NCBTMB Bodywork Application and Physiology 2 — Questions and Answers
Question 1: Which stroke is most appropriate to begin a Swedish massage session because it warms superficial tissues and accustoms the client to touch?
- Petrissage
- Effleurage (Correct answer)
- Tapotement
- Friction
Correct answer: Effleurage
Effleurage is a gliding stroke used to warm tissues, spread lubricant, and introduce the client to the therapist's touch at the start of a session.
Question 2: The physiological effect of slow, rhythmic massage on the parasympathetic nervous system is best described as:
- Increasing heart rate and alertness
- Stimulating the fight-or-flight response
- Promoting relaxation and reducing cortisol (Correct answer)
- Elevating blood pressure and muscle tone
Correct answer: Promoting relaxation and reducing cortisol
Slow, rhythmic massage activates the parasympathetic nervous system, promoting relaxation, reducing cortisol levels, and lowering heart rate.
Question 3: When applying deep transverse friction to a muscle belly, the primary therapeutic goal is to:
- Increase lymphatic drainage
- Break down adhesions and realign collagen fibers (Correct answer)
- Sedate sensory nerve endings
- Stretch the antagonist muscle
Correct answer: Break down adhesions and realign collagen fibers
Deep transverse friction mobilizes scar tissue and helps realign disorganized collagen fibers within muscles, tendons, or ligaments.
Question 4: Which layer of fascia surrounds individual muscle fibers and directly influences the sliding of actin and myosin?
- Epimysium
- Perimysium
- Endomysium (Correct answer)
- Deep fascia
Correct answer: Endomysium
The endomysium is the innermost connective tissue layer, surrounding individual muscle fibers and directly affecting intramuscular movement.
Question 5: A client reports tenderness at the medial epicondyle with pain during wrist flexion. Which condition does this pattern suggest?
- Lateral epicondylitis
- Carpal tunnel syndrome
- Medial epicondylitis (golfer's elbow) (Correct answer)
- De Quervain's tenosynovitis
Correct answer: Medial epicondylitis (golfer's elbow)
Medial epicondylitis involves inflammation of the wrist flexor tendons at their origin on the medial epicondyle, causing pain with wrist flexion.
Question 6: The Gate Control Theory of pain management explains how massage reduces pain perception by:
- Releasing endorphins from the pituitary gland
- Activating large-diameter sensory fibers that inhibit pain signals (Correct answer)
- Increasing substance P in the dorsal horn
- Stimulating sympathetic efferent neurons
Correct answer: Activating large-diameter sensory fibers that inhibit pain signals
Gate Control Theory proposes that stimulating large-diameter A-beta fibers through touch closes the 'gate' in the dorsal horn, reducing transmission of pain signals from smaller C and A-delta fibers.
Question 7: During a massage, a therapist notices the client's skin displays persistent erythema after stripping a muscle. This response indicates:
- Anemia at the surface capillaries
- A histamine-mediated allergic reaction to lubricant
- Local hyperemia from increased superficial blood flow (Correct answer)
- Lymphatic congestion requiring drainage techniques
Correct answer: Local hyperemia from increased superficial blood flow
Persistent erythema after massage strokes reflects local hyperemia — increased blood flow to the area — a normal physiological response to mechanical stimulation.
NCBTMB Bodywork Application and Physiology 2
Which stroke is most appropriate to begin a Swedish massage session because it warms superficial tissues and accustoms the client to touch?