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There are three joints that are part of the shoulder girdle - the sternoclavicular joint, the acromioclavicular joint and the glenohumeral joint.

The brachial artery continues from the axillary artery and runs between the triceps and biceps brachii. The pulse of the brachial artery can be palpated between these muscles on the anterior side of the arm.

The anatomical term “foramen” refers to a hole or opening for nerves or tissues to pass through as in the foramen ovale of the sphenoid bone on the skull which allows several nerves, arteries and veins to pass through.

The purpose of the excretory system is to regulate the chemical composition of the body by removing metabolic waste and to monitor the proper amount of water, salts and nutrients. The integumentary, digestive and respiratory system all play a minor role in the excretory system. However, the urinary system is responsible for the excretion of fluid to maintain homeostasis.

The knowledge base refers to education and special training/skills for providing care. The practice parameters refer to conduct and environment. These two combined explain the basic concept of the scope of practice.

The massage code of ethics is a standard of conduct that defines ethical behavior for a massage therapist. The question lists principles of the massage code of ethics.

A z-line is the dark band that separate sarcomeres and forms the borders where actin molecules within a muscle combine.

A joint that feels restricted and lacking in movement is hypomobile. A joint that is lax and loose would be hypermobile.

When a client asks about the private matters of a common client/friend, they are trying to fill a gap that a massage therapist, as a professional, should not fill. The massage therapist may think the client making the request for information will respect the therapist for divulging privileged information but they will ultimately grow to distrust the therapist’s adherence to client confidentiality. The best answer is one that puts the focus back on them.

A condyle is a large rounded area on a bone, usually at a joint articulation. A trochanter is a large projection from a bone. A spine or spinous process is a flat ridge-like flange protruding from a bone, typically a vertebra.

The question describes the fundamentals of framework. A framework is all encompassing within the massage field and includes the values and visions, conception, design and desires of a massage therapist as they apply to a business model. Developing a solid framework is essential to creating a healthy and successful practice.

An eccentric extension of the neck requires the flexors to fire during contraction, causing the extensor muscle levator scapulae to relax.

Sometimes a client can develop complex issues and it is important for a massage professional to “check in” with their own personal scope of practice to insure a healthy therapeutic relationship. In this case, the massage therapist should recommend another practitioner with special training to better assist the client.

A range of motion assessment is achieved by testing the joints capsular pattern, which will indicate any limitations by structure or function..

Zoning ordinances and regulations are local laws that govern how a property can be used. Always check with the local municipality before making any major changes to a home or office.

Testing the range of motion while the client is moving under their own power is known as an active range of motion test.

The median nerve passes through the flexor retinaculum of the hand.

A grade 4 whiplash is a critical condition associated with extreme neck pain, cervical fractures and/or dislocations, possible spinal cord injury and serious soft tissue damage. Massage is contraindicated until the condition is stabilized and a medical release is provided.

A strict order to not treat by a medical doctor should always be honored, especially in the case of a medical condition that can be adversely affected by massage. If the client insists on massage, then the massage therapist should recommend that the client obtain a second opinion and an authorization letter or prescription from another doctor.

The anatomical term “foramen” refers to a hole or opening for nerves or tissues to pass through as in the foramen ovale of the sphenoid bone on the skull which allows several nerves, arteries and veins to pass through.

A client with a grade 3 disability is considered highly disabled but with moderate limitation of functionality. A good example is an injured construction worker with a crushed vertebrae who is disabled from returning to work, but has moderate limitations in daily functions like walking, sitting and eating.

The brain stem which provides the sensory and motor innervations of the face and neck consists of three parts: the medulla oblongata, pons and midbrain.

The term anatomical snuff box or rather, “snuff box“ was coined by using the space between the tendons of the extensor pollicus longus and the extensor pollicus brevis (and the abductor pollicus longus) as a place to hold snuff tobacco.

A postural assessment can be performed while the client is standing to observe how they hold themselves upright in relation to gravitational forces or while laying down in a supine/prone position to determine any asymmetries.

