MBLEX 3

Question 261: The tibia, fibula, humerus, femur, ulna and radius are all: a. Irregular bones b. Flat bones c. Long bones d. Short bones

c. Long bones Rationale: Long bones are longer then they are wide and at both ends have a shaft and head. All the bones of the appendicular skeleton are long bones with the exception of the wrist and ankle.

Question 287: In Massage Standards of Practice, which of the following situations would be considered under the Roles and Boundaries section? a. A dual or multidimensional relationship b. Follow acceptable accounting practices c. Advertise in an honest manner d. Providing a safe environment

a. A dual or multidimensional relationship Rationale: Roles and Boundaries pertain to adhering to a professional role and ethical boundaries designed to protect both the practitioner and client. Standards of Practice sections include: Professionalism, legal and ethical requirements, Confidentiality, Business Practices, Roles and boundaries, and Prevention of sexual misconduct. The other answers fall under the Business Practice section.

Question 271: Which of the following is a type of athletic stretching method used to lengthen muscles and release the fasica? a. Active Isolated Stretching (AIS) b. Manual Lymph Drainage (MLD) c. Craniosacral Therapy d. LomiLomi

a. Active Isolated Stretching (AIS) Rationale: Active Isolated Stretching (AIS) is a modality used to provide effective stretching of major muscle groups. It restores physiological traits by increasing the function of the superficial and deep fascial layers. To avoid reflexive contractions the stretch used should be no longer then 2.0 seconds.

Question 221: Of the following occupations, which has the ability to study athletic performance, prevent injury, and assist in rehabilitation as a scope of practice? a. Athletic Training b. Acupuncture c. Psychology d. Podiatric Medicine

a. Athletic Training Rationale: Athletic Training is the ability to study athletic performance, prevent injury, and assist in rehabilitation. Scope of practice in giving training regimens, assessment, and evaluation of injury, therapeutic exercise, treatment, reconditioning of injuries, and using therapeutic modalities.

Question 218: Carpal tunnel syndrome (CTS) is a peripheral nervous system condition and is defined as a(n): a. Condition that results from a compression of the median nerve b. Condition that involves compression of the brachial plexus c. Compression of the nerve as it passes through the anterior and middle scalenes d. Compression of the nerve as it passes through the coracoid process and pectoralis minor

a. Condition that results from a compression of the median nerve Rationale: Carpal tunnel syndrome (CTS) is a condition that results from a compression of the median nerve as it passes through the carpal tunnel in the wrist, resulting in numbness and tingling in the lateral three and one-half digits. Thoracic outlet syndrome (TOS) is a condition that involves compression of the brachial plexus and its accompanying artery between the anterior and middle scalene= anterior scalene syndrome, coracoid process and pectoralis minor= pectoralis minor syndrome and clavicle and first rib= costoclavicular syndrome.

Question 211: Elizabeth Dicke of Germany developed what technique in 1929? a. Connective tissue massage b. Polarity Therapy c. Orthopedic Medicine d. Manual Lymphatic Drainage

a. Connective tissue massage Rationale: Elizabeth Dicke of Germany developed Connective Tissue Massage (CTM) or Connective Tissue Therapy (CTT) in 1929

Question 281: Hyperemia is a reflexive effect of what type of treatment technique? a. Cross-fiber friction b. Swedish gymnastics c. Fine vibration d. Coarse vibration

a. Cross-fiber friction Rationale: Cross-fiber friction mechanical effects: broadens and stretches muscle tissue, temporary ischemia, decrease in fascial adhesions, increase in muscle extensibility, and breaks up and reforms scar tissue. Reflexive effects: hyperemia (secondary to ischemia), relaxes muscles and decreases hypertonicity (by the nervous system or if done on a tendon, golgi tendon organ), and increases circulation.

Question 241: While giving an assessment there are three types of questions you ask to obtain relevant information for the treatment plan; General, Specific, and Pain questions. Which of the following is a General question? a. Do you have any pathological conditions, such as diabetes mellitus, hypertension, or cancer? b. If the onset was gradual, when were the first symptoms noticed? c. Was there medical treatment or therapy given prior to coming to get a massage? d. Does the pain move or refer to other areas?

a. Do you have any pathological conditions, such as diabetes mellitus, hypertension, or cancer? Rationale: These pathologies require treatment modifications. General questions address the client's overall state of wellbeing. Family history of conditions, diet, exercise, occupation, hobbies, sleeping posture, level of stress, and current/past pathologies or injuries.

Question 278: To prevent infectious and communicable diseases the simplest, most effective way to minimize risk is hand washing. The CDC has four steps for proper hand washing. What is the fourth step? a. Dry hands with a paper towel b. Rub hands together for at least 20 seconds to work up a lather c. Apply soap to hands d. Rinse hands using warm water

a. Dry hands with a paper towel Rationale: Proper hand washing technique is; #1. Apply soap to hands. #2. Rub hands together for at least 20 seconds to work up a lather. Pay particular attention to scrubbing the backs of your hands, between your fingers, and under your nails. #3. Rinse hands using warm water. #4. Dry hands with a paper towel. Use the paper towel to turn off the faucet, the light, and open the door before placing the towel in the garbage.

Question 246: Which method works toward bringing unconscious movement into conscious awareness so it can be used as a tool for opening the human potential through movement reeducation and functional integration? a. Feldenkrais Method b. Feldenkrais MethodConnective Tissue Massage (CTM) c. Oncology Massage d. Cryotherapy Page

a. Feldenkrais Method Rationale: Developed by Moshe Feldenkrais to establish new connections between the brain and body through movement reeducation and functional integration. Sessions can be one-on-one or in a group.

Question 212: To utilize agonist contractions on a client with right-sided torticollis, you must? a. Isometrically without pain resist rotation to the left b. Isotonically to end feel resisting rotation to the left, it may be painful c. Isometrically without pain resist rotation to the right d. Isotonically to end feel resisting rotation to the right, it may be painful

a. Isometrically without pain resist rotation to the left Rationale: Agonist (prime mover) contraction (shorten or tense muscle), Isometric (no movement, Isotonic (movement), and sub= under, below or less than maximum resistance (no pain). Agonist contraction is also great for diminishing spasms. After you have isometrically without pain or restriction, resisted rotation to the left, slowly and gently move the head out of right rotation (repeated 2-3 times). Then use the same technique in lateral flexion to cover all the actions of the affected muscle.

