. Synergists: Extensor indicis, extensor digiti minimi, lumbricales Antagonists: flexsor digitorum superficialis, flexor digitorum profundus. Palpation: Palpate muscle on middle of dorsal forearm during forced finger and wrist extension; palpate its tendons on dorsal surface of hand.

Origin: (proximal attachment) Common extensor tendon from the lateral epicondyle of humerus. Insertion: (distal attachment) By four tendons to the lateral and dorsal surfaces of all the phalanges of fingers two through five. Action: Extends the fingers and the wrist. Innervation Deep branch of radial nerve (C6-C8)

Extensor Digiti Minimi: (Dorsal View) 1 Trigger point: is in the belly of the muscle. synergist Extensor digitorum Antagonist: Flexor digiti superficialis, flexor digitorum profundus, flexor digiti minimi Palpation: Palpate tendon on ulnar side of tendon of extensor digitorum during resisted extension.

Origin: (proximal attachment) Common tendon from the lateral epicondyle of the humerus. Insertion: ( distal attachment) Dorsal surface of base of the distal phalanx of the fifth finger. Action: Extends the fifth finger Innervation: Radial nerve (C6-C8)

Brachialis (Anterior View) The inferior attatchment may be divided into two or more parts, insertion on the bones and some muscle of the lower arm. 4 Trigger points: are found in the belly of the muscle. referred pain: is primarly in the lower arm to the thumb. this muscle is a strong elbow flexor Synergists: Biceps brachii, brachioradialis Antagonists: Triceps brachii anconeus Palpation: Palpate muscle medial to biceps brachii on lower anterior humerus and its tendon medial to biceps tendon in the antecubital fossa during active flexion of elbow.

Origin: (proximal attachment) Distal half of the anterior surface of the humerus Insertion: (distal attachment) Coronoid process and tuberosity of unla Action: Flexes elbow Innervation: Musclocutaneous and radial nerve (C5, C6)

Gemellus Superior (Posterior View) this is a thin strap-like muscle Synergists: Inferior gemellus, quadratus femoris, interanl obturator, external obturator Antagonist: Gluteus minimus Palpation: Deep muscle cannot be palpated.

Origin: (proximal attachment) Dorsal surface of ischial spine Insertion: (distal attachment) with tendon of oburator internus into the upper border of the greater trochanter Action: laterally rotates the thigh at the hip joint Innervation: L5-S2

Flexor Pollicis Brevis: (Palmer View) 2 Trigger point: are in the belly of the muscle. Referred Pain: is from the wrist to the thumb. there may be a sesmoid bone in the insertion tendon. Synergists: Flexor pollicis longus, adductor pollicis Antagonist: extensor pollicis longus, extensor pollicis brevis, abductor pollicis Palpation: Palpate tendon on anterior surface of proximal phalanx during active flexion: palpate muscle on anterior surface of metacarpal distal to the abductor pollicis brevis during active flexion.

Origin: (proximal attachment) Flexor retinaculum and trapezium bone Insertion: (distal attachment) Radial side of the base of the proximal phalanx of the thumb Action: flexes the proximal phalanx of the thumb Innervation: Median nerve and deep branch of the ulnar nerve (C8-T1)

Adductor Magnus (Posterior View) this is the largest muscle of the adductor group. the Femoral artery and vein emerge through the aductor hiatus. 3 Trigger Point: are in the belly and near the attachment to the ischial tuberosity Referred Pain: is deep in the groin and pelvis down to the knee and the shin. the femoral artery and vein pass through the adductor hiatus in this muscle. Synergists: Other adductor muscles gracilis Antagonist: tensor fasiae latae, gluteus minimus, gluteus medius Palpation: Palpate superficiial portion of adductor magnus between gracilis nerves (L2-L4)

Origin: (proximal attachment) Inferior ramus of pubis and ramus of ishium and inferior portion of ischial tuberosity Insertion (distal attachment) Linea aspera and adductor tubercle of femur Action adducts and extends thigh: assists in medial rotation Innervation: Obturator and sciatic nerves (L2-L4)

Extensor pollicis Longus: (Dorsal View) This muscle forms the lateral border of the "anatomical snuffbox" described with the extensor pollicis brevis 1 Trigger point: is in the belly of the muscle. Referred Pain: is from the lateral epicondyle to the thumb. synergists Exensor pollicis brevis Anagonists: Flexor pollicis brevis. Palaption: Palpate tendon on ulnar side of dorsal proximal phalanx of thumb during active extension

Origin: (proximal attachment) Interosseous membrane and middle one-third of the posterior surface of the ulna Insertion: (distal attachment) Dorsal surface of the base distal phalanx of the thumb Action Extends the interphanalageal joint and assists in extension of the metacarpophalangeal joints in the thumb; it also assists in abduction and extension of the wrist and the lateral rotation of the thumb. Innervation: Posterior interosseous branch of the radial nerve (C6-C8)

Extensor Inicis: (Dorsal View) This is a tiny muscle. 1 Trigger point: in the belly of the muscle. Synergists: Extensor digitorum Antagonist: Flexor digitorum sperficialis, flexor digitorum profundus Palpation: Palpate tendon at base of index finger during resisted finger extension.

Origin: (proximal attachment) Interosseous membrane and posterior surface of the ulna. Insertion: (distal attachment) Into extensor expansion on dorsal surface of proximal phalanx of the index finger Action: extends the index finger at metacarpalphalanx joint. Innervation: Posterior interosseous branch of the radial nerve (C6,C8)

Semitendinosus (Posterior View) the semitendinosus is one of the hamstring group of muscles found on the back of the leg. 3 Trigger Point: are in th ebelly of th emuscle and near the insertion. referred Pain: is the back of the leg to the knee and down the leg to mid-calf. During running and walking, the hamstrings are used to slow down the leg at the end of its swing. they are susceptible to being strained by resisting the momentum of the action. Synergists: other hamstrings muscles, gracilis, gastrocnemius, sartorius Antagonists: Four quadriceps femoris muscles Palpation: Palpate on posterior lower thigh down to medial aspect of popliteal fossa during active knee flexion.

Origin: (proximal attachment) Ischial tuberosity Insertion: (Distal atachment) upper medial surface of the shaft of th etibia Action: Flexes and slightly medially rotates leg at knee joint, and extends the thigh at the hip joint Innervation tibial portion of sciatic nerve (L5-L2)

Subclavius: (Anterior View) 1 Trigger point: is in the belly of the muscle. Entrapment of the brachial plexus, subclavian artery, and vien beneth the subclavius muscle causes costoclavicular syndrome. Referred pain. is into the arm down to the hand. Synergists: Scalenes group, serratus posterior superior, lavatores costarum Antagonists: Superior trapezius, supraspinatus Palpation: Deep muscle difficult to distinguish from pectoralis major

Origin: (proximal attachment) Junction of the first rib and it's costal cartilage Insertion: (distal attachment) Grove on the inferior surface of clavicle elevates first rib. Action: Depresses clavicle and draws shoulder forward and downward; elevates first rib. innervation: C5-C6

Extensor Digitorum Longus: (Anterior View Leg) 1 Trigger point: is located near the origin of the muscle. Referred Pain: Mainly to the top of the foot. Synergists: Extensor digitorum brevis, tibialis anterior Antagonists: Flexor digitorum brevis, tibalis anterior Palpation: Palpate common tendon on anterior surface of ankle lateral to extensor hallucis longus tendon during active extension of toes; Palpate divided tendon on dorsal surface of foot.

Origin: (proximal attachment) Lateral condyle of the tibia, proximal three-fourths of the anterior surface of the fibula, and the interosseous membrane Insertion (distal attachment) By four tendon to the second through fifth toes. Each tendon divides into a middle phalanx and two lateral slips that insert in the base of the distal phalanx. Action: Extends the phalanges of the second through fifth toes, assists in dorsiflexion of the ankle, and in eversion of the foot. Innervation: Deep fibular nerve (L4-S1)

Externsor Carpi Radialis Brevis (Dorsal View) 1 Trigger point: is in the belly of the muscle Referred Pain: is from the lateral epicondyle of the humerus down the posterior portion of the forearm to the hand and the middle finger. Synergists: Extends carpi radialis longus, extensor carpi ulnaris Antagonists: Flexor carpi radialis longus, extensor carpi ulnaris Palpation: Palpate tendon on dorsal surface of wrist at base of third metacarpal medial to tendon for extensor carpi radalis longus.

Origin: (proximal attachment) Lateral epicondyle of the humerus and the radial collateral ligament Insertion: (distal attachment) Dorsal surface of the base of the third metacarpal bone Action: Extends the wrist and assist in abduction of the hand Innervation: Radial Nerve (C6, C7)

What is a bag or sack to use to apply heat or cold?

Pack

Tibialis Posterior: (Posterior View Leg) 1 Trigger point: is in the belly of the muscle near the knee. Referred pain: is in the knee and down the posterior leg to the Achilles tendon. synergists: Flexor hallucis longus, flexor digitorum longus Antagonists: Extensor hallucis longus, extensor digitorum longus, tibalis anterior Palpation: Palpate tendon on medial malleolus during active inversion of foot.

Origin: (proximal attachment) Lateral part of posterior surface of tibia, interosseous membrane, and proximal half of posterior surface of fibula Insertion: (distal attachment) Tuberosity of navicular bone, cuboid, cuneiform, second, third, and fourth metatarsals, and calcaneus Action: Plantar flexes and inverts the foot. Innervation: Tibial nerve (L5, S1)

Popliteus: (Posterior View Knee) This muscle may also attach distally to the lateral meniscus of the knee, facilitating posterior movement of the meniscus during flexion. There is some ebidence that this muscle stablizes the knee by preventing lateral rotation of the tibia during medial rotation of the thigh while the foot is planted. It unlocks the knee so that it can be flexed. It is the deepest muscle in the back of the knee. 1 Trigger point: is in the belly of the muscle Referred pain: is in the back of the knee. Synergists: Semitendinosus, semimembranous, gracilis, Antagonists: Tibialis anterior, extensor digitorum longus, fibularis Palpation: Deep muscle; can not be readily palpated.

