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122 Cards in this Set
- Front
- Back
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What is true of acute inflammation? A. It lasts 3-4 days B. Muscle spasm accompanies acute inflammation. C. A and B D. None of the above are true.
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C. |
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With Chronic inflammation: A. There is a risk of excessive scarring B. There is scarring but ROM is generally at full range C. There is rarely any weakness. D. It is rarely painful. |
A. |
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Scars are characterized by the loss of mobility in the tissue they are affecting. T or F? |
T. |
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Radiculopathy: A. Is also known as radicular pain. B. Directly involves the nerve root. C. Is felt along myotomes, dermatomes, and sclerotomes. D. All of the above. |
D. |
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A myotome is: A. An area of skin innervated by a single nerve root B. A group of muscles innervated by a peripheral nerve. C. A group of muscles innervated by a single nerve root. D. An area of bone innvervated by a single nerve root. |
C. |
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Trigger point pain rarely follows the distribution of peripheral nerves or dermatomes. T or F? |
T. |
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Visceral pain refers to pain felt over an area of skin or viscera. T or F? |
F. |
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Flexion is best described as... |
Decreasing a joint angle. |
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Which is true of normal end feels? |
- Bony end feel occurs during elbow extension. - Soft tissue approximation occurs during knee flexion. |
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Contractile tissue is best described by... |
It is tissue such as muscles or tendons that can have tension placed on them by stretching or contraction. |
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Contractile tissue is involved in strains and tendonitis. T or F? |
T. |
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All of the following are examples of AROM except: A. Active resisted. B. Active free. C. Active assisted. D. Active relaxed.
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D. |
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Goniometry is performed during AROM and PROM. T or F? |
T. |
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Overpresure is applied during AROM and tests end feel. T or F? |
F. |
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What is not true concerning ROM? A. PR and PF are two types of PROM. B. During PROM the therapist palpates and supports the limb throughout the range. C. An example of AR is ROM done in a pool D. Differences in ROM may be caused by a neurological deficit. |
C. |
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Empty end feel is when the patient stops range of motion due to pain. T or F? |
T. |
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Respiratory conditions are a cause of positional factors. T or F? |
T. |
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Goniometry is used to document baseline and show progress or lack of progress at reassessment. T or F? |
T. |
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Reliability in goniometry can be increased by having the same examiner measure patients. T or F? |
T. |
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Chronic pain syndrome differs from chronic pain in that depression usually accompanies the syndrome. T or F? |
T. |
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Which is true of Edema: A. Solid edema results from localized extracellular fluid in a limb. B. It can only be measured if it is pitting. C. Visual assessment is the only true measure of edema volume. D. None of the above are true. |
D. |
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Conducting a client examination for the use of massage techniques requires which of the following: A. Identification of soft tissue dysfunction related to the clients clinical condition B. Identification of other primary and secondary impairments that therapists can treat with massage techniques. C. Identification of the limitations in the clients level of activity. D. All of the above. |
D. |
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Issues that arise during the subjective examination that may prompt further expiration of a soft tissue lesion include all of the following except: A. Respots of any long standing musculoskeletal condition. B. A history of having a relief of symptoms through massage or stretching. C. A history of multiple successful treatments. D. A history of ambiguous symptoms. |
C. |
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Which of the following is false regarding palpation?: A. Objects of palpation are not necessarily physical objects; instead, they may be a characteristic, such as temperature, or a phenomenon, such as a resistance to movement. B. Palpation is the sole means of accurately assessing soft tissue dysfunction. C. Therapits must constantly ask themselves questions as they palpate. D. Both of the therapist's hands may do the same thing or different things during palpation. |
B. |
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A therapist's application of palpation can vary in terms of all of the following except one: - Force - Rate - Tension - Pressure |
Tension. |
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Therapists can use palpation to assess all of the following structures except: A. Fluid status. B. Texture and consistency. C. Deep fascia. D. Periosteum. |
D. |
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Describe a restrictive or pathological tissue barrier.
