Free NCBTMB Bodywork Application and Physiology Questions and Answers — Questions and Answers
Question 1: A client is experiencing a muscle cramp in their gastrocnemius. To help alleviate the cramp using the principle of reciprocal inhibition, which action should the therapist instruct the client to perform?
- Actively plantarflex the foot against resistance.
- Actively dorsiflex the foot against resistance. (Correct answer)
- Passively stretch the gastrocnemius by dorsiflexing the foot.
- Apply sustained ischemic compression to the muscle belly.
Correct answer: Actively dorsiflex the foot against resistance.
Reciprocal inhibition is a neuromuscular reflex where the contraction of an agonist muscle causes the antagonist muscle to relax. In this case, the gastrocnemius (agonist) is cramping. To inhibit it, the client should actively contract the antagonist muscle, which is the tibialis anterior. The primary action of the tibialis anterior is dorsiflexion. Therefore, having the client actively dorsiflex their foot will help relax and release the cramp in the gastrocnemius.
Question 2: Which of the following physiological responses is primarily associated with the stimulation of the parasympathetic nervous system during a massage session?
- Increased heart rate and alertness.
- Decreased digestive activity.
- Increased cortisol production.
- Lowered blood pressure and heart rate. (Correct answer)
Correct answer: Lowered blood pressure and heart rate.
Massage therapy helps shift the autonomic nervous system from a sympathetic (fight-or-flight) state to a parasympathetic (rest-and-digest) state. The parasympathetic response is characterized by a decrease in heart rate, lowered blood pressure, and increased digestive activity, promoting overall relaxation and recovery.
Question 3: A massage therapist applies slow, sustained, deep pressure to a client's fascia, noticing that the tissue gradually feels more pliable and less dense under their hands. This phenomenon, where connective tissue's ground substance becomes more fluid with the application of mechanical force, is known as:
- Piezoelectricity
- Thixotropy (Correct answer)
- Reciprocal Inhibition
- Stretch Reflex
Correct answer: Thixotropy
Thixotropy is the property of some gels and fluids to become less viscous or more fluid when agitated or stressed, and to return to a more solid state when left undisturbed. In bodywork, this concept is applied to the ground substance of fascia, which is believed to transition from a more viscous 'gel' state to a more fluid 'sol' state in response to the mechanical energy (pressure and warmth) of massage, leading to a palpable 'release' or softening of the tissue.
Question 4: A client reports pain that refers from a hyperirritable spot within a taut band of skeletal muscle to a different, predictable location when compressed. Which physiological entity is being described?
- Golgi tendon organ
- Myofascial trigger point (Correct answer)
- Muscle spindle
- Ruffini corpuscle
Correct answer: Myofascial trigger point
A myofascial trigger point is defined as a hyperirritable spot within a taut band of skeletal muscle. A key characteristic of a trigger point is that direct compression elicits not only local tenderness but also characteristic referred pain, motor dysfunction, and sometimes autonomic phenomena.
Question 5: During a massage, applying deep, sustained pressure at the musculotendinous junction is intended to stimulate which proprioceptor, leading to a reflex relaxation of the associated muscle?
- Muscle Spindle
- Pacinian Corpuscle
- Golgi Tendon Organ (Correct answer)
- Free Nerve Ending
Correct answer: Golgi Tendon Organ
The Golgi Tendon Organ (GTO) is a proprioceptor located at the junction where muscle fibers connect to tendon fibers. It is sensitive to changes in muscle tension. When a muscle contracts with significant force, or when deep pressure is applied, the GTO is stimulated and sends a signal that inhibits the muscle's contraction, causing it to relax. This is a protective mechanism known as autogenic inhibition.
Question 6: The carpometacarpal joint of the thumb is a classic example of which type of synovial joint, allowing for flexion, extension, abduction, adduction, and opposition?
- Hinge
- Ball and Socket
- Pivot
- Saddle (Correct answer)
Correct answer: Saddle
The carpometacarpal joint of the thumb is a saddle joint. In this type of joint, both articulating surfaces have a concave shape in one direction and a convex shape in the other, similar to a rider in a saddle. This biaxial structure allows for a wide range of motion, including flexion/extension, abduction/adduction, and circumduction, which enables the unique movement of opposition.
Free NCBTMB Bodywork Application and Physiology Questions and Answers
A client is experiencing a muscle cramp in their gastrocnemius.
To help alleviate the cramp using the principle of reciprocal inhibition, which action should the therapist instruct the client to perform?