Origin: (proximal attachment) Lateral surface of the lateral condyle of the femur. Insertion: (distal attachment) Upper part of the posterior surface of the tibia Action: Medially rotated the knee and flexes the leg at the knee. Innervation: Tibial nerve (L4-S1)

Biceps Brachii (Anterior View) The number of heads maybe as high as five. with the additional heads arising from various points along the length of the humerus. 2 Trigger are found in the belly of each of the two heads of the muscle. Referred pain: is found in the front of the shoulder and into the antecubital space ("crease of the elbow") Synergists: Brachialis, brachioradialis, supinator Antagonists: triceps brachii, anconeus Palpation: Palpate muscle on medial side of humerus and its tendon in antecubital fossa, when arm is flexed

Origin: (proximal attachment) Long head: Supraglenoid tubercle of the scapula; short head: Tip of the corcoid process of the scapula Insertion: (distal Attachment) Radial tuberosite and into aponeurosis of flexor muscle of lower arm Action: Flexes and supinates the forearm; Flexes the humerus Innervation: Musculocutaneous on medial side of humerus and its tendon in antecubital fossa, when arm is flexed

Triceps Brachii (Posterior View) The triceps brachii is the only muscle on the posterior upper arm. 3 Trigger points are in the belly of each head of the muscle. The trigger point closest to the elbow is one the source of pain in tennis elbow Referred pain: is the entire length of the posterior surface of the arm. Synergists: Anconeus Antagonists: biceps brachii, brachialis Palpation: Palpate on dorsal upper arm during active elbow extension.

Origin: (proximal attachment) Long head: infraglenoid tubercle of the scapula; Medial head: distal two-third of the medial and posterior surfaces of the humerus; lateral head; upper half of the posterior surface of the humerus Insertion: (distal attachment) Posterior surface of the olecranon process of the ulna Action: Extends the forearm; the tendon of the long head helps stabilize the shoulder joint and extends the humerus Innervation: Radial nerve (C7, C8)

Vastus Medialis: Anterior View: This is the most medial of the muscles of the qudreceps femoris group. It forms the medial aspact of the thigh. 2 Trigger point: are in the belly and just above the insertion. Referred Pain: is the entire anterior thigh, especially the lower medial aspect with the most concentrated pain in the knee region. Synergists: Other three quadriceps femoris muscle, satorius Antagonists: Hamstring muscles. Palpation: Palplate on anteriormedial surface of lower third of thigh during active knee extension.

Origin: (proximal attachment) Lower half of interrochanteric line, linea aspera, medial supracondylar line, and medial intermuscular septum. Insertion: (distal attachment) Medial border of the patella and then by the patella ligament to the tibial tuberosity Action: extend the leg at the knee joint. and draws the patella medially Innervation: femoral nerve (L2-L4)

Extensor Carpi Radialis Longus: (Doral View) 1 Trigger point: is in the belly. referred pain is to the lateral epicondyle and back of hand. This muscle parallels the brachiradialis on the lateral forearm Synergists: Entensor carpi radialis brevis, extensor carpi ulnaris Antagonists: Flexor carpi radialis, flexor carpi ulnaris palmaris longus Palpation: Palpate tendon on dorsal surface of wrist at base of second metacarpal bone.

Origin: (proximal attachment) Lower third of lateral supracondylar ridge of humerus Insertion: (distal attachment) Dorsal surface of the base of the second metacarpal bone Action: extends the wrist and abducts the hand Innervation: Radial nerve (C6, C7)

Flexor Digitorum Profundus: (Anterior View) 2 Trigger points are in the belly of the muscle. Referred Pain: is the wrist into the fingers. An additional radial origin may be found along the entire border of the flexor pollicis longus. The tendon of this muscle pass through the tendons of the flexor digitorum supericialis. synergists: Flexor digitorum superficialis Antagoinst: Extensor digitorum Palpation: Palpate tendon on anterior surface of middle phanlanges of fingers during active flexion

Origin: (proximal attachment) Medial and anterior surface of the proximal three-fourth of the ulna and the interosseous membrane Insertion: (distal attachment) By four tendons into the anterior surface of the distal phalanges of fingers two through five. Action:Flexes the distal interphalnageal joints of fingers two through five and assists in the adduction of the index, ring and little fingers and in flexion at the wrist Innervation: Ulnar nerve and interosseous surface of middle phalanges of fingers during active flexion

Gastrocnemius: (Postior View of Leg ) 4 Trigger Points: are in the belly of the muscle causes nighttime cramps. Referred Pain: is down the posterior leg to the heel and sole of the foot into the toes. Synergists: Soleus, plantearis, tibials posterir, fibularis longus, fibularis brevis Antagonists: Tibialis anterior, extensor digitorum longus, fibularis terius Palpation: Palpate posterior calf during active plantar flexion.

Origin: (proximal attachment) Medial head upper posterior part medial condyle of femur; Lateral head: supracondylar line and lateral condyle of the femur. insertion: (distal attachment) calcaneous via the Achilles tendon. Action: Plantar flexes the ankle joint and assists in flexion of the kne joint. Synergists: Soleus, plantaris, tibialis posterior, finlaris longus, fibularis brevis Antagonists: tibialis anterior, extensor digitorum longus, fibularis tertius Innervation: Tibial nerve (S1, S2)

What is an unpleasant subjective sensation?

Pain

Quadratus plantae (Plantar View Foot) this is one of the second layers of the sole the foot. 1 Trigger point: is near the attachment to the calcaneous. Referred pain: is it the heel Synergists: Flexor digitorum longus, flexor digitorum brevis Antagonists: Extensor digitorum longus, extensor digitorum brevis. Palpation: Deep muscle, cannot be palpated.

Origin: (proximal attachment) Medial head: medial surface of the calcaneous; Lateral head, lateral border of the inferior surface of the calcaneous. Insertion: (distal attachment) Lateral margin of the tendon of the flexor digitorum longus Action: Flexes the terminal phalanges of the second through fifth toes. Innervation Lateral plantar nerve (S1, S2)

Pronator Quadratus: (Anterior View) The pronator quadratus is the deepest muscle of the distale forearm. It is the only muscle that arises solely on the ulna and inserts solely on the radius. It is the primary pronator of the forearm. Synergists: Pronator teres Antagonist: Supinator Palpation: Palpate on lateral anterior forearm on either side of radial pulse

Origin: (proximal attachment) Medial side of the anterior surface of the distal one-fourth of the ulna Insertion: (distal attachment) lateral side of the distal one-fourth of the radius Action: Pronates the forearm Innervation: Anterior interossesous branch of the median nerve (C8,T1)

Extensor Hallucis Longus: (Lateral View Leg) 1 Trigger point: is in the belly of muscle. Referred Pain: is down the side of the leg into the big toe. Synergists: Extensor hallucis brevis Anatogonists: Flexor hallucis longus Palpation: Palpate tendon lateral to tibialis anterior tendon on anterior surface of ankle and on dorsum of foot near big toe.

Origin: (proximal attachment) Middle half of anterior surface of fibula and adjacent interosseous membrane Insertion: (distal attachment) Base of the distal phalanx of the big toe. Action: Extends or dosiflexes the big toe, aids in dorsiflexing the foot. Innervation: Deep fibular nerve (L4-S1)

Obturtator Internus: (Posterior View) This muscle surrounds the obturator foramen in the pelvis. it leaves the pelvis by the lesser sciatic notch and turns sharply forward to insert on the greater trochanter. 3 Trigger point: are in the belly of the muscle Synergists: Superior gemellus, inferior gemellus, quadratus femoris, piriformis, external oburator Antagonist: Gluteus minimus Palpation: deep muscle; cannot be palpated.

Origin: (proximal attachment) Pelvic surface of the obturator membrane and the margins of the obturator forament; also the internal surface of the pubis and ramus of the ischium Insertion (distal atachment) Medial surface of the greater trochanter of the femur Action: Laterally rotate thigh at hip joint. Innervation: L5-S2

Piriformis: (Anterior View) 2 Trigger Points: are near the points of attachment. Referred Pain: is in the sacoiliac region, the entire buttock and down the posterior thigh. Synergists: Superior gemellus, inferior gemellus, quadratus femoris, internal obturator, external obturator. Antagonist: Gluteus minimus Palpation: Palpate half way between posterior superior iliac spine and sacrum during active lateral rotation of hip

Origin: (proximal attachment) Pelvic surface of the sacrum between the first through fourth sacral foramina and sacrotuberous ligament Insertion (distal attachment) Superior border of the greater trochanter of the femur. Action: Lateral rotates thigh at the hip joint and abducts thigh Innervation: Anterior rami of S1, S2

Flexor Digiti Minimi Brevis: (Palmar View) Either head or the entire muscle may be absent. 1 Trigger point is in it's belly. Referred Pain: is into the little finger. Synergists: Flexor digitorum superficialis, flexor digitorum profundus, opponens digiti minimi Antagonist: Extensor digitorum Palpation: Palpate on palmar surface of fifth metacarpal during active flexion of metacarpophalangeal joint.

Origin: (proximal attachment) Plexor retinaculum and hook of the hamate bone Insertion: (distal attachment) Medial side of base of promimal phalanx of the fifth finger Action : Flexes fifth finger at metacarpophalangeal joint Innervation: ulnar nerve (C8, T1)

Vastus Lateralis: 6 Trigger Point: near each attachment and in the belly of the muscle. Referred Pain: is the anterior thigh, especially the lateral surface, and again with pain concerntrated of the knee, or quadriceps muscle imbalance may pull the patella sideway and produce the condition "chondromalacia patella or runners knee". Synerists: Other three quadriceps femoris muscles, sartorius Antagonists Hamstring muscles Palpation: Palpate on lateral surface of thigh during active knee extension

Origin: (proximal attachment) Proximal intertrochanteric line, greater trochanter, gluteal tuberosity, and linea aspera Insertion: (distal attachment) Petalla and through the patella ligament to the tibial tuberosity Action: Extends the Knee joint and exerts a lateral pull on the patella Innervation: Femoral nerve (L2-L4_

Lumbricales (Palmar View) These four muscles assist the extensor digitorum in extending the fingers. Simultaneous flexion at the metocarpophalangeal joint and extension at the interphalangeal joints as in holding a cup or pencil is charactistic of these muscles. Synergists: Extensor digitorum, extensor indices, extensor digiti minimi Antagonists: Flexor digitorum superficialis, flexor digitorum profundus Palpation: deep muscle can not be readily palpated.