Question 252: Decreasing muscle spasm and increasing the resting length of muscles is an effect of: a. Mechanical stimulation of golgi tendon organs b. Chemical stimulation of golgi tendon organs c. Reflexive stimulation of golgi tendon organs d. Mechanical stimulation of the muscle spindle cells

a. Mechanical stimulation of golgi tendon organs Rationale: The golgi tendon organs are proprioceptive nerve receptors located in the tendons near the junction with the muscle. Mechanical stimulation will help decrease muscle spasm and increase the resting length of an acute injury.

Question 224: The diagnosis, treatment, prevention, cure, or relief of human disease, ailment, defect, complaint, or other physical or mental condition by attendance, advice, device, diagnostic test, or other means is under which occupation's scope of practice? a. Medicine b. Podiatric Medicine c. Psychology d. Physical Therapy

a. Medicine Rationale: Medicine is the diagnosis, treatment, prevention, cure, or relief of human disease, ailment, defect, complaint, or other physical or mental condition by attendance, advice, device, diagnostic test, or other means.

Question 229: The muscle spindles are proprioceptive nerve receptors or minute sensory organs located in the: a. Muscle belly b. Tendons c. Joints d. Capillaries

a. Muscle belly Rationale: Muscle spindles protect the muscle from being overstretched. They monitor muscle length and help control muscle movements by detecting the amount of stretch placed on a muscle.

Question 226: How many Kilocalories does each gram of fat produce? a. Nine b. Two c. Four d. Twenty

a. Nine Rationale: Kilocalories or Calories are the measured units of energy provided by food.

Question 268: A cramp is a: a. Prolonged muscle spasm b. Voluntary, prolonged muscle contraction c. Involuntary, sustained contraction of a muscle d. Short, painless, protective contraction

a. Prolonged muscle spasm Rationale: Spasm= an involuntary, sustained contraction of a muscle. A cramp is a common or lay term for painful, prolonged muscle spasm.

Question 208: Asthma is a chronic inflammatory disorder and termed a(n): a. Respiratory pathology b. Condition of the CNS c. Circulatory pathology d. Condition of the PNS

a. Respiratory pathology Rationale: Asthma is a condition where chronic inflammation narrows the airways in the lungs (bronchospasms) and is reversible with time or after treatments. Respiratory pathologies include: sinusitis, chronic bronchitis, emphysema, and asthma. Peripheral refers to the nervous system outside the central nervous system CNS= brain and spinal cord.

Question 222: The ____________ test is performed on a client who has Whiplash to determine if pain on swallowing is due to sternocleidomastoid trigger point referral pain or other cervical pathologies. a. Swallow b. Finger flexion c. Three-knuckle d. Scalene relief

a. Swallow Rationale: The swallow test determines if the pain on swallowing is due to referred pain of sternocleidomastoid TPs or due to other pathologies; throat infection, hematoma, cervical spine protuberance or tumor. The client is placed in a seated position, palpate the SCM (Sternocleidomastoid) and find the most tender point using the pincer technique, maintain firm pressure while the client swallows. The test is positive if pain diminishes while the client swallows. If pain is experienced on the swallow without muscle compression of the SCM, refer them to their physician, a hematoma may be present. The three-knuckle test (mandible depression), trigger point compression test (agonist muscle belly), scalene relief (ant. scalene) and finger flexion (scalene group) test will be positive if trigger points exist in the respective muscles.

Question 300: All information given is confidential on a health history intake form unless? a. The client gives specific written permission b. Their HCP asks for it c. You feel it is your duty to share client information for legal reasons d. Treatments are complete and they are no longer a client

a. The client gives specific written permission Rationale: State laws vary as to the amount of time you need to keep inactive client information. At any rate you must at all times keep any and all information confidential unless given written permission from client. HCP= Health Care Provider.

Question 267: To reduce symptoms, some massage treatments can be temporarily uncomfortable, such as friction. It is best to: a. Work within the clients pain tolerance b. Work through treatment knowing that the treatment is painful, but for the best c. Have the client focus to help with pain d. Use plenty of lotion

a. Work within the clients pain tolerance Rationale: Always adjust treatment to the client's pain tolerance. Communicate that pain is involved but it can be stopped at any time. Using breathwork along with treatments will help decrease pain during treatment and help to relax muscles more effectively. Include self-care for client in the exit interview including water and stretches to help alleviate the possibility of pain after treatment, always discuss the benefits of the treatment.

Question 254: Which of the following forms would you file with the IRS if you had a contract with another company and was paid over $600 for your services? a. W-9 b. 1099-Misc c. 1040 d. 1040EZ

b. 1099-Misc Rationale: A 1099-Misc must be filled out with the IRS regarding information for every company. You should receive the filing information from each company before federal taxes are due. A W-9 must accompany the application or first CMS-1500 form to insure proper paperwork procedures

Question 219: Patellofemoral syndrome is defined as: a. A contracture or thickening of the IT band b. A painful degenerative change to the articular cartilage on the underside of the patella c. A decrease in the medial longitudinal arch and a pronated hindfoot d. Inflammation and pain at the lateral femoral condyle and IT band juncture

b. A painful degenerative change to the articular cartilage on the underside of the patella Rationale: Patellofemoral syndrome is a painful degenerative change to the articular cartilage on the underside of the patella. Pes planus (pronated foot or flat foot) is a decrease in the medial longitudinal arch and a pronated hindfoot. Iliotibial Band contracture is a contracture or thickening of the IT band. Iliotibial band friction syndrome is the inflammation and pain at the lateral femoral condyle and IT band juncture.

Question 296: What type of joint movement would you use to describe the act of bringing a limb in towards the midline of the body? a. ABduction b. ADduction c. Flexion d. Extension

b. ADduction Rationale: ADduction can be described as the act of bringing the limb in towards the midline of the body. ADding to the midline. Moving on a frontal or coronal plane. Question 297: Which of the following occupations is a discipline of diagnosis, prescription, treatment, and surgery for disease, pain, deformity, deficiency, injury of human teeth, gums, jaw, alveolar processes, and dependent tissue?

