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1 All muscles come in pairs, the agonist and the ________________.
Incorrect. Please choose another answer.
Antagonist is the correct answer. The antagonist works to counter the torque of the agonist, often used in slowing down a motion. Occurring in pairs, the agonist and the antagonist often balance each other, one contracts and the other relaxes. 

Abductor is a movement away from the midline. Bipennate is a type of muscle fiber, where two rows of opposite diagonal fibers come together at a single tendon creating more strength but less shortening. Sarcomere is the smallest and most basic building block of a muscle fiber.

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2 The long shaft of a bone is called ____________________.
Incorrect. Please choose another answer.
Diaphysis is the correct answer.

Epiphysis is the end of a long bone. Endosteum is the thin layer of connective tissue which makes up the medullary cavity. Periosteum is a sheath of connective tissue enveloping the bone except at articulation.
3 Where bones meet to form a joint:
Incorrect. Please choose another answer.
Articulation is the correct answer. It is where two bones meet to form a joint.

A ligament is connective tissue that attaches bone to bone. Enthesis is connective tissue between a ligament and bone or between a bone and a tendon. Bursa is the fluid filled sac found between bones at the joint to counter friction.
4 A massage therapist presses and rolls muscles under her hands. What massage stroke is this?
Incorrect. Please choose another answer.
Petrissage is the correct answer, and is defined by massage techniques performed with the pads of the hands including kneading, rolling and wringing in an effort to reach deeper layers of muscles.

Tapotement, a rhythmic patting or striking percussion, is typically applied with the edge of the hand, loose fists or hands in a relaxed cupped position. Vibration can be manually applied with the hands, forearms, elbows or an electronic massage device as a rigorous shake or a rocking of specific muscles or body segments. Friction, created by quickly rubbing the hands together while against the skin, can be used to create heat in order to help soften superficial layers of muscles.

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5 When standing still in front of a closed door and pushing on it without it moving, the muscle action/tension is called:
Incorrect. Please choose another answer.
In isometric exercise and contraction, the muscle length does not change, but the tension does. In an isotonic exercise, the muscle length changes, but the tension does not. A concentric contraction is the shortening of the muscle fiber, where an eccentric contraction is the lengthening of a muscle fiber.
6 Myofascial Pain Syndrome is associated with which of the following.
Incorrect. Please choose another answer.
Muscle tenderness arising from trigger points is the correct answer. It can be caused by overuse, injury or other stimulus which creates trigger points and referred pain.

While pain can happen in facial muscles, MPS does not refer to the face in any way. Bone spurs can be painful as they are extra bony growths on the edges of bones. Reflux disease or GERD can present as a burning sensation in the chest usually after eating or while lying down or inverting.
7 The ability to guide the session, act as the authority and maintain healthy boundaries and a therapeutic relationship is called what?
Incorrect. Please choose another answer.
The power differential in massage arises out of the authority a client grants to the massage therapist and the client's perception of the massage therapist as skilled in their profession. Professionalism is not the best answer in this question. Transference relates to when a client displaces feelings for another person on the therapist. Countertransference is when the displacement of feelings for another goes from the therapist to the client.

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8 The bones of the arms, legs, pelvis and shoulders make up the appendicular skeleton.
Incorrect. Please choose another answer.
True. The spine, ribs and skull create the axial skeleton.
9 During an assessment, a massage therapist asks a client to stand facing the right. What is the therapist assessing?
Incorrect. Please choose another answer.
The therapist is assessing the curvature of the spine, which may include forward head carriage and posture, to understand which muscles are working overtime and which are not working enough. The therapist will also look for any imbalances in the left and right sides and to get an idea of the direction of the spinal curvature, especially if the client may have scoliosis. These observations may lead to a better understanding of the cause of any pain in particular muscles groups and much more. These observations may even give insight into how the client's lifestyle is affecting the shape of the body and help provide an intentional and therapeutic massage.
10 When a bone turns on its own central axis making a circular movement, it is called ________________.
Incorrect. Please choose another answer.
Rotation is the correct answer.