Origin: (proximal attachment) Tendons of flexor digitorum profundus in palm Insertion: (Distal attachment) Lateral side of corresponding tendon of extensor digitorum on fingers two through five Action: extends fingers at interphalangeal joimts and weakly flexes fingers at metacarpophalangeal joint innervation: Lateral lumbricals: median nerve (C6, C7); medial lumbricals: ulnar nerve (C8)

Pectoralis Major (Anterior View) 7 Trigger point: are in the belly for each portion of muscle. Referred pain: is the chest and breast down to the ulnar aspect of the arm to the fourth and fifth fingers. In " pull-ups" it pulls the thorax up to the fixed arm position. Synergists: Sternal division: Latissimus dorsi, subscapularis, teres major, Clavicular division: biceps brachii, latissumus dorsi, deltoid Antagonists: Sternal division: rhomboideus major and minor, trapeziux; Clavicula division: infraspinatus, teres minor Palpation: Palpate along axillary border during active adduction of arm.

Origin: (proximal attachment) Ventral surface of the sternum down to the seventh rib, sternal half of clavicle, cartilage of true ribs, and aponeurosis of the external oblique muscle Insertion: (distal attachment) Lateral lip of the intertubercular groove of the humerus. Action: Protracts scapula, adducts and medially rotates arm, clavicular head flexes humerus, sternal head extends humerus, and with insertion fixed is assists in elevation of the thorax. Innervation: Medial and lateral pectoral nerves (C5-C8, T1)

What is a scale for communicating level of discomfort?

Pain questionnaire

Planar Interossei: ( Palntar View Foot) Synergists: For flexion: Lumbricales, flexor digitorum longus, flexor digitorum brevis, quadratus plantae Antagonists: to flexion: extensor digitorum longus, extensor digitorum brevis, To adduction: dorsal interossei Palpation: deep muscles, cannot be palpated.

Origin: (proximal attachment) bases and medial sides of the third, fourth and fifth metatarsal bones Insertion (distal attachment) Medical side of bases of proximal phalanges Action: Adducts toes and flexes toes at metatarsalphalageal jont Innervation: Lateral plantar nerve (S1, S2)

Extensor Pollicos Brevis: (Dorsal View) The scaphoid bone forms the bottom of the "anatomical snuffbox" bordered medially by the extensor pollicis brevis and laterally by the extensor pollicis longus. Pain in response to palpation in this region may indicate a possible fracture of the scaphoid bone. Synergists: Adductor pollicis, flexoe pollicis longus Antagonists: Adductor pollicis, flexor pollicis longus Palpation: Palpate tendon during active abduction and extension of thumb.

Origin: (proximal attachment) distal one-third of dorsal surface of radius and adjacent part of interosseus membrane Insertion: (distal attachment) Base of proximal phalanx of the thumb. Action: Extends thumb and abducts hand Palpation Palpate tendon during active abduction and extension of thumb.

Fibularis (Peroneus)Tertius: (Lateral View Leg) this muscle may also insert onto the base of the fourth metatarsal. 1 Trigger Point: is located in the belly of the muscle Referred pain: is to the front of the lateral malleolus, lateral side foot and heel. Synergists: for dorsiflexion: extensor digitorum longus, tibialis anterior, For eversion: fibularis longus, fibularis brevis Antagonists: to dorsiflexion; fiblularis longus, fibularis brevis, gastrocnemius, soleus, to eversion; tibialis anterior, tibialis posterior Palpation: palpate tendon lateral to the tendon of the extensor digitorum longus on dorsal surface of foot at base of fifth metatarsal bone.

Origin: (proximal attachment) lower third of anterior surface of the fibula and the interosseous membrane Insertion (distal attachment) dorsal surface of the base of the fifth metatarsal bone Action: Dorsiflexes and everts the foot Innervation Deep fibular nerve (L4-S1)

Obturator Externus: (Anterior View) this is a flat, triangular muscle deep in the upper medial aspect of the hip under the gluteal muscles. Synergists: Superior gemellus, inferior gemellus, quadratus femoris, internal oburator, piriformis Antagonist: Gluteus minimus Palpation: Palpate slightly lateral to superior margin of ishial tuberosity during active lateral rotation of thigh at hip joint

Origin: (proximal attachment) outer surface superior and inferior rami of pubis and ramus of ischium Insertion: (distal attachment) Trochanteric fossa of femur Action: laterally rotates thigh at the hip joint. Innervation: Obturator nerve (L3, L4)

Gluteus Maximus: (Posterior View) The gluete maximus muscle is important in maintaining the upright posture. it is active primarily during strenuous activities such as running jumping, and climbing the gluteus maximus is an important injection site. The sciatic nerve runs deep through it. 3 Trigger points: one near the sacrum, one near the ischial tuberosity, and one in the belly of the muscle near the lower fibers. Referred pain: is the entire gluteal region. Synergists: hamstring muscles. Antagonists: Adductors group, rectus femoris. Palpation: Palpate buttock during active extension and lateral rotation of thigh.

Origin: (proximal attachment) posterior gluteal line ilium, adjacent posterior surface of sacrum and coccyx, sacrotuberous ligament and aponeurosis of erctor spinae muscles insertion: (distal attachment) Iilotibial tract of fascia lata and gluteal tuberosity of femur. Action: upper part: extends and laterally rotates the thigh: lower part: extends laterally rotated thigh assists in adduction of the hip joint, and assists in rasing the trunk from a flexed position Innervation: Inferior gluteal nerve (L5-S2)

Anconeus (Posterior View) This muscle is sometimes refrred to as the "fourth head" of the triceps brachii. It may also be only a fibrous band or totally absent. This small muscle works with the triceps brachii. 1 Trigger point: is in the belly of the muscle. Referred pain: is at elbow. Synergists: Biceps brachii, brachiradialis brachialis Antagonists: biceps brachii, brachioradialis brachialis Palpation: Palpate between olecranon process of ulna and lateral epicondyle of humerus during active elbow extension..

Origin: (proximal attachment) posterior surface of the lateral epicondyle of the humerus Insertion (distal attachment) Lateral surface of the olecranon process and posterior proximal surface of the ulna. Action: Extends the forearm and stabilizes the elbow joint. Innervation Radial nerve (C6-C8)

Coracobrachialis (Anterior View) 1 Trigger point: for this muscle is near the coracoid attachment. Referred pain: is down the triceps and dorsal forearm into the hand. Contraction causes the scapula to upwardly tilt at the scapulocostal joint Synergists: For adduction: anterior deltoid, pectoralis major, latissimus dorsi, for flexion: clavicular division of pectoralis major, anterior deltiod, biceps brachii. Antagonists: To adduction: supraspinatus, infraspinatus, middle deltoid, posterior deltoid; to flexion: posterior deltoid, teres major, triceps brachii, latissimus dorsi Palpation: Palpate media to short head of biceps brachii when humerus is flexed against resistance.

Origin: (proximal attachment) tip of coacoid process of scapula Insertion: (distal attachment) Anteromedial surface of the middle of the humerus shaft opposite the deltoid tuberosity Action: Flexes and adducts the humerus Innervation: Musclocutaneous nerve (C5-C7)

Fibularis (Peroneus) Longus (Lateral View Leg) together with the fibularis brevis, it helps stabilize the lateral ankle and the lateral longitudinal arch of the foot. 1 Trigger points: are located near the origin and insertion. Referred Pain: is to the lateral malleolous and heal Synergists: Antagonists: Palpation: Palpate on lateral surface of the proximal half of lower leg during active eversion of foot; palpate tendon just above lateral malleolus.

Origin: (proximal attachment) upper two-thirds of lateral surface of the fibula Insertion: (distal attachment) Lateral side of medial cuneiform and the base of the first metatarsal Action Planta flexes and evert the foot. Innervation: Superficial fibular nerve (L4-S1)

Intercostales Externi(nal) (Anterior View) The external intercostal muscles act synergistically with the diaphragm to aid in inspiration. the fibers are oriented obliquely down and forward toward the coistal cartilages. In the lower intercostal spaces, tht fibers are continuous with the external oblique muscle of the abdominal wall. 4 Trigger points: are located anteriorly between the ribs. Synergists: Serratus posterior superior, Scalene group Antagonists: Internal intercostals Palpation: Palpate between ribs.

Origin: (superior attachment) Lower margin of upper eleven ribs Insertion (Inferior attachment) Superior border of rib below. Action: Elevates rib cage Innervation: Intercostal nerves (T1-T11)

Deltoid(eus) (Anterolateral View) 5 Trigger points: is in the deltoid region an down the lateral surface of the arm. Synergists: For abduction: supraspinatus: for flexion: clavicular division of pectoralis major. Anatagonists: to abduction: latissimus dorsi, sternal division of pectoralis major, to flexion teres major. Palpation: Palpate different heads during active adduction, abduction, and extension of humerus.

Origin: (proximal/ medial) Anterior portion superior surface of lateral border third of clavicle; middle portion: lateral border of acromion process of scapula; Posterior portion: lower border of the crest of the spine of the scapula Insertion: (Distal/ lateral) Deltoid tuberosity of the humerus. Action: Anterior portion: flexes and medially rotates the arm: middle portion: abducts the arm; Posterior portion; extends and laterally rotates the arm. Innervation: Axillary nerve (C5, C6)

Infraspinatus (Posterior View) 3 Trigger points: in the belly of the muscle below the spine of the scapula and near the medial border of the scapula. Activation of the trigger point can cause restriction in rotation of the arms. referred pain: is deep into the shoulder and deltoid area down into the arm. Synergists: teres minor, susraspinatus, middle deltoid, posterior deltoid Antagonists: Anterior deltoid, latissimus dorsi, teres major, pectoralis major, subscaplaris Palpation: Palpate below spine of scapula at axillary border during active lateral rotation of humerus.

Origin: (proximal/medial) Infraspinous fossa of the scapula. Insertion: (distal/lateral) middle part of the greater tubercle of the humerus and the capsule of the shoulder joint Action Laterally rotates the shouder and acts to stabilize the humeral head in the glenoid cavity; it abducts the humerus. Innervation: Suprascapular nerve (C5, C6)

Supraspinatus (Posterior View) 3 Trigger point: are near the tendon and in the belly of the muscle. Referred pain: is deep in the shoulder and down the arm to the elbow. Synergists: Middle deltoid, infraspinatus Anatgonists: Coracobrachialis, Sternal head of pectoralis major, latissimus dorsi teres major. Palpation: Palpate above the spine of scapula during active abduction of arm.