The mesencephalon is also known as the midbrain, and is associated with arousal, hearing, motor control, vision, sleeping patterns and more.

Nerves that send messages to the central nervous system (CNS) are called afferent nerves. Sensory receptors are examples of afferent nerves. The nerves that send messages from the CNS to the body are called efferent nerves. Somatic nerves are an example of efferent nerves.

When the body is exposed to prolonged heat, more blood is shunted to superficial veins in order to lower body temperature. This results in decreased venous return to the heart. The resulting lowered cardiac output causes less oxygenated blood to reach the brain, causing dizziness and fainting.

The O is for objective, which is based on a therapist’s visual and physical findings of the client.

The pineal gland is a small endocrine gland that produces seratonin, the hormone that regulates sleep patterns.

Any client who routinely requests to explore beyond the professional environment is testing the boundaries and professionalism of the therapist. Remember, the therapist is always at fault for allowing a breach of professional boundaries. The repercussions can lead to a hefty fine and/or loss of a massage license.

Tantra is a Sanskrit word meaning expanding liberation and has a place amongst certain spiritual practices. However, tantric massage is often associated with massage that focuses on various levels of “sexual healing“ and, therefore, an establishment seeking a tantric massage practitioner is outside the code of ethics of the massage profession.

The ulna is stationary during wrist rotation.

ABCDE refers to irregularities in skin. A - asymmetrical shape of skin B - border unevenness C - color variations D - diameter E - evolution Any changes in the ABCDE category is cause for a referral to a dermatologist.

Keloids are a type of scar tissue with an overgrowth of type 3 collagen fibers, creating firm, often shiny fibrous nodules. Cross fiber friction is best suited to break up and smooth over keloid tissue.

Using your hands to assess the condition of a client is a palpation assessment.

There are three arches in a normal human foot. These are the medial longitudinal arch, the lateral longitudinal arch and the transverse arch.

The Phalen’s test requires the client to firmly press the backs of the hands together for a duration up to a minute. If the client experiences pain, tingling or numbness in the thumb, index, middle and lateral half of the ring finger along the palmar side, then the test is positive for a carpal tunnel compression. The test can be done in reverse with palms pressed firmly together.

There are laws, rules and regulations against developing a sexual relationship with a client. If a sexual relationship existed prior to the client/therapist relationship, then continued sexual interaction is allowable. A typically safe amount of time to wait is 6 months after the client/therapist relationship has been dissolved (documented and signed by both parties) before pursuing a romantic interaction. However, the best path to preserving your career and avoiding a possible investigation is to never engage a client or previous client in any relations outside of a therapeutic environment.

The obturator foramen is the gap created by the ischium and pubis bones of the pelvis which allows passage for the nerves and blood vessels that supply the leg. The shape of the obturator foramen differ between the sexes with the gap in men being round and in women being oval.

The plasma membrane is made of two layers of fat molecules that contain phosphorus and is also known as the phospholipid bilayer.

The Arndt-Schultz Law states that a weak stimulus will have no effect on a physiological process, that an intermediate stimulus will promote a physiological process whereas a strong stimulus will inhibit a physiological process.

The deep groove between the greater and lesser tubercules of the humerus is the home of the bicipital tendon which lies in the intertubercular groove, also known as the bicipital groove.

Systole or systolic pressure is the measured amount of force required by the heart to pump or squeeze blood out of its chambers.

During a forced exhalation, the abdominal muscles are engaged to assist the expulsion of air from the lungs.

A bulboid corpuscle is a cutaneous thermo-receptor which detect changes in temperature and relay the message to the CNS.

Systole and diastole refer to the contraction (systole) and relaxation (diastole) phase of a heart beat.

The epiglottis is a fold of cartilaginous tissue located above the glottis in the pharynx. During normal swallowing the larynx moves upward and the epiglottis folds over the glottis. This prevents substances from entering the respiratory system.

The S is for subjective, which is a description of the client’s experience.

The adrenal glands, known for releasing “fight or flight” hormones in response to stressors, are located superiorly to the kidneys.