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The resistance that therapists feel at the the end of passive ROM when they are taking the "slack" out of or "engaging" the tissue. |
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Which of the following statements is false regarding the barrier-release phenomenon? A. If therapists sustain the pressure on the tissue barrier, a "release may occur after a latency period. B. Different types of tissue will respond in the same manner to sustained pressure. C. Therapits can observe the barrier-release phenomenon during their application of horizontal drag, vertical compression, or shear forces. D. The barrier-release phenomenon is most useful when palpating connective tissue. |
D. |
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Which of the following statements is false regarding palpation? A. Therapists can identify bone, joint space (joint line), ligament, tendon (including junctions to boh periosteum and to muscle), aponeurosis, fascia (septa, sheathes, retinacula), nerves, vessels, and viscera during palpation. B. Therapists must select a consistent pressure that they will use for palpating the client's body structures. C. Therapists must be able to discriminate between tissue types and to distinguish a structure from its surrounding structures with accuracy. D. Therapists need to use compressive contact when they palpate anatomical structures. |
B. |
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Which of the following statements is false regarding pain in response to palpation? A. Therapists can quantify pain in response to palpation. B. Various types of pain responses differ in their significance and reliability. C. Tenderness to deep palpation is a reliable finding. D. Palpation itself can sometimes produce negative or positive changes in the tissues being palpated. |
C. |
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Research capacity is... |
The ability to find and critically evaluate research evidence. |
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Based on Sackett's hierarchy of evidence, the kind of study that gives the strongest evidence of cause and effect is... |
Randomized controlled trial. |
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information on clinical care that researchers and therapists collect in a systematic manner is called... |
Evidence. |
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Name three uses of evidence. |
- Therapists need evidence in order to provide the best possible care to their clients. - fosters pblic acceptance of massage and other complimentary health care techniques - enables therapists to stay curren, to be lifelong learners, and to be better consumers of health are resources themselves |
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Complete Sackett et. al.'s definition of evidence-based-medicine (EBM): "...the integration of..." |
Best research evidence with clinical expertise and client values. |
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Which of the following statements is true about sources of evidence? A. Information on the internet is a primary source. B. The researchers documentation of his or her work is a primary source. C. Primary sources do not always provide a more accurate representation of the evidence than secondary sources. D. Literature reviews and meta-analyses are primary sources.
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B. |
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Qualitative and quantitative research differ on 5 basic assumptions. Which of the following is not one of these assumptions? A. Nature of reality. B. Relationship between clinician and the subject. C. Nature of truth. D. Relationship between fact, values, and research. |
B. |
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How are the Evidence Hierarchy and the Evidence House different? |
The Evidence Hierarchy is hierarchical, and the Evidence House is not. |
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Which of the following activities will facilitate evidence-based-practice? A. Join your professional association B. Subscribe to your local newspaper. C. Give your clients longer treatment sessions. D. All of the above. |
A. |
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Which of the following is not one of the causes of poor evidence for massage techniques? A. Homogenous samples. B. Weak research methods. C. Poorly designed procedures for interventions. D. Lack of relevant outcome measures. |
A. |
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What technique engages tissues down to the investing layer of deep fascia, using centripetal pressure for each stroke? |
Superficial fluid. |
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Which technique is commonly used as a transitional stroke between deeper strokes? |
Superficial effleurage. |
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Which of the following massage techniques increases the circulation of lymph: a. superficial effleurage b. static contact c. superficial stroking d. fine vibration |
A. |
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What is the name of the massage system developed by Emil Vodder that affects circulation of lymph? |
Manual lymph drainage. |
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How does superficial lymph drainage differ from superficial effleurage? |
Uses a non-gliding contact. |
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The force of superficial fluid techniques is directed towards which tissue layer? |
Investing layer of the deep fascia. |
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The preferred lubricant for superficial lymph drainage technique is: |
Powder. |
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Which connective tissue technique is sometimes classified as a form of petrissage? |
Skin rolling |
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When using friction, you should obtain feedback from the client, or retest key signs at least every: |
2 minutes. |
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A technique that can produce a viscoelastic stretch of tissue when it is applied correctly is: |
Direct fascial technque. |
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Which of the following is an extracellular component of connective tissue: a. collagen b. fibrocyte c. chondrocyte d. mitochondria |
A. |
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When performing friction on a superficial structure, the tissues must be... |
Stretched. |
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After applying the first interval of friction to a soft tissue lesion, you may increase the pressure and continue to perform friction, as long as the client reports that the target tissue feels.... |
Less tender. |
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Direct fascial techniques are contraindicated when: |
A joint is unstable. |
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Friction is appropriate on the site of a traumatic injury when the stage of inflammation is: |
Subacute. |
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"A gliding stroke in which tissue superficial to the investing layer of deep fascia is grasped, continuously lifted, and rolled over underlying tissues in a wave-like motion." This statement describes what technique? |
Skin rolling. |
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When some of the length that is gained during a stretch remais after the tensile force is released, the stretch is called: |
Viscoelastic. |
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Which physician advocated cross-fiber friction to treat various orthopaedic injuries? |
James Cyriax. |
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"Gradual, palpable, viscoelastic lengthening of connective tissue that occurs with sustained tensile force" defines what technique? |
Creep. |
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"A repetitive, specific, non gliding technique that produces movement between the fibbers of dense connective tissue, increasing tissue extensibility and promoting ordered alignment of collagen within the tissues." defines what technique? |