Origin: (proximal/medial) Superaspinous fossa of the scapula Insertions: (disal/lateral) Superior part of the greater tubercle of the humerus and the capsule of the shoulder joint. Action: abducts the arm and acts to stabilize the humeral head in the glenoid cavity during movements of the shoulder joint.

Teres Minor (Posterior View) 1 Trigger point of this "rotator cuff" muscle is in the belly of the muscle near its point of attachment. Referred pain: is in the deltoid region. Activation of the trigger point may cause numbness in the fourth and fifth fingers. Synergists: Posterior deltoid, infraspinatus Antagonists: anterior deltoid, latissimus dorsi, teres major, pectoralis major, subscapularis Palpation: palpate along axillary border of scapula immediately below infraspinatus during active lateral rotation of humerus.

Origin: (proximal/medial) Upper two-thirds of the dorsal surface of the axillary border of the scapula. Insertion: (distal/lateral) The capsule of the shoulder joint and the inferior part of the greater tubercle of the humerus Action: Laterally rotates the arm and draws the humerus toward the glenoid cavity Innervation: Axillary nerve (C5)

Teres major (Posterior View) 2 Trigger points are near both attatchment Referred pain: is in the posterior deltoid region and down the dorsal surface of the arm. Synergists: teres minor, supraspinatus, middle deltoid, posterior deltoid Antagonists: Anterior deltoid, latissimus dorsi, teres major, pectoralis major, subscapularis Palpation: plapate below spine of scapula at axillary border during active lateral rotation of humerus

Origin: (proximal/meidal) Infraspinous fossa of the scapula Insertion: (distal/lateral) Middle part of the greater tubercle of the humerus and the capsule of the shoulder joint. Action: Latereally rotates the shoulder and acts to stabilizes the humeral head in the glendoid cavity: it abducts the humerus. Innervation: Surascapular nerve (C5, C6)

Serratus Anterior (Lateral View) 9 Trigger points: are along the midaxillary line near the ribs. ( sixth rib is major trigger point the rest are minor.) Referred pain: is along the side and back of the arm into the hand. Synergists: Pectoralis minor. Antagonists: Lower trapezius, latissimus Palpation: Palpate along anterior surface of ribs below the axilla during active scapula protraction

Origin: (proxmial attachment) outer surfaces and superior border of the first eight or nine ribs. Insertion: (distal attachment) Anterior surface of the medial border of the scapula. Action: Abducts protracts, and upwardly rotates the scapula, it also holds the scapula firmly against the thorax Innervation: Long thoracic nerve (C5-C7)

Digastricus: (Lateral View) 2 Trigger points: for this muscle are in the belly of each division of the muscle. Referred pain: is in the SCM area and the bottom front teeth. the external carotid artery lies deep to the anterior belly. Synergists: at the TMJ: mylohyoid, geniohyoid, platysma; at hyoid: mylohyoid,geniohyoid, styhyoid. Palpation : Palpate between superior edge of SCM and mandible while mouth is opening. Innervation: Anterior belly: mandibular branch of trigeminal nerve (V); Posterior belly: Cervical branch of facial nerve (VII)

Origin: (superior attachment) Posterior belly: between the mastoid and styloid processes of temporal bone; Anterior belly: inner side of inferior margin of mandible near mandibular symphysis Insertion: (inferior attachment) Both bellies insert on the body of the greater cornu of the hyoid bone by a fibrous loop. Action: acting together the digastric muscles elevate the hyoid bone and steady it during swallowing and speech; the posterior belly helps open mouth and depresses the mandible.

Scalenus Medius- Middle Scalene: (Anterolateral View) 3 Trigger points: along the length of the muscle. referred pain: is along the upper and lower arm, lateral side of the hand and just lateral to the midline in both the anterior and posterior upper thorax. Synergists: other scalene muscles, SCM, longus capitis, longus colli Antagonists: upper division of the erector spine muscles, rhomboids, rectus posterior muscles. Palpation: palpated with anterior scalene

Origin: (superior attachment) Front of the posterior tubercles of the transverse processes of the second through seventh cervical vertebrae. insertion (inferior attachment) Upper surface of the first rib. Action: fleses the neck anteriorly and laterally, raises the first rib capisits longus colli. innervation: Ventral rami of the fourth through the eighth cervical nerve (C4-C8)

Palmaris Brevis: (Palmar View) This is a small muscle lying in the fascia of the hypothenar eminence. it is often absent. Palpation can not readily be palpated

Origin: Palmar aponeurosis Insertion: Skin of pal of hand. Action: Corrugates (wrinkles) skin of palm Innervation: Ulnar nerve (C8)

Mylohyoid(eus): (Lateral View) referred pain: is to the tongue. Contraction of this muscle can cause muscle pain when swallowing. Synergists: at TMJ: digastric, geniohyoid, platysma; at hyoid: digrastric, geniohyoid, stylohyoid. Antagonists: At TMJ: temporalis, masseter, medial and lateral pterygoids; at hyoid: sternohyoid, thyrohyoid, omohyoid. Palpation: Palpate with fingers under chin while placing tip of tongue against roof of mouth. Innervation: Mandibular branch of trigeminal nerve (V)

Origin: (superior attachment) Mylohyoid line of mandiable . Insertion: ( inferior attachment) Upper border and median raphe of hyoid bone. Action: elevates hyoid bone, raise floor of mouth and tongue, and depresses mandible at TMJ.

Stylohyoid(eus): ( Lateral View) The styloyoid parallels the posterior belly of the digastric muscle.The central tendon of the digastric penetrates the insertion of stylohyiod. Synergists: digastric,mylohyoid, geniohyoid Antagonists: Sternohyoid, thyrohyoid, omohyoid Palpation: palpate by placing fingers between SCM and posterior ramus mandible as you swallow. Innervation: Facial nerve (VII)

Origin: (superior attachment) styloid process of temporal bone. Insertion (inferior attachment) body of hyoid bone at junction of great cornu. Action elevates and retracts the hyoid, elongates the floor of the mouth and lifts the tongue during swallowing.

Levator Scapulae: (Posterior View) 2 Trigger are at the belly of the muscle just as it begins its rotation and at the attachment point of the scapula. Referred pain: is along the angle of the neck and the vertebral border of the scapula. Synergists: Rhomboids, trapezius Antagonist: Latissimus dorsi Palpation: Palpate neck between SCM and trapezius during elevation of scapula.

Origin: (superior/medial attachment) Transverse processes of the first four cervical vertebrae (C1-C4) Insertion: (inferior/lateral attachment) verterbral border of the scapula between the superior angle and the spine. Action: raises scapula and draws it medially: with scapula fixed, bend the neck laterally and rotates it to the same side; extends the neck Innervation: third and fourth cervical spinal nerves and dorsal scapular nerve (C3-C5)

Biceps Femoris: (Posterior View) 4 Trigger points are in the belly of the muscle and near the insertion. referred Pain: is from the ishcial tuberosity to the back of the knee and down the posterior leg to mid calf. Synergists: Other hamstrin muscles, gracilis, gastrocnemius, sartorius Antagonists: Quadriceps femoris Palpation: Palpate on Lateral posterior surface of thigh during resisted knee flexion.

Origin: 9proximal attachment) Long head: ischial tuberosity; proximal two-thirds of supracondylelar line. Insertion: (distal attachment) Common tendon passes downward to insert on head of fibula and lateral condyle of the tibia Innervation: long head: tibial division of the sciatic nerve (L5-S2); Short head: fibular division of the sciatic nerve (L5-S2)

Exteranal Anal Spincter: (Inferior View)

Origin: Central tendon of perineum Insertion: Midline raphe and the coccygeus muscle Action: Voluntary muscle circling the anus preventing defecation. Innervation: Pudendal nerve (S2-S4)

Bulbospongious: (Postier View)

Origin: Central tendon of the perineum and midline raphe of male penis. Insertion: Anteriorly into corpus cavernosa of penis or clitoris Action: Empties male urethra and assists in erection of penis and clitoris in female

Transversus Throacis: (Internal View) This muscle, found on the inside of the rib cage, decreases the size of the thoracic cavity and thus aids in forced exipriation. the attachment of these muscle slips can vary. Synergists: Quadratus lumborum, serratus posterior inferioe, subcostales, internal intercostals Anatgonists: Scalenes group, serratus posterior superior, Lavatores costarum, subclavius, external intercostals. palpation: Deep muscles : can not be palpated.

Origin: Inner surface of the body of the sternum, xiphoid process, and sternal ends of the costal cartilages of the three or four true ribs. Insertion: Inner surfaces of the costal cartilages of the secon through sixth ribs. Action: Dresses ribs Innervation: intercostal nerves (T1-T12)

Sphincter Urethrae ( Inferior View) In females, this muscle encircles the urethra and the vagina.

Origin: Isheiopupic rami Insertion: Midline raphe Action: constricts Urethra and helps support pelvic organs Innervation: Perineal branch of pudendal nerves. (S2-S4)

Transversus Abdominis: (Lateral View) The transversus abdominis is the innermost of the three abdominal muscle layer. its fibers run horizontally while the other two abdominal muscle layers fibers run obliquely. Palpation: Deep muscle: cannot be readily palpated.

Origin: Lateral part of inguinal ligament, iliac crest, thoracolumbar fascia, and cartilage of lower six ribs. insertion: Abdominal aponeurosis to linea alba Action: Constrict the abdomen and support the abdominal visera. Innervation: Ventral rami of the lower six thoracic and first lumbar spinal nerves (T7-T12, L1)

Cremaster: (Anterior View) Contraction of the cremaster muscle reflexively elevates the testis to a higher position in the scrotum for warmth and to protect against injury. Under very warm conditions, the muscle relax, enabling the testis to sit lower with greater heat loss from the surrounding scrotal skin. these responses help maintain an optimal temperature in the testis for the production of male sex cells. Although a striated muscle, the cremaster is not usually under voluntary control.