Question 266: While it is regrettable, transference does happen during treatments. If you encounter a client who has experienced a negative childhood emotion and transferred an irrational reaction towards you, it is best to: a. Continue the massage as if nothing has happened and use effleurage only b. Allow the client to be informed of the transference and possibility give them the option of ending the session or having a moment to themselves. Always respect the clients needs (within reason) c. Terminate the session, communicating that you can't work with unstable emotions. It's not within your scope of practice d. Communicate to them that these things happen and there is nothing that can be done except to end the session

b. Allow the client to be informed of the transference and possibility give them the option of ending the session or having a moment to themselves. Always respect the clients needs (within reason) Rationale: Not taking a reaction personally is important. Transference reactions aren't always recognized right away. Thinking logically with a rational conclusion will help you to realize not everything is about you. Take extra care not to counter-transfer your past emotional reactions to the transference that is expressed by your client.

Question 204: For better response to treating whiplash in the chronic stage, you should? a. Muscle strip simultaneously both SCM's b. Avoid rapid increases in the range of motion treatments c. Focus treatment on the neck only d. Use only passive range of motion

b. Avoid rapid increases in the range of motion treatments Rationale: A gradual approach of ROM treatment and treating compensatory structures helps in reducing pain, trigger points, and hypertonicity for better recovery. (SCM= Sternocleidomastoid)

Question 298: All of the following muscles share the same attachment site: a. Pectoralis minor, Biceps brachii, and Brachialis b. Biceps brachii, Coracobrachialis, and Pectoralis minor c. Brachialis, Coracobrachialis, and Biceps brachii d. Coracobrachialis, Pectoralis minor, and Brachialis

b. Biceps brachii, Coracobrachialis, and Pectoralis minor Rationale: The coracoid process of the scapula is the origin of the short head on biceps brachii and the coracobrachialis. This structure also is the insertion for pectoralis minor.

Question 294: In a ninth century temple carving in India, who can be found getting a massage? a. Ambroise Pare b. Buddha c. Galen of Rome d. Yellow Emperor

b. Buddha Rationale: Buddha is depicted in a ninth century temple carving in India getting a massage. The Hindi term champna means to press or massage and is highly thought to be the origin of the word shampooing, a word used by English writers to describe a wash, rub, or lathering of the hair.

Question 263: The stomach is: a. S-shaped located in the left abdominal cavity b. C-shaped and located in the left abdominal cavity c. C-shaped and located in the right abdominal cavity d. S-shaped located in the right abdominal cavity

b. C-shaped and located in the left abdominal cavity Rationale: The stomach is C-shaped and located in the left abdominal cavity hidden by the liver and diaphragm.

Question 231: Piriformis syndrome is a peripheral nervous system condition and is defined as a(n): a. Condition that involves compression of the brachial plexus b. Compression of the sciatic nerve c. Condition that results from a compression of the median nerve d. Compression of the nerve as it passes through the anterior and middle scalenes

b. Compression of the sciatic nerve Rationale: Piriformis syndrome is a compression of the sciatic nerve by the piriformis muscle. Carpal tunnel syndrome (CTS) is a condition that results from a compression of the median nerve as it passes through the carpal tunnel in the wrist, resulting in numbness and tingling in the lateral three and one-half digits. Thoracic outlet syndrome (TOS) is a condition that involves compression of the brachial plexus and its accompanying artery between the anterior and middle scalene= anterior scalene syndrome, coracoid process and pectoralis minor= pectoralis minor syndrome and clavicle and first rib= costoclavicular syndrome.

Question 235: Bell's Palsy is a condition of the peripheral nervous system (PNS) and is defined as a(n): a. Motor function disorder resulting from damage to the immature brain b. Condition involving a lesion on the facial nerve resulting in flaccid paralysis c. Progressively diminishing basal ganglia function d. A condition where demyelination of the nerves occurs

b. Condition involving a lesion on the facial nerve resulting in flaccid paralysis Rationale: Bell's Palsy is a condition involving a lesion on the facial nerve resulting in flaccid paralysis of the facial expression muscles on the same side as the lesion. All other definitions are CNS conditions. Cerebral palsy (CP) is a motor function disorder resulting from damage to the immature brain. Parkinson's is a Progressively diminishing basal ganglia function resulting in slow, increasingly difficult movement, accompanied by resting tremors and muscular rigidity. Multiple sclerosis (MS) is a condition where demyelination of the nerves occurs.

Question 210: What action is limited by the coxal joint because of the four femoral neck ligaments? a. Flexion b. Extension c. Lateral rotation d. Medial rotation

b. Extension Rationale: The coxal joint's four supporting ligaments are the deep zona orbicularis, anterior iliofemoral ligament, medial pubofemoral, and posterior ischiofemoral ligament. They wrap around the femoral neck, starting anteriorly, ending posteriorly. Extension tightens the ligaments and flexion loosens them. Ligaments encircle the coxal joint capsule counter clockwise.

Question 255: A new client intake reports they are diabetic, what treatments are contraindicated for this condition? a. Petrissage and manual lymphatic drainage b. Extreme hydrotherapy and deep cross-fiber friction c. Petrissage and tapotement d. Effleurage and petrissage

b. Extreme hydrotherapy and deep cross-fiber friction Rationale: Deep petrissage, cross-fibre friction and hydrotherapy in extremes are contraindicated because of the possible decreased tissue health and sensory impairments.

Question 248: When a body is divided into anterior and posterior portions, it is called the: a. Sagittal plane b. Frontal plane c. Transverse plane d. Mid-sagittal plane

b. Frontal plane Rationale: Frontal or Coronal plane divides the body into front and back portions. The terms anterior and posterior relate to the frontal plane; actions are ADduction and ABduction.

Question 234: What bone in the body does not articulate with other bones? a. Choroid b. Hyoid c. Patella d. The floating ribs

b. Hyoid Rationale: The hyoid is the only bone in the body that does not articulate with other bones. It is suspended by ligaments and tendons. It is supported by the muscles of the neck and in turn is the root of the tongue.

Question 216: Congestive heart failure is a circulatory pathology and is defined as a(n): a. Inflammation of a superficial or deep vein b. Inability to pump sufficient blood to supply the needs of the body c. Peripheral vascular disorder that affects the blood vessels outside the heart and thorax occurring secondary to another underlying condition d. Elevation of blood pressure above the normal range for a prolonged time

b. Inability to pump sufficient blood to supply the needs of the body Rationale: Congestive heart failure (heart failure) is the heart's inability to pump sufficient blood to supply the needs of the body. Hypertension is an elevation of blood pressure above the normal range for a prolonged time that increases the risk of stroke or heart attack. Raynaud's Phenomenon is a peripheral vascular disorder that affects the blood vessels outside the heart and thorax, occurring secondary to another underlying condition. Thrombophlebitis is an inflammation of a superficial or deep vein that leads to the formation of a thrombus (fibrin-based clot).