Friction. |
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The best way to permanently lengthen connective tissue structures without compromising their structural integrity is to apply: |
Prolonged, low-intensity forces. |
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Which of the following is not a component of the ICF model: a. body structures and function b. activity c. disability d. participation |
A. |
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In the ICF and disablement models, the process that occurs at the level of the organ or system is: |
Impairment. |
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Carpal tunnel syndrome involves inflammation of the flexor retinaculum, with pressure on the median nerve and loss of conduction. This is a description of: |
Pathiophysiology. |
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The therapist's choice of techniques is an example of: |
The process of care. |
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In the ICF model, inability to carry out a normal employment role as a date entry operator is an example of: |
Participation limitation. |
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In an intervention for treatment of impairments, the therapists primary goals are: |
- Treatment of impairments - Recovery - Prevention of secondary impairments
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What are the 3 steps that therapists use to determine potential treatment outcomes for a client? |
- Determine whether she is treating the client's impairments or providing a wellness intervention - Understand potential therapeutic effects of massage and the evidence for those effects - Identify which of the client's body structures and functions she can appropriately treat with massage techniques
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The therapeutic effects of massage techniques fall into which of the following six categories? |
- Mechanical - Physiological - Psychological - Reflex - Psychoneuroimmunological - Kinetic |
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Although interventions for wellness and the treatment of impairments differ in several ways, the primary distinction is whether or not: |
The treatment is focused on one or more of the clients impairments. |
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The phase that differs the most for the treatment of impairments versus wellness interventions is the: |
Evaluative phase. |
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During which of the clinical reasoning process does the emphasis on education for home maintenance and self-care increase? |
Discharge phase. |
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The therapist a client examination during what phase? |
All of them. |
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What is true about the client examination? |
Therapists use different examination approaches for clients with neurological, musculoskeletal, cardiopulmonary, or psychoneuroimmunological conditions. |
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Based on the clinical decision-making model for Outcome-Based massage, a therapist can begin to treat a client using massage techniques when: |
The client has impairments that are not contraindicated for the use of massage techniques. |
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Which of the following is not a contraindication to treatment? a. open sore b. acute disc herniation c. Acute flare up of inflammatory arthritis d. intoxication |
Acute disc herniation. |
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Which of the following is not an endangerment site? - neck - axilla - gluteal fold - umbillicus |
Gluteal fold. |
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The initial examination, interim examination or re-examination, discharge examination, and follow-up examination differ in terms of: |
Selectivity, timing, objectives, and components. |
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Which of the following would be considered objective data in a plan of care: - posture - medication - strength |
Posture and strength. |
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What does a discharge examination do? |
Provides a record of the client's impairments and functional level at discharge. |
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What are parts of the treatment planning phase of clinical decision making? |
- Identifying functional outcomes - Identifying treatable impairments - generating a clinical problem list |
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T or F: There is always only one treatment within a POC. |
F. |
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Planning compensatory strategies occurs during the treatment planning stage of clinical decision making. T or F? |
T. |
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Mechanical effects of massage are caused by compression, tension, shearing or bending tissues. T or F? |
T. |
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Sedation and arousal are outcomes of the reflex effects of massage. T or F? |
T. |
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Reflex effects of massage are mediated by the nervous system. T or F? |
T. |
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What is hydrotherapy? |
The internal or external use of water in any of its states to prevent and treat disease or trauma. |
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What are some of the therapeutic effects of massage techniques? |
- Mechanical - Reflex - Physiological - Psychological - Psychoneuroimmunological - Energetic |
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What is impairment massage VS wellness massage |
Impairment = aim to reduce the impairments associated with medical conditions
Wellness = not concerned with addressing the client's impairments |
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What are the 4 phases of clinical decision making? |
Evaluative Phase Treatment Planning Treatment Phase Discharge Phase |
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What are functional limitations? |
when activities of daily living are affected. |
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What are myotomes, dermotomes and sclerotomes? |
Myotome - group of muscles supplied by a single nerve root, e.g injury to trees minor can result in referred pain near insertion of deltoid. Dermatome - area of skin supplied by a single (dorsal) nerve root. *injury to dorsal root can result in sensory loss or burning/electric Sclerotome - area of bone or fascia innervated by a single nerve root, eg. hip pain can be referred to groin, SI joints, lumbar spine, knee, ankle |
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What can we palpate? |
- Anatomical structures - Body rhythms (pulses, respiratory) - tremors and fasciculations - vibrations (crepitus and fremitus) |
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What is the difference between research capacity and research literacy? |
A process of individual and institutional development leads to higher levels of skills and greater ability to perform useful research. |
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What is sackett's least level and highest level of evidence? |
least = personal experience highest = randomized control trials |
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Who is Jonas? |
"Evidence house" includes many kinds of rigorous research methods. - suggests that including a variety of methodologies can provide a more balanced and complete picture of what constitutes massage and how it works |
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What is the difference between primary and secondary sources of evidence? |
Primary - directly documents the primary research. e.g: professional journals, conference presentations, and occasionally textbooks
Secondary - Summary of info presented in a primary source. *secondary research studies, e.g. textbooks, pop media, the Internet, professional courses, and professional journals. |
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What is the difference between manual lymph drainage and superficial effleurage?