Origin: Lower edge of internal oblique miscle and middle of inguinal ligament. Insertion: pubic tubercle and crest of pubis Action: pulls the testes up toward the superficial inguinal ring. Innervation: Genital branch of the genitofemoral nerve from the first and second lumbar nerves. (L1, L2)

Serratus Posterior Superior (Posterior View) This muscle lies under the rhomboideus next to the ribs. the orign of these muscles slips can vary 4 Trigger points: are under the scapula near the insertion of the muscle on the ribs. Referred pain: is under the upper portion of the scapula Synergists: Scalenes group, levatores costarum, subclavius, external intercostals Antagonists: Quadratus lumborum, serratus posterior inferior, subcostales internal intercosals, transversus thoracis Palpation: Place palapating hand in region of upper rhomoids while taking a deep breath; difficult to palpate.

Origin: Lower portion of ligamentum nuchae and the spinous Processes of the sixth and seventh cervical through the third thoracic vertbrae (C6-T3) Insertion: Upper border and external surfaces of ribs two through five lateral to their angles. Action: Assists in raising ribs during inspiration Innervation: second through fifth intercostal nerves. (T2-T5)

Coccygeus: (Inferior View) this is a small triangular muscle lying posterior to the lavator ani. It forms the posterior part of the pelvic diaphragm.

Origin: Pelvic surface of the ischial spine and the sacrospinous ligament. insertion: Margin of the coccyx and the lower sacrum. Action: supports pelvic viscera, Supports coccyx and pulls it forward after it has been reflected by defecation or childbirth and assists in closing the posterior part of the pelvic outlet Innervation: Fourth and fifth sacal nerves (S4, S5)

Levator Ani (Lateral -Interanl View) This is a broad, flat muscle whose fibers extend inferomedially, forming a muscle sling around the male prostate or female vigina, urthra, and anortectal junction before meeting in the median plane. Palpate: internal in females

Origin: Pelvic surface of the pubis, inner surface of the ischial spine, and the oburator fascia Insertion: Inner surface of the coccyx, levator ani of opposite side, and sides of rectum Action: Constricts the lower end of the rectum and vagina and support and slightly raises the pelvic floor. Innervation: fourth sacral nerve and inferior rectal nerve (S4)

Serratus Posterior Inferior (Posterior View) 1 Trigger point: is in the belly of the muscle near the eleventh rib. Referred pain is a nagging ache in the area of the muscle. Synergists: Internal intercostals, subcostales, transversus thoracis, quadratus, external intercostals, serratus posterior superior Antagonists: Scalenes group, levatores costarum subclavius external intercostals serratus posterior superior Palpation: Deep muscle cannot be readily palpated.

Origin: Spinous process of the last two thoracic and upper three lumbar vertebrae (T11-L3) Insertion: inferior border and outer surfaces of lower four ribs just lateral to the angles Action: Depresses last four ribs. 9 this is somewhat controverial in light of recent studies since it shows no electromyographic activity during respiration Innervation: the ninth through twelfth thoracic nerves (T9-T12)

Obliquus externus Abdominis: (Lateral View) This is th emost superficial of the three side abdominal muscles. Its fiber angle obliquely downward and medially. the inguinal ligament is formed from the aponeurosis of external oblique. the midline aponeurosis of the sexternal and internal obliques form the sheath that covers the rectus abdominis. Synergists: Rectus abdominis, internal oblique, psoas major Antagonists: erector spinae muscles Palpation: Palpate on lateral side of abdomen during active trunk rotation.

Origin: external surface of the lower eight ribs. Insertion: Antrior part of iliac crest and by abdominal aponeurosis to line alba Action: Laterally flexes and rotates vertebral column; both sides flex vertebral column anteriorly. Innervation: Ventral rami of the lower six thoracic nerves (T7-T12)

Diaphragm: (Inferior View) Palpation: palpate on inferior margin of anterior rib cage while taking a deep breath and slowly exhaling.

Origin: first three lumbar vertebrae, lower six costal cartilages, and inner surface of xiphoid process of sternum Insertion muscle fibers converge upward and inward to form the centreal tendon Action: Flattens on contractio, increasin the vertical dimensions of thorax Innveration: Phernic nerve (C3-C5)

Ischiocavernosus: (Inferior View)

Origin: inner surface of the ischial tuberosity and the ramus of the ischium. Insertion: Aponeurosis on the sides and undersurface of the crus penis or clitoris Action: compresses the crus penis, which obstructs venous return and maintains erection of penis of clitoris Innervation: Perineal branch of the pudendal nerve (S2-S4)

Onliquus Internus: (Lateral View) The internal oblique is important in forced expiration, coughing and sneezing. Contration squeezes the abdominal contents. It is the middle of the three layers of abdominal wall muscles. Synergists: External obliques, rectus abdominis. Antagonists: Erector spinae muscles. Palpation Deep muscle; can not be readily palpated.

Origin: lateral half of inguinal ligament, anterior two thirds of the iliac crest, and thoracolumbar fascia. Insertion: upper fibers into cartliages of last three ribs, the remainder into the aponeurosis extending from the tenth costal cartilage to the pubic bone. Action: Laterally bends and rotates vertebral column; also aids the rectus abdominal contents Innervation: Venteral rami of the lower six thoracic and first lumbar spinal nerves (T7-T12, L1)

Superficial Transverse Perineus ( inferior View) in males, these pair muscle bands are posterior to the urethral opening: in females they are posterior to the viginal opening. They are sometimes absent.

Origin: medial and anterior part of the ischial tubeosity Insertion: Central tendinous point of perineum Action: Stabilizes and strengthens perieum Innervation: Perineal branches of pudendal nerve (S2-S4)

Longissimus Capitis: Synerhists: Iiocostalis, semispinalis, spinalis groups

Origin:(Inferior Attachment): Transverse processes of upper thoracic vertebrae (T1-T5) and articular processes of lower four cervical vertebrae Insertion: (superior attachment) transverse processes of upper fivej thoracic vertebrae (T1-T5) and artivular process of lower four cervical vertebrae. Action Extends and rotates the head. Innervation Rectus abdominis

Scalenus (Scalene) Posterior: (Anterolateral View) Scalene group acts as an accessory muscle of repiration by raising the first and second ribs, they assist in inspiration. 1 Trigger point: in the belly near the rib attachment points. Referred pain: is in the pectoral region, the rhomboids region, and the entire length of the arm to the hand. Synergists: Other scalene muscles, SCM, Longus capitis, longus colli. Antagonists: Upper division of the erector spine muscles, rhomboids, rectus posterior muscles. Palpation: Palpate just posterior to where the anterior and middle scalenes are palpated.

Origins: (superior attachment) Posterior tubercles of the transverse processes of the fourth through sixth cervical vertebrae. Insertion: (inferior attachment) Outer surface of second rib Action: Flexes the neck anterior and laterally; raise the second rib Innervation: Ventral rami of the sixth through eighth cervical nerves (C6-C8)

Osgood-schlatter disease

Osteochondrosis (inflammation of the bone and cartilage) of the tibial tuberosity. Indications: N/A. Contraindications: Regional; avoid affected area

Defective development of connective tissue, bone becomes thin and fragile/massage is often contraindicated so consult with the client's doctor.

Osteogenesis Imperfecta

A benign growth of the skin or mucous membrane?

Papilloma

Raised reddened bump on the skin?

Papule

Joint moved with no resistance or assistance from a client, increases circulation of lymph and blood, nourishes the skin, relaxes in lengthens muscles, soothes nerves, lubricates joints.

Passive joint movement

When a client remains relaxed

Passive joint movement

Exercise during which the patient does not assist the therapist is called?

Passive range of motion exercises help keep a person's joints flexible, even if he cannot move by himself. Range of motion is how far the person's joints can be moved in different directions. The exercises help you move all the person's joints through their full range of motion.

What is a slow gentle movement to lengthen muscles when resistance is minimal?

Passive stretching

The study of the physiologic processes of a disease.

Pathophysiology

What is the study of functional or physiologic changes in the body that result from various disease processes?

Pathophysiology

Which muscle is an agonist to flexion of the hip?

Pectineus

Ulcer

Peptic Ulcer— break or open sore not covered by protective mucus in the gastrointestinal wall that is exposed to pepsin and gastric juice; often caused by alcohol, pepsin, bile salts, and stress. Indications: massage is beneficial to reduce stress levels; lifestyle and dietary changes may be necessary. Contraindications: Refer client to physician for specific diagnosis; support physician's treatment plan

The nutrients needed in the Haversian system are supplied by blood vessels found in___________?

Periosteum

What stimulates blood flow through deeper arteries and veins?

Petrissage or kneading

What immune response process destroys foreign cells?

Phagocytosis

What is pain from an amputated limb?

Phantom pain

What increases metabolism, Hastens healing, relaxes and refreshes muscles, improvefunction of lymphatic system, helps prevent and relieve muscle cramps and spasms, improves circulation of blood and lymph,improves delivery of oxygen and nutrients to cells, and enhances removal of metabolic waste?

Physical effects of massage

Organic process of the body, on cellular, tissue, or organ system levels, activation of parasympathetic nervous system, and releases endorphins

Physiological effects of massage

Mole

Pigmented, fleshy growth of skin. Indications: Watch for any change in a mole; refer client to physician if a change is noted. Contraindications: Regional; avoid mole

Where on the SOAP chart, referrals, self care recommendations, and functional outcomes?

Plan

What is the name of the movement that allows a person to stand on their toes?

Plantar flexion

________________is the movement which decreases the angle between the sole of the foot and the back of the leg. For example, when depressing an car pedal or standing on the tiptoes can be described as plantarflexion

Plantar flexion

Pectoralis Major (Anterior View):

Poland's Syndrome is typically characterized by absence of pectoral muscles on the right side combined with abnormalities in the skeletal structure and skin, fusion of the digits (syndactyly) and assorted shoulder/ thoracic bone anomalies.

What is a PNF technique involves holding and waiting for the nervous system to trigger relaxation, strain counter strain, uses triggerpoints?

Positional release (PR)

What is a prior proprioceptive neuromuscular facilitation technique that uses active movement to lengthen the muscle?