Question 213: How is edema caused by heart or kidney disease? a. Exercise stimulates lymph circulation and cleans muscle tissue b. Kidneys regulate blood volume and an increase in fluid volume can overload the heart c. The more salt a person consumes the more water is retained to balance it d. It can increase the permeability of blood capillaries

b. Kidneys regulate blood volume and an increase in fluid volume can overload the heart Rationale: These diseases affect the blood and lymph circulation. When using lymphatic massage caution is used because an increase of fluid can overload the heart. Kidneys regulate the blood volume so an increase in fluids will overload the weakened kidneys.

Question 289: Which muscle ADducts the arm? a. Biceps brachii b. Latissimus dorsi c. Supraspinatus d. Rhomboid major

b. Latissimus dorsi Rationale: The ADductors of the glenohumeral joint: Latissimus dorsi, teres major, infraspinatus, teres minor, pectoralis major (all), triceps brachii (long head), and coracobrachialis.

Question 245: What muscle is palpable at the lateral cervical vertebrae and deep to the upper trapezius and is capable of moving the scapula? a. Splenius capitis b. Levator scapula c. Scalenes d. Rhomboid major

b. Levator scapula Rationale: The levator scapula can be palpated in between the splenius capitis and posterior scalenes. It is the only muscle attached to the lateral cervical vertebrae that is capable of moving the scapula. Actions are: Unilaterally rotating head and neck to same side along with laterally flexing the head and neck, elevation and downward rotation of the scapula. Bilaterally extends the head and neck.

Question 264: In the 1932 Dr. Emil and Estrid Vodder develop what technique? a. Polarity Therapy b. Manual Lymphatic Drainage c. Connective tissue massage d. Orthopedic Medicine

b. Manual Lymphatic Drainage Rationale: In 1932 Dr. Emil and Estrid Vodder of France developed Manual Lymphatic Drainage.

Question 277: The resistance of a relaxed muscle to passively stretch or elongate is described as: a. Muscle approximation b. Muscle tone c. Muscle strength d. Muscle weakness

b. Muscle tone Rationale: Muscle tone is the resistance of the muscles and connective tissue to palpation and the active, but not continuous, contraction of muscle response to the stimulation of the nervous system.

Question 292: With a muscle injury, active free and passive relaxed range of motion are used to assess: a. Synergists b. Pain in the muscle's range c. The client's tolerance to compressed pain d. Where the trigger points are effecting the muscles

b. Pain in the muscle's range Rationale: Active free ROM is performed when the client actively contracts the muscles crossing a joint, moving the joint through the unrestricted range. Passive relaxed is performed by the therapist, without the client contracting the muscle. Active and passive test the prime movers. Resistive tests for synergists.

Question 220: A mother-in-law comes to redeem a gift certificate given to her by your spouse. As a massage therapist it is best to avoid a damaging dual or multidimensional relationship by: a. Allowing her to talk through the whole massage telling you about all the latest gossip b. Providing clear boundaries before the massage begins on what the desired outcome and expectations are for both the therapist and client making the recommendation to concentrate on breathing and deep relaxation for a beneficial treatment c. Initiating conversation by asking the mother-in-law about anything and everything, keeping her talking to avoid uncomfortable silence d. Pointing out your no talking rule during the massage to avoid uncomfortable or inappropriate conversations

b. Providing clear boundaries before the massage begins on what the desired outcome and expectations are for both the therapist and client making the recommendation to concentrate on breathing and deep relaxation for a beneficial treatment Rationale: Dual or multidimensional relationships happen between a massage therapist and another individual that could be a longtime client, neighbor, family member, close friend, business partner, boy/girlfriend, husband, or wife. Boundaries need to be made clear by the massage therapist before a treatment can be done to insure clear expectations for both parties involved.

Question 253: The term ___________ describes the location __________________________? a. Sagittal /farthest from the injury b. Proximal / nearest the origin of the structure c. Distal / to the side of the origin d. Medial / at the bottom of the structure

b. Proximal / nearest the origin of the structure Rationale: Proximal describes a location nearest to the origin or injury.

Question 249: The application of principles, methods, and procedures of understanding, influencing, and predicting behavior for the purpose of diagnosis for treatment is within which occupation's scope of practice? a. Podiatric Medicine b. Psychology c. Osteopathic Medicine d. Acupuncture

b. Psychology Rationale: Psychology can be rendered to an individual, group, or an organization and involves the application of principles, methods, and procedures of understanding, influencing, and predicting behavior for the purpose of diagnosis for treatment.

Question 202: ___________ is used by the therapist during treatments and by the client after treatment as self-care. It includes range of motion, resistance exercise, and stretching. a. Manual Lymphatic Drainage (MLD) b. Remedial exercise c. Diaphragmatic breathing d. Effleurage

b. Remedial exercise Rationale: This use of active and passive exercise will restore and improve the client's musculoskeletal strength and health.

Question 284: What two muscles ADduct the scapula? a. Latissimus dorsi and rhomboids b. Rhomboids and trapezius (middle fibers) c. Rhomboids and latissimus dorsi d. Latissimus dorsi and Trapezius

b. Rhomboids and trapezius (middle fibers) Rationale: ADduct or retraction= Trapezius (middle fibers) and Rhomboid major and minor.

Question 290: To test the anterior scalene muscles to see if they are the cause of your client's thoracic outlet syndrome, it is best to place them in what position: a. Prone position b. Seated position c. Side-lying position d. Supine position

b. Seated position Rationale: With the client seated, stand behind them with their affected arm extended and slightly externally rotated. While monitoring the client's radial pulse, instruct the client to rotate the head towards the affected shoulder. Elevate the chin and take a deep breath holding it for 15 to 20 seconds. When a breath is taken it elevates the first rib and compresses the neurovascular bundle against the tight anterior scalenes. If the radial pulse diminishes or a recurrence of the client's symptoms manifest, the test is positive. This test is known as the Adson's Test.

