MBLEx Massage & Bodywork Examinations 2015

1. MBLEx Massage & Bodywork Examinations 2015 Physiological Effects of Massage (476-564) Section 5

2. MBLEx Review • 476. The nervous system responds to massage through the stimulation of _______________. • muscle fibrils • b. the integumentary system • c. sensory receptors • d. varied pressure 476 c - In the nervous system, sensory receptors are nerve endings which respond to stimuli. Massage triggers these sensory receptors to send messages to the central nervous system.

3. MBLEx Review • 477. What are neuroendocrine chemicals called when they are released into the blood? • Hormones • b. Neurotransmitters • c. Neuropeptides • d. Erythrocytes a - Neuroendocrine chemicals regulate physiological functions within the body. Hormone producing glands are part of the endocrine system. Massage reflexively stimulates the endocrine system to send neuroendocrine chemicals into the blood to transport messages from one area of the body to another, and in this form they are a hormone.

4. MBLEx Review • 478. Massage creates the pleasure and feel-good response by stimulating the release of which neuroendocrine chemical? • Serotonin • b. Dopamine • c. Epinephrine • d. Cortisol b - Dopamine is the neuroendocrine chemical responsible for many processes within the body including muscle movement, emotion, motivation, joy, pleasure and satisfaction. When a massage therapist is able to create a satisfactory massage experience for a client, the massage therapist helps release dopamine and, in effect, create a feel-good response.

5. MBLEx Review • 479. The effects of massage typically raise cortisol levels within a client. • True • b. False b - Cortisol is typically reduced during a massage through the activation of the parasympathetic nervous system. High levels of stress are common causes of elevated cortisol and an indication of an overactive sympathetic nervous system responsible or the “fight or flight” response. Excess cortisol production suppresses the immune system and is a major contributing factor for weight gain, high blood pressure, fatigue and disease.

6. MBLEx Review • 480. How much time is generally needed of sustained touch to engage the parasympathetic nervous system? • 2 minutes • b. 8-10 minutes • c. 15 minutes • d. 30 minutes c - Touch can initially trigger the sympathetic nervous system. However, after a sustained period of 15 minutes, the parasympathetic nervous system engages. Once this engagement occurs, the release of dopamine, serotonin, oxytocin, endorphins and a decrease in cortisol will aid and assist in the healing process of massage.

7. MBLEx Review • 481. Which of the following best describes the technique of myofascial release? • Vigorous, deep pressure • b. Light, circular strokes • c. Gentle, sustained pressure • d. Deep, focused pressure c - Myofascial release relies on a gentle, sustained pressure approach to unwinding fascial tension. The goal is to break the tension pattern and allow the underlying tissues to naturally release.

8. MBLEx Review • 482. What is a beneficial effect of the application of aromatherapy during a massage? • Reduces edema • b. Local vasodilation • c. Mood enhancer • d. Releases trigger points c - Although the scientific data is inconclusive, most people claim to have an improved sense of well being from the scent of certain aromatherapy oils.

9. MBLEx Review • 483. What massage technique would be best to use on an athlete 30 minutes before their sporting event? • Brisk and invigorating strokes • b. Deep focused pressure • c. Very light, soft pressure • d. Long sustained compression a - The goal of pre-event sports massage is to increase circulation, flexibility and increase mental clarity. Applying brisk and invigorating strokes is the best way to achieve this goal.

10. MBLEx Review • 484. Which of the following anatomy does craniosacral therapy directly affect? • Digestion • b. Cerebrospinal fluid • c. Lymph • d. Interstitial fluid b - The craniosacral system consists of the skull, vertebrae, meninges and cerebrospinal fluid. The purpose of craniosacral therapy is to rebalance the flow of cerebrospinal fluid to restore sensory, motor and intellectual function.

11. MBLEx Review • 485. A client has a noticeable hypertonic rectus femoris and is wincing in discomfort from deep pressure, What is the best method of treatment? • Work as deep as necessary and explain, “no pain, no gain” • b. Apologize for causing pain and avoid the area • c. Lighten your pressure and work within pain threshold of client • d. Alternate between light pressure and painful pressure c - The number one rule of massage is “do no harm”. Forcing a client to work beyond their pain threshold is counterproductive and can often lead the client to transfer the tension to another area within the body. However, avoiding the hypertonic muscle does not help either. The best approach is to work within the client’s pain threshold.

12. MBLEx Review • 486. What is a positive effect of effleurage on the integumentary system? • Supports healthy digestion • b. Assists in the healing process of local skin infections • c. Releases deep fascial adhesions • d. Promotes healthy circulation for improved waste removal d - The soothing strokes of effleurage assists the circulation of lymph vessels within the dermal layers of the integumentary system. This process is a great benefit to removing toxins and waste.

13. MBLEx Review • 487. Which technique would you choose to release adhered tissue in cutaneous and subcutaneous layers? • Tapotement • b. Effleurage • c. Compression • d. Skin rolling d - Cutaneous and subcutaneous refers to the layers of skin. The best technique to undo or release adhesions within skin tissue is with skin rolling.