Circumduction is a combination of abduction and adduction as well as flexion and extension, a conical movement usually originating at a ball and socket joint. Gliding is a planar joint (where two bones meet at a majorly flat articular surface) allowing bones to move along the joint's plane in any direction. Angular movements are defined by the fixed point from which they move, like a pendulum.
 

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11 In the acronym used to notate interactions with clients, S.O.A.P., what does the O represent?
Incorrect. Please choose another answer.
The "O" in S.O.A.P. notes stands for the massage therapist's observation of how the client presents him or herself. Answer option A would fall under A for assessment in the S.O.A.P. notes. Answer option b describes what is "subjective", the S in S.O.A.P. Answer option D is part of the subjective component given by the client.
12 How does massage affect the Immune system?
Incorrect. Please choose another answer.
Massage beneficially affects the immune system by improving lymphatic flow and the production of CD4 T cells, which help trigger the body's response to infection. A decrease in the production of lymphocytes does not happen. Rather, massage increases the transport of lymphocytes to increase excretion of bodily fluid waste. The decrease of leukocyte production is actually an effect of cortisol being released into the system. Finally, answer option d is incorrect. If anything, lying still during a relaxing (blood pressure lowering) massage decreases body temperature.
13 All of the following are types of massage except _________________________.
Incorrect. Please choose another answer.
Kinesis is not a type of massage. Rather it refers to non-directional stimulus motivated movement or activity, usually in conjunction with another word part (i.e. photokinesis).

Swedish massage employs long gliding strokes toward the heart to help circulation and to bring overall relaxation to the body. Deep tissue massage is similar to Swedish massage but focuses on the deeper layers of muscle and fascia helping relieve chronic tensions, pains and contractions. Trigger point focuses on points in sensitive taut muscle bands that are painful and may even refer pain by using isolated pressure to help melt and release the tension and introduce fresh blood flow and oxygen.

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14 What is the meaning of the Greek root "derm"?
Incorrect. Please choose another answer.
Skin is the correct answer.

Ligament translates from Latin, “to bind, tie.” Bone comes from old English, bon. Muscle is a Middle French/Latin derivative translating to “muscle, sinew”/“little mouse”.
15 A client comes in with a sprain which occurred "3 or 4 days ago". How do you treat the area?
Incorrect. Please choose another answer.
Massaging proximal to the sprain will encourage more efficient healing and any residual swelling to be handled by the lymphatic system. Answer option A is incorrect, as it is fine to massage the limb. Answer option D would likely irritate or re-inflame the injury and B may encourage swelling below and around the injury.
16 What plane divides the body into front and back regions?
Incorrect. Please choose another answer.
Frontal is the correct answer.

Transverse refers to the plane dividing the upper trunk from the lower body horizontally. Lateral plane or sagittal plane divides the body into left and right sides vertically. Midsagittal plane is just like the lateral or sagittal, only it specifies the direct center of the body as the division line.

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17 Smooth muscle is also known as ___________________.
Incorrect. Please choose another answer.
Visceral muscle is the correct answer; it is smooth muscle associated with the organs, especially those in the abdominal cavity.

Skeletal muscle is a form of striated muscle. Cardiac muscle is only found in the heart and is its own classification. Striated muscle is composed of sarcomeres which form contractile fibrils and then run parallel to one another in small groupings creating muscle marked in dark and light bands. It includes skeletal, cardiac muscle and most of our other muscles.
18 A massage therapist reminds a client of a former high school teacher who was stern with his students, thus making it difficult for the client to relax. What is occurring in this situation?
Incorrect. Please choose another answer.
This is a situation of transference, where a client displaces feelings he or she has from someone from their past onto the therapist. A dual relationship describes a scenario where the massage therapist and that client have a relationship outside the context of the therapeutic relationship which may mar or confuse the professional boundaries. Countertransference is the opposite of transference, where the massage therapist transfers feelings from their past to the client.
19 The main purpose of draping is ______.
Incorrect. Please choose another answer.
A massage therapist's drape serves the purpose of maintaining professional boundaries to help the client feel comfortable and safe. While draping may serve to keep the client warm, this is not its primary purpose. Draping's main purpose is not to help protect the therapist.