Question 285: There are two divisions of the skeleton, which are axial and appendicular, the _________ is part of the axial. a. Clavicle b. Sternum c. Scapula d. Femur

b. Sternum Rationale: The axial; cranium, vertebral column, ribs, sternum and hyoid bone. The appendicular; shoulder or pectoral (scapula & clavicle) and hip or pelvic girdles with upper and lower limbs.

Question 265: What is another name for the subacromial bursa? a. Subteres b. Subdeltoid c. Subscapularis d. Subcoracoid

b. Subdeltoid Rationale: Subacromial bursa is also known as the subdeltoid bursa, for a portion of the bursa is between the deltoid and the humerus. BursITIS= inflammation of the bursa. Caused by overuse of the structures surrounding the bursa. Bursa's reduce friction normally between tendons and bones, the only way to palpate a bursa if it is inflamed.

Question 240: Loosening mucus in the thoracic cavity is a mechanical effect of what type of treatment technique? a. Fine vibration b. Tapotement c. Jostling or shaking d. Light effleurage

b. Tapotement Rationale: Tapotement's mechanical effects: loosens mucus in thoracic cavity, temporary ischemia. Reflexive effects: hyperemia (secondary to ischemia), stimulation of the nervous system, muscles, vessels, skin, and also induces numbing effect if prolonged more then three minutes, increases muscle tone (contract/ relax response), brief vasoconstriction followed by vasodilation, increase in circulation, stimulates organs (lungs and abdominal organs/LB), increases gaseous exchanges, and increase cellular activity.

Question 214: The pectoralis major has three fiber segments, the upper, middle and lower otherwise known as what? a. The cephalic, sternal and costal fibers b. The clavicular, sternal and costal fibers c. The capitus, sternal and costal fibers d. The manubrial, sternal and costal fibers

b. The clavicular, sternal and costal fibers Rationale: The pectoralis major upper fibers are the clavicular, the middle fibers sternal and the costal are the lower fibers. Working together they ADduct and medially rotate the glenohumeral joint. The upper clavicular fibers flex and horizontally ADduct the shoulder and the lower costal fibers extend the shoulder.

Question 227: What are the two most popular stances among MT's? a. The parallel and T stance b. The parallel and one-foot forward stance c. The one-foot forward and T stance d. The T and Y stance

b. The parallel and one-foot forward stance Rationale: In parallel stance your feet are placed side-by-side and is utilized at the head/foot of the table or facing across the table. The one-foot forward stance is with one foot in front of the other, it is utilized when advancing along the side of the table. The T stance creates rotation at the hip and is not a stable or aligned stance to utilize.

Question 230: The major components of the nervous system are? a. Branch nerves and trunk nerves b. The spinal cord and brain c. The nerves d. The peripheral nervous system

b. The spinal cord and brain Rationale: The major components are the brain and the spinal column.

Question 207: If you were to start at the anterior flap of the upper trapezius and move anteriorly, what order would you palpate the following muscles? a. Trapezius, posterior scalene, levator scapula, middle and anterior scalenes b. Trapezius, levator scapula, posterior, middle and anterior scalenes c. Trapezius, splenii, posterior, middle and anterior scalenes d. Trapezius, longus capitis, anterior, middle and posterior scalenes

b. Trapezius, levator scapula, posterior, middle and anterior scalenes Rationale: The order is trapezius, levator scapula, posterior, middle and anterior scalenes.

Question 295: What is the best way to access the rhomboid muscles while your client is in the prone position? a. Both arms off the superior edge of the table b. With their hand in the small of his back c. With arm at a 90 degree angle off the table d. The arm is placed right next to their side

b. With their hand in the small of his back Rationale: The rhomboids major and minor originate on the spinous processes of C7-T5 and inserts on the medial border of the scapula. The best way to access them is to place your clients hand in the small of his back and palpate the fibers that run oblique or at an angle like a christmas tree off the spine deep to the trapezius. Have your client press their elbow up towards the ceiling resisting 30% of their strength, this will tighten the traps as well but you will feel the oblique fibers.

Question 270: The insertion of needles and the application of moxibustion is within which of the following occupation's scope of practice? a. Psychology b. Podiatric Medicine c. Acupuncture d. Athletic Training

c. Acupuncture Rationale: Acupuncture is a form of primary health care that is based on traditional Chinese medicine. It is used to promote, restore, and maintain health to prevent disease. Many adjunctive therapies are used to diagnose and treat including but not limited to the insertion of needles and applying moxibustion (herbs burned near the skin).

Question 272: A spasm is: a. A voluntary, prolonged muscle contraction b. A short muscle contraction c. An involuntary, sustained contraction of a muscle d. A painful, voluntary, quick muscle contraction

c. An involuntary, sustained contraction of a muscle Rationale: Spasm= an involuntary, sustained contraction of a muscle. A cramp is a common or lay term for painful, prolonged muscle spasm.

Question 243: Leaving a client's health history document lying on the counter during a massage is: a. Ok if you are not busy b. Permitted if you are in a hurry c. Breaching client confidentiality laws d. Not something to be worried about

c. Breaching client confidentiality laws Rationale: Keep your client's personal information in a secure place.

Question 274: To maintain clear and honest communication falls under what business code of ethics category? a. Scope of practice b. Advertising claims c. Client Relationships d. Appropriate techniques

c. Client Relationships Rationale: Keeping all communications clear, honest and confidential is part of Client Relationships.

Question 206: As a person inhales, the diaphragm will? a. Expand and create a negative pressure drawing air into the lungs b. Expand and create a positive pressure drawing air into the lungs c. Contract and create a negative pressure drawing air into the lungs d. Contract and create a positive pressure drawing air into the lungs

c. Contract and create a negative pressure drawing air into the lungs Rationale: Inhalation (inspiration) expands the chest laterally, elevating the rib cage and depressing/flattening the diaphram, stretching the lungs and enlarging the thoracic volume, this creates negative pressure to draw air into the lungs. Exhalation (expiration) depresses the chest, reducing the lateral dimension of the rib cage and elevating the diaphragm into a dome, relaxing the stretch on the lungs to decrease the volume and raise pressure to draw air out of the lungs.

Question 286: What two ligaments stabilize the AC joint? a. Anterior talofibular and anterior tibiofibular b. Anterior cruciate and anterior tibiofibular c. Coracoclavicular and acromioclavicular d. Coracoclavicular and anterior sternoclavicular

c. Coracoclavicular and acromioclavicular Rationale: AC= Acromioclavicular joint articulates between the acromion, scapula, and the acromial end of the clavicle. The anterior sternoclavicular ligament stabilizes the clavicle to the manubrium or sternum.