14. MBLEx Review • 488. Which technique is best suited to elongate muscles, increase range of motion and decompress the spine? • Myofascial release • b. Compression • c. Traction • d. Shaking/jostling c - Traction is the gentle process of separating tissues and can be applied to any part of the body or extremity and is best suited to elongate muscles, increase range of motion and decompress the spine.

15. MBLEx Review • 489. Which of the following techniques is characterized as kneading? • Effleurage • b. Petrissage • c. Tapotement • d. Friction b - Petrissage, a component of Swedish massage, is an alternating press and release technique similar to kneading bread.

16. MBLEx Review • 490. What massage stroke would a massage therapist use to assist with peristalsis in the abdomen? • Myofascial release • b. Effleurage • c. Friction • d. Tapotement b - Peristalsis in the abdomen is the muscular contraction that moves contents through passageways within the body like the intestines. The best technique of the answer options is effleurage, which gently assists in the natural flow of the digestive rhythm.

17. MBLEx Review • 491. Which of the following is a mechanical effect for deep effleurage? • Releases endorphins • b. Stretches vein and lymph vessels • c. Stimulates parasympathetic nervous system • d. Increases local metabolism b - Mechanical effects are directly associated with the immediate area of treatment. The other three choices are reflexive effects of deep effleurage.

18. MBLEx Review • 492. Which of the following is a reflexive effect for deep effleurage? • Stretches veins and lymph vessels • b. Warms superficial tissues • c. Removes waste • d. Stimulates parasympathetic nervous system d - Reflexive effects are those that indirectly affect the body. Therefore, the reflexive effects of deep effleurage are those that stimulate the parasympathetic nervous system. The other three choices are mechanical effects of deep effleurage.

19. MBLEx Review • 493. To assist a client with the reduction of edema, which direction would a massage therapist focus the massage strokes? • Centrifugal • b. Centripetal • c. Omnidirectional • d. Proximal to distal b - Centripetal means toward the heart or toward the center, which is the direction a massage therapist would want to direct massage strokes to assist with the reduction of edema. Centrifugal means away from the center.

20. MBLEx Review • 494. Which technique would be best suited for loosening mucus in the thoracic cavity? • Tapotement • b. Trigger point • c. Fine vibration • d. Petrissage a - One of the mechanical effects of tapotement is specifically designed to release mucus in the thoracic cavity. Another mechanical effect of tapotement is to cause temporary ischemia (decrease in blood flow) which is then quickly followed by the reflexive effect of hyperemia (increase of blood flow).

21. MBLEx Review • 495. Massage has both mechanical and reflexive physiological effects on our bodies. Which of the following is a mechanical effect? • Lowered heart rate • b. Reduction of trigger points • c. Release of serotonin • d. Increased mental clarity b - A mechanical effect of massage is one that directly affects the immediate tissues. The reduction of trigger points is a direct effect of massage and therefore a mechanical physiological effect.

22. MBLEx Review • 496. What is a reflexive effect of massage that helps a client cope with stress? • Stimulates the parasympathetic nervous system • b. Directly releases adhesions • c. Minimizes trigger points • d. Unwinds fascial tension a - Reflexive effects of massage are those that stimulate various systems indirectly. The parasympathetic nervous system is responsible for returning the mind to a state of peace and normal functioning.

23. MBLEx Review • 497. A client is in her third trimester of pregnancy. Why is a side laying position indicated? • To assist with proper breathing • b. To help with trigger points in the abdomen • c. To avoid compression of the aorta and inferior vena cava • d. No particular reason c - The aorta and inferior vena cava are susceptible to compression during later stages of pregnancy while in the supine position. Extra care must be taken to assist with the comfort of an expecting mother. Always have extra blankets and pillows handy and you must also be willing to interrupt the treatment at any time to aide her when needed.

24. MBLEx Review • 498. Massage stimulates the release of _______________ which causes local vasodilation. • Serotonin • b. Dopamine • c. Cortisol • d. Histamine d - Histamine is a neurotransmitter that stimulates a local inflammatory response which is the reason for the redness of an area of the body after massage.

25. MBLEx Review • 499. When working on an acute or subacute frozen shoulder, the best technique to reduce pain in your client is _______________. • Diaphragmatic breathing • b. Active-passive range of motion • c. Deep tissue massage • d. Positive thinking a - Diaphragmatic breathing, also known as belly breathing or deep breathing, is based on engaging the diaphragm upon inhalation to draw in more air and oxygen into the lungs. The rhythmic action and increased oxygen assist in the parasympathetic response to reducing pain and stress.

26. MBLEx Review • 500. Which of the following is the best technique for stretching a hypertonic iliopsoas muscle? • Post isometric relaxation • b. Trigger point • c. Passive range of motion • d. Deep tissue massage a - The iliopsoas is a difficult muscle to access and palpate rendering both trigger point and deep tissue massage as not the best choices. Passive range of motion is good for assessing rotation issues of the coxal joint but the best technique is post isometric relaxation. The technique requires the client to isometrically contract the iliopsoas into the therapists resistance, then relax as the therapist extends and stretches the iliopsoas muscle. Three passes are typical with clients force at about 30% of power for a period of 10 seconds each.