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20 Skeletal muscles normally work __________________.
Incorrect. Please choose another answer.
Muscles have to work in at least pairs as antagonists, because they pull bone without pushing them. So, one muscle works to flex and the other to extend.

Isometrically is one version of how we can use our muscles. This just means that we can use more or less pressure but the distance will stay the same. An example is pushing on a locked door. While we have some muscles that move automatically, like our heart that moves without intention, our skeletal muscles are not among them generally.
21 All of the following guidelines should be applied to uphold a good standing professional massage and bodywork practice, except:
Incorrect. Please choose another answer.
Showing your sense of humor is an important part of a healthy practice, as it helps humanize your practice.
22 Skeletal muscle is attached to bone by __________________.
Incorrect. Please choose another answer.
A tendon connects a muscle to a bone.  It is typically a flexible but inelastic cord of strong collagen fiber tissue.

Ligaments connect bone to bone. Epidermis refers to the skin. Joints are the articulating parts of our body like the elbows and the knees.

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23 While assessing a client, a massage therapist asks that they move their arm against a light applied resistance. What is this called?
Incorrect. Please choose another answer.
In a manual resistance ROM assessment, a massage therapist applies light resistance to a client's movement. Passive ROM describes when the therapist moves the client's arm for them. In active ROM, the client moves her arm with no assistance from the therapist. Finally, during, active assisted ROM, the therapist helps the client move their arm through their full ROM.
24 Which of the following are voluntary muscles ________________.
Incorrect. Please choose another answer.
Skeletal muscle is the correct answer, as voluntary refers to muscles that are generally under control of the individual's will.

Cardiac muscle is what makes up the heart and is an involuntary muscle. Visceral describes the muscle type making up the intestines and most of the organs. Spindle fibers are actually proprioceptors in the bellies of the muscles.
25 If a massage therapist writes, "hyperkyphosis of the thoracic spine" in his SOAP notes, what is he referring to?
Incorrect. Please choose another answer.
Hyperkyphosis is present when the thoracic spine has an excessive forward curve. A person with hyperkyphosis will have rounded shoulders with the head and neck forward of the trunk. Answer option A describes lordosis. Flat back means the back has little to no natural curve of the spine and scoliosis creates more of a lateral 'S' shape of the spine.

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26 Which of the following is not a type of oriental massage therapy?
Incorrect. Please choose another answer.
Tai Chi Chuan refers to a type of Chinese martial art.

Jin Shin Do is a type of therapeutic acupressure. Shiatsu is a Japanese style of bodywork using finger pressure on specific points and lines of the body in order to restore energy flow. Anma is a type of Chinese massage, and is where Shiatsu came from.
27 All of the following are bone density and connective tissue disorders which require a doctor's approval to proceed with massage, except this disorder for which clearance cannot be given while the disorder is still present:
Incorrect. Please choose another answer.
Osteomyelitis is an infection of the bone tissues and marrow caused by staph or strep resulting from a compromised bone from injury or surgery. Massage is contraindicated and a doctor's clearance cannot be given for massage while the infection is still present. For the other answer options, a doctor's clearance for massage is required. However, deep or high-pressure massage would be contraindicated even with a doctor's clearance. Osteogenesis Imperfecta is a defective development of connective tissue where the bones become fragile. Osteopenia is lowered bone density and often the precursor to Osteoporosis, which is a loss of bone tissue causing fragile or porous bones.
28 The hypodermis is directly below what layer of skin?
Incorrect. Please choose another answer.
Dermis is the correct answer. The order from superficial to deep goes stratum corneum (mostly dead, non-nucleated skin), epidermis, dermis, hypodermis, and stratum germinativum (the 5th layer and the basal layer).