Post - isometric contraction (PIR)

Multiple Sclerosis

Primary disease of the central nervous system marked by degeneration of myelin. Indications: massage is beneficial as part of a physician-directed treatment plan. Contraindications: General

Syphilis

Primary stage: usually painless lesion (chancre) present on exposed skin; secondary stage: begins about 2 months after chancre disappears and produces a variety of symptoms, including skin rash. Indications: N/A. Contraindications: Rash; is contagious; refer to physician

What is the standard of conduct, goals, quality of workers in the same field?

Professionalism

What is the expected outcome of disease?

Prognosis

What is it when a person has uncomfortable feelings and projects them onto others?

Projection

What is in lactation?

Prolactin and oxytocin

With a client's arm at their side in a 90 degree angle and the palm facing up, what is the movement of the forearm that rotates the palm to face downward?

Pronation

Hernia

Protrusion of a loop or piece of an organ or tissue through an abnormal opening; hiatal—protrusion of any structure (usually the esophagus or end of the stomach) through the hiatus of the diaphragm; inguinal— protrusion through the inguinal ring, causing swelling of the scrotum and possible a medical emergency; umbilical—protrusion at the umbilicus; in inguinal and umbilical hernias, weakness may be felt in the abdominal wall. Indications: N/A. Contraindications: refer client to physician; avoid area

Which conditions is an autoimmune disease that is typically hereditary and not contagious?

Psoriasis

Which muscle is a synergist to mandible elevation?

Pterygoid

Furuncle (Boil)

Pus-filled cavity formed by infection of a hair follicle. Indication: massage may increase circulation and assist healing Contraindication: Regional; refer client to physician; avoid affected area

Small blister filled with pus.

Pustule

With client in supine position,to work on a client's pectoralis major. What would you do?

Put a pillow under abducted bent elbow

Which muscle group is responsible for leg extension?

Quadriceps

What is the first aide principle, rest, ice, compression, elevation, stabilization, and appropriate first sprains and strains?

R.IC.E.S

Which would you use to increase mobility at a joint?

Range of motion

What is it when a client contracts the antagonist to the target muscle, and reduces muscle cramping?

Reciprocal inhibition (RI)

Which of the following muscles is known as a pinnate muscle?

Rectus femoris

Anemia

Reduced red blood cell count or hemoglobin; symptoms include fatigue and pallor. Indications: Massage can be beneficial as part of the treatment plan. Contraindications: General; refer client to physician for diagnosis and proceed under physician's direction. Aneurysm

When a client mentions during a session that he is considering suicide, The massage practitioner should?

Refer to a mental healthcare professional

What is recommendation to see if this specific professional, the most appropriate method for giving a referral is to provide a list of practitioners?

Referral

The original of humeral rotators would most likely be on what bone?

Scapula

Lateral curvature of the spine/do not massage in extreme cases without doctor's consent.

Scoliosis

What is the lateral curvature of the spine?

Scoliosis

The knowledge base and practice parameters of profession are called

Scope of practice

What is service limits boundaries as determined by legal, educational, competency, and accountability factors, knowing base and practice parameters of profession?

Scope of practice

What repeats themselves annually?

Seasonal rhythms

Suggestion that support the client in achieving their goals is ?

Self care recommendation

Recommendation for activities between sessions is?

Self help

If the therapist is aware of someone practicing massage therapy without a license the therapist should do what?

Send a complaint to the states massage board

Vertigo

Sensation of movement, not to be confused with dizziness. Indications: N/A. Contraindications: General; usually symptomatic of underlying condition; physician's diagnosis required.

What is any action of verbalization of inappropriate sexual nature towards the client?

Sexual misconduct

What is watching a client undress or holding a client in a sexual way?

Sexual misconduct

What is it when intoeing, pigeon toes increase with height,tendency toward parallel position from out toeing increases with heel height,and gastrocnemius and soleus are shortened?

Shoes with heels

What is a good position to start a massage for pregnant client?

Side lying or laterally recumbent position

Outward, observable abnormalities such as fever, rash, bleeding.

Signs

What is observed by a health professional?

Signs of disease

A complete fracture however unlike compound fracture this one is closed and does not protrude through the skin,

Simple or closed fracture

What is a breaking a bone that does not break the skin or injure soft tissue?

Simple or closed fracture

What is this sitting bath with the water coming up to the navel?

Sitz bath

What is cushioned limited ?

Soft end feel

What is short lived and is localized unpleasant feeling?

Somatic pain

What would you call a sudden and painful involuntary muscle contraction in a client?

Spasm

Tic

Spasmodic twitching; often occurs in the face. Indications: May be stress-induced; massage is beneficial in reducing stress. Contraindications: Refer client to physician for diagnosis to rule out underlying pathologic condition

A development problem in which the vertebral arches do not fuse into spinous processes?

Spina bifida

What is tear in ligaments?

Sprain

Skin cancer

Squamous cell carcinoma, basal cell carcinoma, melanoma, kaposi sarcoma. Contraindications; watch for any change in a mole or existing skin condition; if this occurs, refer client to physician

Ligaments are in every joint in the body. That means that wherever two bones meet, ligaments are there to connect them. The elasticity of the fibrous ligaments allows them to change shape and lengthen under stress and then return to their original shapes. Function of Ligaments is to ?

Stabilize the joint

What is roles and procedures for professional contact and quality of care to followed by members of a profession, guiding principles by which professional should conduct themselves and their day to day business?

Standards of practice

Toxic Shock Syndrome

Staphylococcal bacterial infection that can arise from the use of tampons; can be life-threatening; initial flulike symptoms with red rash; can be prevented by changing tampons several times a day—this condition also has occurred in women who do not use tampons. Indications: N/A. Contraindications: Immediately refer client to physcican.

What uses hot vapors in confined area for temperatures from 105 to 120°F and with 100% humidity?

Steambath

A massage therapist has created a vision statement for her practice, designed a thoughtful layout to her office and organized a marketing campaign to attract clients. What business practice is being applied?

Strategic planning

A tiny microscopic fracture in a bone.

Stress Fracture

Cerebrovascular accident

Stroke; a disturbance in cerebral circulation; major causes include atherosclerosis (thrombosis), embolism, hypertensive intracerebral hemorrhage or ruptured saccular aneurysm; symptoms differ, depending where the disturbance of circulation occurs. Indications: Massage may be beneficial during recovery under physician's supervision and during long-term care for continued support. Contraindications: Refer client to physician for diagnosis.

Where on the SOAP chart, a client says they did not sleep well?

Subjective

The partial displacement of bones of the joint?

Subluxation

Innervation:

Supply of nerve to a body part or area

Abnormalities that patient complains of but cannot necessarily be seen by an observer such as fatigue, achiness.

Symptoms

There are several methods a massage therapist can use to assess a client. The therapist can ask questions to create a detailed intake and the therapist can provide a postural assessment. What is the most viable skill a massage therapist possesses?

The ability to feel with the hands

Diaphragm: (Inferior View)

The diaphragm is the most important muscle of insiration, When the muscle is relaxed, it is dome-shaped. It flattens as it contracts, increasing the volume of the thoracic cavity. The alternate contraction and relaxation causes pressure changes in the abdominoplvis cavity that assist in the return of venous blood and lymph to the heart. A protrusion of a structure through a weakended musclar layer is called a hernia. A hiatal hernia occurs because there is higher pressure in the abdomen than in the thorax, forcing part of the fundus of the stomach upward through the esophageal haitus into the thorax due to the weakening of the cardiac sphincter. * Other examples if herbuas are umbilical, femoral and inguinal. The Heimlic maneuver causes pressure on the diaphragm to increase intrathoracic pressure that forces food out of the laryngeal opening of a choking victum.

Sternocleidomastoid (SCM): (Lateral View)

The fleshy parts of this strap-shaped muscle divide the cervical region into anterior and posterior triangles. It is key muscle landmark in the neck. Spasms in one of these muscles may cause "wryneck," or torticollis. This can also be a congenital condition when the muscle is injured in a difficult birth, particularly in the breach position,. It causes a fixed rotation and tilting of the head due to fibrosis and shortening of the muscles on one side.

Gastrocnemius: (Postior View of Leg)

The gastrocneimius is the large calf muscle. A third head may arise along some portion of the popliteal surface of the femur. the two major heads may retain separate insertions on the calcaneus. the calcaneus tendon can be ruptured during. The calcaneus tendon can be ruptured during games that require quick starts and stops. Complete rupture brings abrut, sharp pain to the posterior lower leg and a lump or swelling apears in the calf due to the shortening of the muscles. the patient will no longer be able to planter flex the foot.

Gluteus Medius: (Lateral View)

The gluteal region is a common site for intramusclar injections because the muscles are thick and large. to aviod the sciatic nerve, gluteal nerves, and blood vessels deep in the gluteus maximus, injections are applied to the gluteus medius in the superolateral part of the buttock where the gleteus medius is not covered by the gluteus maximus.

What is the goal of myofascial release?

The goal of myofascial release is to release fascial restrictions and allow the layers to move freely

Myofascial pain and muscle strength:

The muscle may suddenly release, just before pain occurs. The patient avoids contractions forceful enough to hurt

Serratus Anterior (Lateral View)

The number of slips may vary between seven and twelve. the most superior slip may not attach to the first rib, and muscle slips may be continuous with other adjacent muscles. This muscle i s important in horizontal arm movement such as pushing and punching. It is sometimes called the "boxer's muscle.

Pectineus (Anterior View)

The pectineus is the upper of the adductor group of muscles there is controversy about whether it medially rotates the thigh. Straining of this muscle causes a pulled groun injury. All of the adductor group are important in horse back riding or other activities that require the pressing together of the thighs.

Soleus: (Posterior View of foot)

The soleus and gastrocnemius are jointly referred to as the triceps surae. the soleus is located beneath the gastrocnemius, and may insert onto the calcaneus separately from the gastrcnemius. Its tendon is part of the achillies tendon.

Epidemiology?

The study of the occurrence, transmission, and distribution of a disease.

Longus Capitis: ( Anterior View)

The superior portion of this this muscle may be fused with the longus collis. The longus capitis and the longus colli are often injured in a whiplash accident, causing neck pain. tightness of this muscle may mimic a sore throat.

Supinator: (Anterior View)

The supinator is a large muscle that wraps around the bone of the forearm. this muscle is covered by the more bones of the forearm. This muscle is covered by the more superificial muscle. An acessory supinator may arise from the coronid process of the ulna just lateral to the ulnar tuberosity, and insert onto the radial tuberosity , posterior to the insertion of the biceps tendon.