Question 232: Sebaceous glands are found in which layer of tissue? a. Subcutaneous b. Epidermis c. Dermis d. Pangaea

c. Dermis Rationale: The epidermis (epithelium) is the tough protective layer that is avascular (no blood supply or nerves). Strata layers, deep to superficial; stratum basale, spinosum, granulosum, lucidum, and corneum. The dermis is rich in blood vessels the dense connective tissue layers; upper papillary and deep reticular, also contains nerves.

Question 283: Hypertension is a circulatory pathology and is defined as a(n): a. Inability to pump sufficient blood to supply the needs of the body b. Peripheral vascular disorder that affects the blood vessels outside the heart and thorax occurring secondary to another underlying condition c. Elevation of blood pressure above the normal range for a prolonged time d. Inflammation of a superficial or deep vein

c. Elevation of blood pressure above the normal range for a prolonged time Rationale: Hypertension is an elevation of blood pressure above the normal range for a prolonged time that increases the risk of stroke or heart attack. Congestive heart failure (heart failure) is the heart's inability to pump sufficient blood to supply the needs of the body. Raynaud's Phenomenon is a peripheral vascular disorder that affects the blood vessels outside the heart and thorax, occurring secondary to another underlying condition. Thrombophlebitis is an inflammation of a superficial or deep vein that leads to the formation of a thrombus (fibrin-based clot).

Question 288: If a client is taking anti-inflammatories or blood thinners it is contraindicated to perform: a. Rhythmic techniques b. Trigger point therapy c. Friction techniques d. Effleurage

c. Friction techniques Rationale: Using aggressive friction techniques can cause pooling of blood and easy bruising.

Question 209: When using your thumb without reinforcements you must: a. Keep your wrist and forearm bent b. Use your other thumb as well c. Keep it in line with the radius d. Tense your wrist and forearm muscles

c. Keep it in line with the radius Rationale: The thumb has many advantages over your fingers. It has one less interphalangeal joint and it is larger making it more stable and stronger with a wide range of motion due to the carpometacarpals joint. Like all other tools, alignment is essential. It can be used without being reinforced but not for long. For long periods of pressure reinforce it with a soft open or closed fist or your other hand to protect and stabilize the joints.

Question 258: What would be the best action for your client to resist in finding the latissimus dorsi's lateral border, when the client is in prone position with the arm off the side of the table? a. Flexion b. ABduction c. Medial rotation d. Lateral rotation

c. Medial rotation Rationale: Grasp the latissimus dorsi's lateral tissue with your thumb and fingers of one hand at the lateral border of the scapula. Use the other to place on the palm side of the forearm for medial rotation resistance. You will be able to follow the latissimus dorsi superiorly to the armpit or axilla and inferiorly to the ribs. The fibers of both the latissimus dorsi and teres major are distinguishable during medial rotation, lats are lateral and teres major is medial they are complete synergist.

Question 205: Which plane divides the body into right and left halves? a. Frontal b. Sagittal c. Midsagittal d. Transverse

c. Midsagittal Rationale: Midsagittal or median can be viewed as a midline dividing the body into right and left halves. Sagittal is a vertical cut but not in equal halves. Transverse= horizontal, superior/inferior, and frontal or coronal is anterior/posterior.

Question 291: The muscle approximation technique uses the reflex effect of these cells to reduce tone or spasm in a muscle? a. Golgi tendon b. Mitochondria c. Muscle spindle d. Memory

c. Muscle spindle Rationale: Muscle approximation or bringing the ends of the muscle closer together, lessens the stretch on the muscle spindles reducing muscle tone and spasm.

Question 280: Most long nerve fibers are covered with a whitish, fatty material that is called: a. Nissel b. Dendrites c. Myelin d. Synapse

c. Myelin Rationale: Myelin has a waxy appearance that protects and insulates the fibers of the axon to increase the transmission rate of nerve impulses. Dendrites are part of the neuron that extend from the cell body to convey messages TOWARD the cell body.

Question 242: Osteoporosis is defined as a(n): a. Painful non-articular rheumatic condition of at least three months duration with tender points at 11 of 18 prescribed locations b. Condition distinguished by persistent fatigue c. Progressive disease where the bones gradually become weaker and thinner, increasing fracture risks d. Chronic condition resulting in problems with carbohydrates, protein, and fat

c. Progressive disease where the bones gradually become weaker and thinner, increasing fracture risks Rationale: Osteoporosis is a progressive disease where the bones gradually become weaker and thinner, increasing fracture risks. It also causes changes in posture .

Question 275: In acute conditions it is best to do all of the following except? a. Reduce pain and decrease sympathetic nervous system firing b. Treat any compensating structures and maintain local circulation c. Reduce or remove protective muscle spasms d. Reduce inflammation and edema

c. Reduce or remove protective muscle spasms Rationale: Reflex muscle guarding is due to a local tissue injury present in acute stages of a condition. The muscle spasm serves to functionally splint the injured structures, reducing movement, and preventing further injury. Removing could cause longer recovery time.

Question 276: For treatment of a repeat client it is best to: a. Check notes and repeat last treatment b. Assume treatment is working with out communicating with client c. Review the client's health history (HH)/SOAP's and request feedback on effects of the treatment d. Change treatment plan every time

c. Review the client's health history (HH)/SOAP's and request feedback on effects of the treatment Rationale: It is necessary that you ask about any changes that may have occurred in health status for proper treatment.

Question 279: What action can you have your client perform to distinguish between the posterior scalene and levator scapula? a. Rotate your head back and forth b. Take a deep breath c. Slowly bring your shoulder up toward your ear d. Slowly bring your ear down toward your shoulder

c. Slowly bring your shoulder up toward your ear Rationale: The best action for palpation is elevation of the scapula or bringing the shoulder up toward the ear. While this action is being performed, place your fingers just anterior to the levator scapula and feel the relaxed posterior scalenes.

Question 217: What three muscles work together to ABduct the hip? a. Gracilis, psoas major and iliacus b. ADductor magnus, sartorius and piriformis c. Tensor fasciae latae, sartorius and piriformis d. Rectus femoris, piriformis and psoas major

c. Tensor fasciae latae, sartorius and piriformis Rationale: The ABductors of the hip: Gluteus maximus (all), gluteus medius (all), gluteus minimus, tensor fasciae latae, sartorius and piriformis (flexed hip).