 

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29 All of the following are serious contraindications for massage except:
Incorrect. Please choose another answer.
Borborygmus is the sound of a rumbling tummy, so is not contraindicated for massage. Answer option A is incorrect because a massage therapist does not want to spread, exacerbate or contract the disease, even if it is the common cold. Massaging frostbitten areas can cause more or worsened tissue damage. Also, a therapist does not want to create more inflammation and/or pain by massage areas with acute flare ups of rheumatoid arthritis.
30 Where is the liver located?
Incorrect. Please choose another answer.
Upper right abdomen. The lower right abdomen holds the ascending colon and small intestines. The lower left abdomen is the location of the large and small intestines. The upper left abdomen carries the gallbladder, pancreas and many other small but important parts.
31 Which of the following is NOT an effect of massage on the nervous system?
Incorrect. Please choose another answer.
Massage actually increases or heightens proprioceptive response. The other answer options are benefits of massage.

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32 With an arm pinned to the side of the body at a 90 degree angle and the palm facing up, what is the movement of the forearm that rotates the palm to face downward?
Incorrect. Please choose another answer.
Pronation is the correct answer. Abduction would occur if she lifted her arm straight up. Supination would be returning the hand where it was, palm facing upward.
33 Which of the following techniques should be avoided when massaging appendages presenting with signs of overuse such as varicose veins, swelling or other warnings of poor circulation?
Incorrect. Please choose another answer.
Using deep effleurage proximal to distal or medial to lateral could create excess pressure on the veins and prove troublesome if there are varicose veins or any sort of swelling or circulatory issues. On the other hand, deep effleurage distal to proximal, later to medial will encouraging ease on the veins and healthy blood circulation. Petrissage helps oxygenate and move blood toward larger veins. By using strokes in the direction of venous return, the therapist eases blood toward the heart and ultimately creates easier oxygenation for the whole body.
34 What plane divides the body into upper and lower regions?
Incorrect. Please choose another answer.
Transverse (horizontal) is the correct answer.  The lateral (sagittal) plane divides the body into two sides vertically. The frontal (coronal) plane divides the body into a front and back halves. The midsagittal (median) plane is a vertical division along the midline, with two equal sides.

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35 In the event that the initial intake process reveals a pathology or injury that a massage therapist is not trained to work with (pregnancy, COPD, TBI, severe autism), what is the appropriate way to proceed?
Incorrect. Please choose another answer.
The best way to move forward is to refer the client to an LMT with the appropriate training and education. It is unethical to use the client to practice techniques the therapist is not qualified to perform. A client cannot consent for a massage therapist to perform techniques for which they are not qualified. The massage therapist should make a referral, if possible.
36 What connective tissue ensheaths the entire muscle?
Incorrect. Please choose another answer.
Epimysium is the correct answer, literally meaning on or above the muscle. It creates a fibrous envelope which surrounds each skeletal muscle, protecting them from friction.

Endomysium literally means within the muscle; it ensheaths each myocyte, capillary and nerve. Fascia surrounds, stabilizes and separates muscles and organs. Muscle fiber is a building block of the muscle, often cylindrical containing more than one nucleus and made of many myofibrils which respond to stimulation by contracting.
37 If a client and a massage therapist desire to engage in an intimate sexual relationship, what is the common waiting period after the termination of the therapist/client relationship?
Incorrect. Please choose another answer.
According to American Massage Therapy Association and Tappan's Handbook of Massage Therapy, a 6 month wait period is common across the country after the termination of the therapist/client relationship.

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38 Which of the following is positively affected by regular massage?
Incorrect. Please choose another answer.
Massage offers all of the benefits listed in the answer options.
39 Blood vessels, hair follicles, nerve receptors and skin glands are located in the ______________________.
Incorrect. Please choose another answer.
The dermis is between the epidermis and the subcutaneous layers of skin, consisting of irregular dense connective tissue to cushion the body but also nerve receptors, hair follicles, sweat glands and the like.

The epidermis is the most superficial layer of the skin. The subcutis layer is the deepest layer of our integumentary system, consisting mostly of fatty cells. The stratum corneum is the outermost layer of skin and is made up majorly of dead and flattened cells.
40 The axial skeleton contains the skull, vertebral column and rib cage.
Incorrect. Please choose another answer.
True. The bones of the head and trunk make up the axial skeleton.