If the therapist for the first time suddenly gives a regular client a big hug after the session what did the therapist do?

The therapist has cross the clients boundary

What is it when a therapist can refuse to work on a client and a certain situation that makes the therapist uncomfortable?

Therapist right of refusal

If a client reenact abuse while on the massage table by crying and shaking what should the therapist do?

Therapist should be calm and excepting

If a client does not want to fill out a medical history form, the client must feel that the disclosure would cross a boundary and the therapist should do what?

Therapy should offer alternatives such as taking the information verbally or filling out a shorter form

Rectus Capitis Posterior Minor:

There is different of opinion about the action of this muscle. It is generally assumed that it extends the head, but myographic studies inicate that it does not act in extension, but rather function as a restraint to flexion and forward movement of the head.

Femoris (Anterior Rectus View)

This is one of the four quadriceps femoris muscles. It sits on the anterior aspect of the femur and is the only one of the four that crosses both the hip and knee joint. this group is a powerful knee joint. this group is apowerful knee extensor used in running, jumping climbing. The rectus femmoris is used when the thigh flexion and leg extension are needed such as kicking a soccer ball or foot ball. The pain and muscle stiffness associated with "charley horse" results from a contusion and tearing of muscle such tissue of a quadreiceps muscle such as the rectus femoris. Direct trauma of hockey stick or tackle may produce a thigh hematoma, an accumulation of blood into the muscle and surrounding tissues from damaged blood vessles This muscle is a common injection site, especially in very young children

Extensor Digitorum: (Dorsal View)

This muscle divides into four prominent tendons on the dorsum of the hand. Sudden tension on a long extensor tendon may tear its attachment to a finger at the distal phalangeal joint. This occurs when the finger is forced into extreme flexion. This is called "mallet finger" or metacarpalfinger. This muscle tends to hyoerextend the metacarpophalangeal joint. Inflammation of this common tendon of orign is a primary cause of "tennis elbow."

Flexion-opposition of thumb and Digits: ( Palmar View)

Thumb 1) Flexor pollicis longus tendon 2) Flexor pollices brevis 3) opponens pollicis Fingers 4) Flexor digitorum profound tendon 5) Flexor digitorum superficialis tendon 6) Lumbricales 7) Opponens digiti minimi 8) Palmar interossei 9) Flexor digiti minimi

What is the movement in which the thumb meets the ring finger?

Thumb opposition

Spinal Cord Injury

Traumatic injury or degenerative process of the spinal cord; may result from compression, cut, or tissue replacement in scarring. Indications; Massage is beneficial as part of a physician-directed treatment plan. Contraindications: Regional

Recommendations for future treatment is called?

Treatment plan

Duodenal Ulcer

Ulcer caused by hyperacidity in duodenal bulb; stress related; symptoms include burning pain that feels better after eating. Indications: Massage is beneficial for reducing stress; lifestyle and diet changes may be necessary. Contraindications: Refer client to physician for specific diagnosis; support physician's treatment plan.

Stress Ulcer

Ulcer related to severe stress— trauma, burns, long-term illness—symptoms similar to those seen in gastritis. Indications: massage is beneficial for reducing stress; lifestyle and dietary changes may be necessary. Contraindications: Refer client to physician for specific diagnosis; support physician's treatment plan.

What repeats themselves every few hours?

Ultradian rhythms

What is it when a client stretches into resistance and applies light contraction, such as yoga?

Unassisted static stretching

Hypothyroidism

Underproduction of thyroid hormone; symptoms include sensitivity to cold, weight gain, fatigue, and dullness. Massage is beneficial for stimulating metabolic function. Contraindications: General; work within physician's recommendations.

The wearing of protective gear like medical gloves, finger cots and goggles refers to which of the following?

Universal precautions

Warts

Usually benign excess cell growth of the skin. Indications: N/A. Contraindications: Regional; avoid affected area; contagious; may become malignant; if any changes in wart occur, refer client to physician

What is friction?

What addresses adhesions and tendinous tissue, increases joint flexibility, deep effleurage, deep fiber friction, rolling, wrinkling, reduces tissue, stretching or pulling, effects for reducing adhesions, and more effective without oil

What is pain and inflammation of plantar fascia?

What is pain and inflammation of plantar fascia?

What happens when muscle tissue is damaged?

When muscle tissue, fascia and other tissues are damaged, the body tends to quickly patch the area with scar tissue which does not necessarily match the original composition it becomes less elastic, less vascularized, less innervated, less oriented and thus poorer in performance, and possibly numb or painful. When a muscle is stretched, its fascia is also lengthened.

__________________ is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension.

__________________ is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension.

An individual's range of motion is the best determined through?

an assessment of joint movement

Holding weight in a fixed position with no movement is an example of _______________ contraction.

an isometric contraction is one where muscle length is constant or unchanging under force.

What is Compression?

applies pressure to soft tissues to squeeze together without any slip, and both temporary stopping a floating area, then releasing allow greater blood flow, good for sports massage, before massaging the intercostals?

What would it be when connective tissue or fluid retention issue?

area is stiff

What would it be when it is a joint issue?

area is stuck

What would it be when it is a muscle tone issue?

area is tight

The best way to turn a client is to hold the edge of the sheet and have the client turn?

away from the therapist

Radiculopathic model for myofascial pain

based on the super sensitivity in target organs that results from denervation which expresses as an increase in the area of the muscle membrane that contains ACh receptors making the muscle more sensitive to ACh and other chemicals could result from milder functional and structural alterations in the nerves in the spine due to intervertebral disk degeneration, hence the radicular aspect of this model

What is a small fluid filled sac that reduces friction?

bursa

The concept that suppression of emotions causes muscular tension is?

character armer

Who would you be friend at the work station without power differential?

co worker

Diminished blood flow to an area is?

cold area

The up phase of a wide arm push-up creates which type of contraction of the tricep muscle?

concentric contraction is one where the muscle shortens under force.

The sternocleidomastoid action of flexion of the neck is an example of _______________ contraction.

concentric contraction is one where the muscle shortens under force. Flexion of the neck is the concentric contraction and natural action of the sternocleidomastoid.

Trigger points:

defining characteristic of myofascial pain syndrome

An inferior movement of the scapula is known as scapular _______________.

depression

When assessing extension of the hip,resistance is applied to the end of the?

femur

When assessing the function of the shoulder,resistance is applied at the distal end of the?

humerus

Piriformis, gemelli superior and obturator internus are part of the _______________ group.

lateral rotator

Limit range of motion in lateral rotation and abduction of the shoulder. What do you lengthen?

lengthen teres major

Arm pain and a depressed coracoid process of the scapula. What do you lengthen?

lengthen the pectoralis minor

local twitch response

may occur when firm pressure is applied over the tense band of muscle in a snapping fashion perpendicular to the muscle fiber direction the close this palpation is applied to the trigger point, the more vigorous the resultant contraction likely produced by a sudden change of tension on the trigger point producing a local stretch reflex

What is golfer's elbow and can be cause by hammering and screwdriver?

medial epicondylitis

Palpation:

method of examining the body with the hands; it is particularly useful for locating skeletal and muscular landmarks and for diagnostic purposes, treatment such as massage, or identifying appropriate location for injections.

Involves a hypertonic muscle stabilizing or splinting an area is?

muscle guarding

Antagonists:

muscle that opposes the action of another muscle; Example: the triceps brachii is antagonistis to the biceps brachii

Myofascial pain and posture

often the muscle used to maintain body posture are affected with trigger points. These muscles include the muscles in the neck, shoulder, and the pelvis, including the upper trapezius, scalene, sternocleidomastoid, elevator scapulae, and quadratus lumborum

guidelines for placatory trigger point examination

optimal position for palpating trigger points is to lengthen the muscle to approximately two thirds it's length, just short of the pain muscles palpated must be relaxed the examiner's finger nails must be trimmed the examiner will feel a taut cord of tense muscle fibers among normally slackened fibers the examiner should locate the spot of maximum tenderness and maintain pressure to elicit the referred pain pattern one should palpate only the trigger points that will be treated that day

Levatores Costarum (Posterior View) In some individuals, the muscle slips arising from T8 to T10 may each have a second division that extends to the second rib. Synergists: Scalenes group, serratus posterior superior, subclavius, external intercostals. Anagonists: Serratus posterior inferior, quadratis lumborum, subcostaled, transversus thoracis. Palpation: Deep muscles cannot be readily palpated

origin (superior atachment) Transverse processes pf seventh cervical and upper eleven thoracic (C7-T11) Insertion: (inferior attachment) Latterally to costal angle of next lower rib. Action Raises ribs and laterally flexes and rotates vertebral column Innervation: Intercostal nerves (T1-T11)

IIiocostalis Lumborum: (Posterior View) 1 Trigger point: near the bottom of the muscle near the Lumbar region. Synergists: longissmus, semispinalis, spinalis group, quadratus lumborum. Antaginist: Rectus abdominis, Palpation: Palpate erector spine muscle as a group lateral to spinous processes of the vertebrae.

origin : (inferior attachment) medial and laterail scaral crests and medial part of iliac crest insertion (superior attachment) Angles of all ribs. Action: extends and laterally flexes the vertebral column; laterally moves pelvis Innervation: Palpate erector spinae muscle as a group lateral to spinous processes of the vertebrae.