Question 244: Choose from the following groups of muscles the unilateral, same side lateral flexors of the cervical spine? a. Trapezius (middle), levator scapula and opponens pollicis b. Trapezius (lower), latissimus dorsi and sternocleidomastoid c. Trapezius (upper), levator scapula and sternocleidomastoid d. Trapezius (lower), levator scapula and sternocleidomastoid

c. Trapezius (upper), levator scapula and sternocleidomastoid Rationale: The muscles in charge of unilaterally same side lateral flexion of the cervical spine: Trapezius (upper), levator scapula, splenius capitis / cervicis, sternocleidomastoid, longus capitis / colli, scalenes (all with fixed ribs), (assistors) longissimus capitis / cervicis and iliocostalis cervicis.

Question 247: To assess the pectoralis minor as a possible thoracic outlet syndrome (TOS) cause, what test is performed? a. Travell's b. Adson's test c. Wright's HyperABduction d. Costoclavicular syndrome

c. Wright's HyperABduction Rationale: To assess the pectoralis minor muscle for the cause of thoracic outlet syndrome (TOS), use Wright's HyperABduction test. Start with the client in a seated position and while standing behind your client passively ABduct the client's affected arm fully to 180 degrees and then extend the arm slightly, monitoring the radial pulse of the arm. This passive action places your client in a stretch and torsion of the pectoralis minor as the brachial plexus and axillary artery pass through the muscle inferiorly. The test is positive if the radial pulse diminishes or the client's symptoms reoccur. Adson's= Anterior scalens, Travell's= Middle Scalene, Wright's HyperABduction= pectoralis minor and Costoclavicular syndrome= clavicle and first rib compression.

Question 223: What is the definition of contraindication? a. A fungal infecton caused by yeast b. A deep inflammatory condition affecting the superficial to subcutaneous skin c. A superficial proliferation of blood vessels or telangiectasis d. A symptom or circumstance that makes treatment inappropriate

d. A symptom or circumstance that makes treatment inappropriate Rationale: Contraindication (CI)= a symptom or circumstance that makes treatment inappropriate. Question 224: The diagnosis, treatment, prevention, cure, or relief of human disease, ailment, defect, complaint, or other physical or mental condition by attendance, advice, device, diagnostic test, or other means is under which occupation's scope of practice?

Question 257: Antalgic posture may develop 24/48 hours after Whiplash has occurred. A lateral view of the head and neck may show an anterior head-forward posture (the external auditory meatus is anterior on the plumb line). What test may massage therapists conduct in this acute stage? a. AR (active resisted) strength tests b. Vertebral artery test c. AR (active resisted) ROM (range of motion) d. AF (active free) ROM (range of motion)

d. AF (active free) ROM (range of motion) Rationale: If an F/C (Foreman and Croft Classification) Grade 2 or higher is suspected because of #1 a gap in the tissue, #2 protective muscle guarding, and #3 severe pain and reduced ROM with AF ROM, the client should seek an additional medical assessment from their doctor. If ROM is fine AF ROM, PR ROM and AR isometric testing can be done. However, the duration of the injury may be prolonged or aggravated if tests are done inappropriately. If ROM is a factor the AF ROM along the principal plane of motion and the swallowing test are the only tests indicated.

Question 239: After using slow ischemic compressions on your clients trigger points to relieve their tension headache, you may want to do the following for a more effective treatment? a. Heat the treated area b. Use slow passive stretching c. Have your client perform active free range of motion d. All of the above

d. All of the above Rationale: A tension headache is a muscle contraction or myofascial pain associated with trigger points. During a tension headache to avoid kick back pain, do not work to deep. Stay away from any vigorous techniques. Apply ischemic compressions slowly. After working on trigger points it is best to follow it up with heat, slow passive stretching and pain-free full active range of motion.

Question 282: To integrate your entire body within your manual manipulations utilizing all your tools, it is best to? a. Use a variety of movements b. Use the bodies weight c. Use proper alignment d. All of the above

d. All of the above Rationale: Using a variety of movements, the bodies weight, and proper alignment will help to develop a dynamic application of your mechanics, for successful use and longevity of your body's tools for manual therapy.

Question 273: The muscle that performs opposite actions of the prime mover is an: a. Synergist b. Agonist c. Aggressor d. Antagonist

d. Antagonist Rationale: Antagonist, a muscle that performs the opposite action of the prime mover and synergist muscles.

Question 299: Which of the following occupations is the study of athletic performance, injury prevention, and rehabilitation? a. Osteopathic Medicine b. Massage Therapy c. Physical Therapy d. Athletic Training

d. Athletic Training Rationale: Athletic training is defined as the study of athletic performance, injury prevention, and rehabilitation.

Question 262: What does the Eustachian tube do? a. Connects the uterus to uvula b. Connects the ovary to the uterus c. Connects the pancreas to bile duct d. Connects the middle ear with the nasal cavity

d. Connects the middle ear with the nasal cavity Rationale: The Eustachian tube (auditory tube) connects the middle ear (tympanic cavity) with the nasal or nasopharynx cavity serving as a pressure equalizer.

Question 228: Generally, any technique applied in a slow, rhythmical, and repetitive manner will evoke a relaxation response and ___________. a. Increase sympathetic nervous system firing b. Decrease parasympathetic nervous system firing c. Increase both the sympathetic and parasympathetic firing d. Decrease sympathetic nervous system firing

d. Decrease sympathetic nervous system firing Rationale: This is facilitated if the techniques are applied in a predictable pattern, at an even rate. Working superficial using light pressure or even using deeper pressure, if applied with a broad surface, such as a full palm or the ulnar boarder of the forearm, can achieve the soothing effect expected from a relaxation massage. Reducing the fight-or-flight response.

Question 297: Which of the following occupations is a discipline of diagnosis, prescription, treatment, and surgery for disease, pain, deformity, deficiency, injury of human teeth, gums, jaw, alveolar processes, and dependent tissue? a. Psychology b. Osteopathic Medicine c. Podiatric Medicine d. Dentistry

d. Dentistry Rationale: Dentistry is a discipline of diagnosis, prescription, treatment, and surgery for disease, pain, deformity, deficiency, injury of human teeth, gums, jaw, alveolar processes, and dependent tissue. Concern with preventative care and maintenance of good oral health is another part of being a dentist.