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Manual lymph is a non-gliding technique. |
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Who is Vodder? |
Created manual lymph drainage. |
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Who is Cyriax? |
Created friction technique. |
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What are frictions and how do you perform them properly? |
A repetitive, non-gliding technique where a specific contact such as the fingertips or thumb is used to penetrate dense connective tissue and produce small movements between its fibers. - applied to tissues in chronic stage of inflammation and repair. *locate tissue, focused specific contact, don't glide, use short strokes < 2cm to move superficial part of target tissues back and forth over deep part.. 1-2 cycles per second. |
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What are some of the CIs for connective tissue techniques? |
- all general CIs - signs of acute inflammation (spasm, pain at rest, heat, redness, unsolidated edema) - hematomas, calcification - hypermobile or unstable joints (dislocations) - osteoporosis |
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What body temp do we want to continuously maintain? |
37 degrees |
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What occurs if cold is left on too long? |
Huntington's response *negative warming response. |
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What is retrostasis? |
Vasodilation of the skin surface in order to retain heat. |
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What are the four stages of cryotherapy? |
C - cool B - burning A - aching N - numb |
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What are the different forms of drug administration? |
Enteral - GI tract absorption (sublingual, buccal, rectal, vaginal, urethral) Parenteral - bloodstream directly IV, IM, sub dermal, intrathecal) *absorbed fast Transdermal, inhalation, topical - applied to skin and inhaled. |
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What does the term "drug metabolism" mean? |
The body's ability to change a drug from its dosage form to a more water soluble form that can be excreted. *sometimes drugs may compete for metabolization leading to potential accumulation and adverse effects. |
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What is onset, peak and duration in terms of medication? |
Onset - the time interval that starts when the drug is administered and ends when the therapeutic effect bigs Peak conc - Reached when the absorption rate equals the elimination rate Duration - length of time the drug produces its therapeutic effect |
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What are narcotics? |
- induce sleep, tranquilize the CNS - bind with opiate receptors, altering pain perception and emotional response |
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What are anti-diabetic drugs? |
- for stabilizing blood glucose level (insulin) - used for diabetes EX: insulin |
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What are the 3 types of active ROM? |
1- Active free 2- Active assisted 3- Active resisted |
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What are the 4 different types of end feels? |
- Bony (elbow ext) - soft tissue approximation (elbow flexion, biceps interfere) - capsular (ext rotation of the shoulder) - tissue stretch. (hamstring during hip flex) |
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What is the order the we use ROM |
- Active Free - Passive Relaxed - Passive Force - Active resisted |
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What are the four phases of clinical decision making? |
1 - Evaluative 2 - Treatment planning 3 - Treatment 4 - discharge |
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What is a peripheral neuropathy VS and radiculopathy? |
Peripheral = impaired sensation due to entrapment of nerve, deficiency, diabetes.. Radiculopathy = nerve root at or near the spine is affected. |
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What is inert VS contractile? |
Inert: any tissue that is not considered contractile or neurological, also have tension placed on them when stretched (joint caps, ligaments, bursar, blood vessels, cartilage and dura mater).
Contractile: can have tension placed on them by stretching or contraction. *these are the muscles, their tendons and attachments onto the bone. |
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What are some of the reflex effects of massage? |
- sedation/arousal - facilitation of skeletal muscle contraction |
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What is the difference between subjective and objective information? |
Subjective = own personal findings Objective = what the patient tells you or what the other health care professional tells you |
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What is a trigger point? |
Referred pain, rarely follows distribution of peripheral nerve or dermatome. |
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How do we eradicate a trigger point? |
Holding in the area until the client reports that the pain is dissipating. Combination of heat is always helpful. Must not use cold because it will cause an increase in muscle tone and it is highly likely that the fibers will start to bind again. |
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What are the 4 connective tissue techniques? |
- Skin rolling - Myofascial release - Direct fascial technique - Friction |