Multifidus: (Posterior View) The multifidi are part of the transversospinalis group of muscles they lie deepto the erector spinae. this group extends and rotates the spine. 3 Trigger points: are in the belly of the muscle in the lumbosacral region and the the cervical region. Referred pain: may feel like it is in the spine itself because tension in these small diagonal muscles may pull one or more vertebrae our of line to one side, pressing nerves and producing addition pain. synergists: rotatores, interspinales, intertransversarii groups Antagonists: Dosal rami of spinal nerves palpation: Place hands on either side of sacrum while upper part of body is being actively extended.

origin: (Inferior attachment) Articular processes of the last four cervical, transverse prosesses of all thoracic, and mammillary processes of lumbar vertbrae, the posterior superior iliac spine, posterior sacoiliac ligaments and dorsal surface of sacrum adjecent to sacral spinous processes Insertion: (superior attatchment) Spineous process of the vertebra above the vertebra of origin. Action Extends and rotate vertebral column Innervation: Dorsal rami of spinal nerves

Rhomboid(eus) Minor (Posterior View) The fibers of both muscles are arranged in an oblique, downward patrern. 1 Trigger point: are on the belly of the muscle. Synergists: pectoralis major Antagonist: Pectoralis major Palpation: Palpate along vertebral border during active retraction and adduction of scapula.

origin: (Medial Attachment) Spinous processes of the seventh cervical and first thoracic vertebrae (C7_T1) insertion: ( lateral attachment) Medial border of the scapula at the root of the spine. Action: retracts and stabilizes the scapula, elevate the vertebral border, and rotates the scapulae, to depress the inferior angle. Innervation: Dorsal scapular nerve (C5)

Geniohyoid(eus): (Lateral View) Synergists: At the TMJ: digastric, mylohyoid, platysma; at hyoid: digastric, mylohyoid, stylohyoid. Antagonists: At TMJ: temporalis, masseter, medial and lateral pterygoids: at hyoid: sternohyoid, thyrohyoid, omohyoid. Palpation: Cannot be palpated separately. Innervation: First cervical nerve (C1) through the hypoglossal nerve (XII)

origin: (Superior attachment)Inferior mental spine on inner surface of mandible. Insertion (Inferior attachment) anterior surface of body of hyoid bone. Action: Pulls hyoid bone superiorly and anteriorly, shortening the floor of the mouth, it draws the tongue forward and depresses mandiable at TMJ.

Omohyoid(eus): (Lateral View) Like the digastric muscle, the omohyoid is a straplike muscle with two bellies united by an intermediate tendon. It is lateral to the sternohyoid. Antagonists: digastric, stylohyoid, mylohyoid, geniohyoid Palpation: palpate lateral to SCM just superior to clavicle while depressing mandible against resistance.

origin: (inferior atachment) Superior belly: arises from tendon of inferior belly near SCM; Inferior belly: superior border of scapula near scapula notch and suprascapula ligaments insertion: (superior attachment) Inferior belly: ends as a tendon (bound to clavicle by central tendon); Superior belly: inserts on lower border of hyoid bone. Action Depresses and retracts hyoid bone; retracts larnx Innervation: Ansa cervicalis (C1-C3)

Longus Capitis: ( Anterior View) Synergists: Longus colli, SCM scalenes muscles, rectus capitis anterior platyma. Antagonists: Rectus capitis posterior major, rectus capitis posterior minor, longissimus capitis Palpation: Deep muscle: cannot be readily palpated.

origin: (inferior attachment) Anterior tubercles of the transverse process of the third through sixth cervical vertebrae. insertion: (superior attachment) Basilar process of occipital bone anterior to foramen magnum. Innervation C1-C4

Thyrohyoid(eus): (Lateral View) Synergists: sternohyoid, omohyoid Antagonists: Digastric, stylohoid, mylohyoid, geniohyoid. Palpation: Cannot be palpate separately.

origin: (inferior attachment) Lamina of the thyoid cartilage at the oblique line. insertion: (superior attachment) Greater cornu of hyoid bone. Action: Depression hyoid and elevate larynx if hyoid is fixed. Innervation: First cervical nerve (C1) through (C1) through the hypoglossal nerve (XII)

Recutus Capitis Lateralis: (Anterior View) Synergists: rectus capitis posterior major, obliquus Capitis, splenius SCM, trapeszius muscles on the same side. Antagonists: Same muscles on the opposite side. Palpation: Deep muscle cannot be readily palpated.

origin: (inferior attachment) Transverse process of atlas. insertion: (superior attachment) Jugular process of occipital bone Action: Bends head laterally Innervation: C1, C2

Flexor Digitorum Longus (Posterior View Leg) Trigger Point: is in the belly of the muscle. Referred Pain: down the posterior leg into the heel and into the metatarsal arch and call synergists: Tibialis posterior, flexor hallucis longus, flexor digitorum brevis Anatagonists: Extensor hallucis longus, extensor digitorum longus, tibialis anterior Palpation: Palpate tendon going around the medial malleolus just posterior to the tibialis posterior tendon.

origin: (proximal attachment) Medial part of posterior surface of tibia Insertion: (distal attachment) Plantar surface of the bases of the distal phalanges of the second, third, fourth, and fifth, toes Action: Flexes distal phalanges of lateral foot, inverts foot. Innervation: Tibial nerve (L5, S1)

Scalenus (Scalene) Anterior: (Anterior Lateral View): 3 Trigger point: along the length of the muscle. Referred pain: is along the upper and lower, lateral side of the hand, and just lateral to the midline in both the anterior and posterior upper thorax. Synergists: Other scalene muscles, SCM, Longus capitis, longus colli. Antagonists: Upper divisions of the erector spinae muscles rhomboids, rectus posterior muscles. Palpation: Pa;pate anterior and middle scalenes by placing fingers slightle lateral to the SCM and superior to the clavicle while taking in short deep breaths.

origin: (superior attachment) Anterior tubercle of the traverse processes if the third through sixth cervical vertebrae insertion (inferior attachment) Scalene tubercle on the inner border and upper surface of the first rib. Action Flexes the neck anteriorly and laterally; raises the first rib. Innervation: Ventral rami of the fourth through sixth cervical nerves (C4-C6)

Sternalis (Anterior View) 2 Trigger points: more common on the left side or in the midline of the sternum when the muscle fuses across the sternum. Referred pain: include the entire sternal and substernal region and may extend on the same side across the upper pectoral are and front of the shoulder to the underarm and to the ulnar aspect of the elbow. the pattern is similar to the substernal ache of myocardial infarction or angina pectoris. Clinically, the sternalis has the potential to initially cause misdiagonosis of breast tumors or their recurrence post- treatment. Palpation: deep muscle can not be readily palpated.

origin: (superior attachment) may attach to the sternum. to the fasica over the pectoralis major or SCM or it may form a continuation of these muscle. Insertion: (Inferior attatchment) May attach to the third through seventh costal cartilages, the fasicia covering the pectoralis major, and/or the sheath of the rectus abdominis muscle. Action: no skeletal movement is attributed to this muscle. Innervation: Since the muscle may be a variant of part of the pectorailis major and/or the rectus abdominis muscle the nerve innervation may be similarly varbiable.

The use of touch to examine tissues is?

palpation

Tender points

points that produce pain only at the site of palpation don't produce referred pain occur in the insertion zones of muscles, not in taut bands in the muscle belly

Another name for itching.

pruritus

When a massage therapist is petitioning a governing body of one state to accept a massage license from another state, the therapist is seeking

reciprocity

What may be caused by throwing sports such as baseball or occupants such as dry wall hanging?

rotator cuff muscles

Myofascial pain is typically increased by

strenuous use of the muscle, especially in the shortened position passive stretch of the involved muscle manual pressure on the trigger point holding the involved muscle in the shortened position for a prolonged period of time sustained or repeated contraction of the involved muscle cold, damp weather viral infection exposure to a cold draft nervous tension

A small painful area hypertonicity is?

tender point

What is too strong?

tense muscle

Erector Spinae Muscles: (Posterior View) Spinalis Capitis Spinalais Cervicis Spinalis thoracis

the erector spinae muscles go into powerful spasms following injury to back structure.. 2 Trigger points: for this group are usally found in the midscapular and lumbar regions. Referred pain: is to the scapular, lumbar, gluteal, and abdominal regions.

Flexor Carpi Radialis: (Anterior View)

the flexor cari radialis runs diagonally across the forearm. Its fleshy belly is repalced midway by a flat tendon that becomes cord-like at the wrist. the tendon acts as a guide to the position of the radial artery in order to take a pulse. "Golfers elbow" is painful condition that follows repetitve use of the superficial muscles on the anterior forearm, strain the common flewor tendon. the flexor carpi radialis is the most commonly affected muscle. Another name for this syndrom is medial epicondylitis, reflecting the site of inflammation.

Levator Scapulae: (Posterior View)

the lavator is an elevator. it works with the upper portion of the trapezius when the shoulders are shrugged. It has a twist in it so that the attachments at the atlas and axis are from muscle fibers that attach to the inferior portion of the border and the attachment at C4 are from fibers at the superior portion of the border.

Supraspinatus (Posterior View)

the tendon of this rotator cuff muscle is frequently torn. Pain is described as deep in the shoulder and becomes progressively worse during abduction. The entrapment of the tendon of this muscle under the acromion process of the scapula causes impingement syndrome which makes it painful to raise the arm. The bursa located between this muscle and the acromion process is called the subacromial bursa.

When a client discuss personal matters with the therapist you should?

therapist should listen and be compassionate

Satorius: (Anterior View)

this is a strap-like muscle running obliquely across the anterior surface of the thigh to the knee. It is the longeast in the body. It crosses both the hip and knee joint. It is sometimes called the "tailor muscle' and is used in sitting on the floor with thighs spread andlower legs crossed similar form to a yogo position. The accessory portion may arise from various points near the anterior superior iliac spine, the pectineal line, pubic bone, or inguinal ligament, Insertion vary between adjacent areas of the femur, patellar ligament, tendon of the semitendinosus, or tendon of the twin muscle.

Tibialis Anterior (Anterior View Leg)

this is a superficial muscle of the shin. It parallels laterally the sharp anterior margin of the tibia. Paralysis of this muscle causes foot drop in which the foot must be lifted high to prevent the toes from dragging during walking. Irritation of this muscle often causes shin splints. Shin splints occur in the anterior compartment of the leg following vigorous exercise in someone who does not usally exercise. The tibialis anterior muscle swells and the blood supply is reduced, causing ischemia. Proper warm up and cool down techniques help prevent this problem.

Biceps Femoris: (Posterior View)

this muscle is the most lateral of the hamstrings group. The two heads may be more separated lengthwise than normal or the short head may be absent. It crosses both the hip and knee joints, and it is a prime mover of both hip extension and knee flexion Pulled hamstrings are a common sports injury. It occurs with hard running, fast starts, or kicking. A contusion occurs with tearing of the muscle fibers and a hematoma forming is contained by the dense fascia of the muscle. Occasionally the tears are in the tendons attaching it to the ischial tuberosity.

Active trigger point symptoms

weakness, temperature changes, paresthesia, tinnitus, tempuromandibular joint area pain, headache, eye symptoms, and torticollis