Question 256: What is the main portion or the shaft of the bone called? a. Compact bone b. Bone marrow c. Medullary cavity d. Diaphysis

d. Diaphysis Rationale: The Diaphysis is the main shaft or largest portion of the bone. It is composed of compact bone and contains (in adults) the yellow bone marrow. In infants it is the site for forming blood cells and red bone marrow.

Question 259: The ___________ is a strong plantarflexor and crosses both the knee and the ankle joints? a. Tibialis anterior b. Fibularis (peroneus) longus c. Soleus d. Gastrocnemius

d. Gastrocnemius Rationale: Gastrocnemius is in charge of flexing the knee and plantar flexion of the ankle. It originates on the posterior surfaces of the femur condyles, inserting on the calcaneus crossing two joints. Soleus does not cross both the knee and ankle joints.

Question 293: Which muscle from the ADductor group has its insertion on the pes anserinus tendon? a. ADductor magnus b. ADductor longus c. Pectineus d. Gracilis

d. Gracilis Rationale: The gracilis is the only muscle that crosses the knee in the ADductor group. It inserts on the medial/proximal shaft of the tibia on the pes anserinus tendon. It originates on the pubis inferior ramus as well as the ischium ramus.

Question 238: The best way to locate the intertubercular groove that houses the biceps brachii tendon, is to: a. Medially rotate the arm b. Flex the arm c. Extend the arm d. Laterally rotate the arm

d. Laterally rotate the arm Rationale: When placing the arm in lateral rotation have your client flex their elbow against slight resistance, you should feel the taut tendon. Make sure they don't flex the shoulder, the deltoid muscles will flex and not allow a proper palpation.

Question 250: Relative to its size, this muscle is the strongest muscle in the body, it can manage nearly one hundred-fifty pounds of pressure. a. Anterior Scalene b. Medial Pterygoid c. Teres Minor d. Masseter

d. Masseter Rationale: Masseter is the primary chewing muscle; Medial Pterygoid assists the Masseter.

Question 201: The P in the acronym SOAP stands for? a. Passive b. Palpate c. Project d. Plan

d. Plan Rationale: The practitioner's treatment plan, goals, and patient education information.

Question 225: Parkinson's is a central nervous system condition that is: a. A condition where demyelination of the nerves occurs b. An injury to the vertebral column, spinal cord, or both, due to a direct or indirect trauma c. Acute viral infection, specifically affecting the motor neurons in the spinal cord and brain stem d. Progressively diminishing basal ganglia function

d. Progressively diminishing basal ganglia function Rationale: Parkinson's is a Progressively diminishing basal ganglia function resulting in slow, increasingly difficult movement, accompanied by resting tremors and muscular rigidity. Multiple sclerosis (MS) is a condition where demyelination of the nerves occurs. Spinal cord injuries (SCI) are an injury to the vertebral column, spinal cord, or both, due to a direct or indirect trauma. Poliomyelitis is an acute viral infection specifically affecting the motor neurons in the spinal cord and brain stem. All conditions are CNS.

Question 203: What affect does Direct pressure or DP have on a cramp or spasm? a. Prolongs the pain b. Agitates the muscle and continues the cramp or spasm c. Depletes the pain on new injuries only d. Redirects the message to the brain and interrupts the pain cycle

d. Redirects the message to the brain and interrupts the pain cycle Rationale: The use of DP on any type of cramp or spasm that is not a result of an injury is useful, hold until pain dissipates. R/I is better to use if you are not sure of the severity of the injury. Send your client to a physician or medic tent for approval to work on them when injuries are involved.

Question 236: The ________ ______ divides the body into left and right portions. a. Transverse plane b. Mid-sagittal plane c. Frontal plane d. Sagittal plane

d. Sagittal plane Rationale: The descriptive terms medial and lateral are used on this plane along with flexion and extension as actions. Mid-sagittal would be left and right halves, down the mid-line. Sagittal is unequal left and right halves.

Question 233: Which two muscles ABduct the scapula? a. Serratus anterior and pectoralis major b. Trapezius (middle) and serratus anterior c. Pectoralis major and minor d. Serratus anterior and pectoralis minor

d. Serratus anterior and pectoralis minor Rationale: The two scapula ABductors: Serratus anterior and pectoralis minor.

Question 215: What is the Greek name of the sesame seed shaped bones in the body? a. Cuboid b. Tarsus c. Phalanx d. Sesamoid

d. Sesamoid Rationale: The Greek word sesamoid means shaped like a sesame seed. They are found throughout the body, embedded in tendons, providing protection for the tendon and an increase in mechanical effectiveness. Located in the knee (patella), hands, and feet.

Question 269: The two joints which create inversion and eversion are: a. Proximal radioulnar and distal radioulnar b. Metacarpophalangeal and Talocalcaneal c. Talocrural and talocalcaneal d. Talocalcaneal (subtalar) and talocalcaneonavicular

d. Talocalcaneal (subtalar) and talocalcaneonavicular Rationale: The talocalcaneal and talocalcaneonavicular joints are modified gliding joints, they function in unison to produce pronation (eversion) and supination (inversion) of the foot.

Question 237: Of the following choices, which is the best that defines professionalism? a. An occupation requiring training and specialized study b. A group of interacting elements that function as a complex whole c. One who engages in a profession d. The adherence to professional status, methods, standards, and character

d. The adherence to professional status, methods, standards, and character Rationale: Professionalism is the adherence to professional status, methods, standards, and character.

Question 251: Which of the two lower leg bones is the largest? a. Ulna b. Fibula c. Femur d. Tibia

d. Tibia Rationale: The tibia or shin bone is the largest out of the tibia and fibula.

Question 260: What is the correct order of muscle layers, from superficial to deep, between the thoracic vertebrae and the medial border of the scapula? a. Trapezius, ESGs, and rhomboids b. Rhomboids, trapezius, and ESGs c. Rhomboids, ESGs, and trapezius d. Trapezius, rhomboids, and ESGs

d. Trapezius, rhomboids, and ESGs Rationale: From superficial to deep, the muscles that run in between the thoracic vertebrae and medial border of the scapula are the trapezius, rhomboids, and ESGs (Erector Spinae Group). ESGs next to the spine and ribs, rhomboids are felt throughout the broad superficial trapezius.