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41 When a part of the body is toward the side, away from the midline, it is referred to as _____________________.
Incorrect. Please choose another answer.
Lateral is the correct answer. The further from the midline toward the side body, the more lateral.

Rostral is toward the front of the body, in particular toward the nose and mouth. Caudal refers to a body part which is both inferior and posterior, or toward the tail. Dorsal refers to the back body.
42 Which of the following are not accepted goals of massage?
Incorrect. Please choose another answer.
Medical treatment is not within a massage therapists scope of practice.  The other answers are goals of massage.

 
43 The ends of a long bone are called ___________________.
Incorrect. Please choose another answer.
Epiphysis is the correct answer. Usually growing separate from the shaft at the start, the epiphysis makes up the ends of the long bones.

Endosteum is the thin layer of connective tissue which makes up the medullary cavity. Diaphysis is the shaft of the long bone. Periosteum is a sheath of connective tissue enveloping the bone except at articulation.

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44 A client's SOAP notes state that the client presented with pediculosis in their last visit.  What condition did they have?
Incorrect. Please choose another answer.
Lice is the correct answer. 

Bad breath would be called halitosis. Athlete's foot is otherwise called tinea pedis.
45 What bones are found in locations where a tendon passes over a joint, such as the hand, knee, and foot?
Incorrect. Please choose another answer.
Sesamoid is the correct answer. These bones develop inside the tendon are typically at the joint's surface and are generally thought to serve as pressure and friction modifiers.

Short bones are typically as wide as they are long, usually providing little movement but lots of stability. Flat bones are generally flat and broad providing protection and more space for muscle attachment as in the skull and pelvis. Irregular bones are the bones whose shape serve a very specific purpose, so cannot be grouped in the aforementioned long, short, flat or sesamoid. Examples would include the lower jaw bone (mandible) and the sacrum.
46 A client presents with diagnosed Carpal Tunnel Syndrome. Should this be addressed by a massage therapist? If so, how?
Incorrect. Please choose another answer.
Massage can help restore full ROM as well as alleviate increased stress on the wrist. The massage therapist should encourage the client to take breaks from heavy wrist work to avoid overuse flare ups. Answer option A is incorrect, as it may irritate the already inflamed ligaments. Answer option B is incorrect. While surgery is an option, it is far from the only option. Finally, there is no reason to avoid the arm, though NSAIDS may help alleviate pain temporarily.

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47 The movement of the sole towards the median plane.
Incorrect. Please choose another answer.
Inversion is the correct answer, as the sole would have to reverse its normal position to move toward the midline.

Angular movement is any movement which changes the angle of the bones at the joint. Rotation is a pivotal movement, a revolving around a single axis. Abduction is a movement away from the midline.
48 A client has been diagnosed with cataplexy.  What condition do they have?
Incorrect. Please choose another answer.
Temporary muscle weakness is the correct answer. It is usually a weakness triggered by the sudden expression of emotion like laughter.

Brittle bones may be just that, osteogenesis imperfecta, or could refer to osteoporosis or osteopenia. Momentary fits of rage may be due to depression, intermittent explosive disorder or just uncontrolled anger. Sleepwalking can be called somnambulism and describes activity or walking during sleep.
49 One of the main focuses of Oriental massage therapy is restoring a proper flow and balance to the energy in the body.
Incorrect. Please choose another answer.
This statement is true. Restoring the proper balance and flow to the energy of the body is one of the main focuses of Oriental massage therapy.

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50 If a client says something during a session that a therapist thinks is a sexual pass, what should the therapist do?
Incorrect. Please choose another answer.
It is best to pause the session and remind the client of professional boundaries and find clarity surrounding the purpose of the session. Make sure the client is on the same page before proceeding. Immediately terminating the session may be required depending on the situation, but is not necessarily the suggested first response. The massage therapist should not respond vaguely and hope it does not happen again or ignore it.