There are two bones that make the shoulder girdle - the clavicle and the scapula.

Federal and state law form the legal boundaries of the massage profession.

The mitral valve is also known as the bicuspid, which controls blood flow between the opening of the left atrium into the left ventricle.

There are times when undraping sensitive areas for treatment is within the scope of practice of massage. However, a massage therapist who routinely drapes in an unprofessional manner is breaking a standard of conduct indicated in the massage code of ethics.

Lactic acid buildup occurs when the demand for energy exceeds the tissues ability to process the metabolic waste. Sprinting is the only activity mentioned that can create this scenario.

A Podiatrist is a doctor devoted to the study, diagnosis and treatment of disorders that affect the foot, ankle and lower leg. Practitioners of podiatry may focus on varying specialties within the field including primary care, orthopedics, biomechanics, pediatrics, geriatrics, sports medicine and surgery. Having an understanding of the different branches of medical providers will increase your effectiveness with your clients and allow for a better network of practitioners.

Kinesthesia is another term for proprioception, or the ability of a person to perceive their own movement.

One of the few times a massage therapist is allowed to break confidentiality is when he or she suspects a client to be in personal danger or harm. In this case, the massage therapist has a professional obligation to ensure the safety of the client.

Protons located within the nucleus are counted to determine the atomic number of an atom. This is different than the atomic mass which is a count of the total count of neutrons and protons within a nucleus.

Assisting a client through an active movement is active-assisted ROM. This is used to test for muscle adhesions, muscle strengths and muscle weakness.

Muscle tone relates to a continuous muscle contraction that resists stretching or elongation during a resting state. In other words, muscle tone describes a muscle that is unable to relax.

The posture for bicycling requires the rider to rest on the palms while steering. Guyon’s canal syndrome is also known as handlebar palsy.

The talus is also known as the ankle bone to which the tibia and fibula connect. The other bone of the hindfoot region is the calcaneus also known as the heel.

Costoclavicular test is often used to determine a brachial plexus compression syndrome. The costoclavicular test is also known as the military position test since the client rotates shoulders back and thrusts chest forward much like standing at attention. The practitioner feels for changes in the radial pulse to indicate a compression syndrome.

The digestive tract contains a smooth muscle cell layer (the muscularis externa) having no motor innervation. Pacemaker cells located throughout the digestive tract send signals to the muscularis externa. This causes rhythmic waves of muscular contraction and propels material through the digestive tract.

Speaking about a client to another client, a client’s friend, or even the client’s family member is a violation of confidentiality. However, we do not need to be rude to maintain our professionalism. Simply suggesting that your client speak to his wife is a perfectly acceptable response.

A client who routinely presses the structure of the practice, like in this case, is testing the boundaries on what is acceptable. Regardless of a client’s situation, it is the therapist’s responsibility to set appropriate boundaries to ensure all participants feel safe and comfortable within the therapeutic environment.

A latent trigger point only produces pain during palpation.

Muscle flaccidity pertains to the weakness of a muscle.

Having concise and clear boundaries is the best way to eliminate confusion and gain trust from a client, and in doing so the massage therapist establishes integrity.

All the muscles listed in the question are examples of postural muscles. Postural muscles are slow twitch and highly susceptible to hypertonicity in over-use and under-use scenarios.

Although it may seem cold and unfriendly, it is up to the client to approach the massage therapist if they wish in a public setting.

ABCDE

All the muscles listed in the question are examples of postural muscles. Postural muscles are slow twitch and highly susceptible to hypertonicity in over-use and under-use scenarios.

Stratum lucidum is a translucent buildup of two to three layers of dead skin cells typically found on the palms of the hands or the soles of the feet. Stratum lucidum is located between the deeper stratum granulosum and the more superficial stratum corneum layers of skin. The thickness of stratum layers of cells is governed by the rate of mitosis (cellular division.)

Capillaries are the smallest blood vessels with endothelial linings that are only one cell thick. This allows for the transfer of water, oxygen, carbon dioxide, nutrients and waste between the blood and surrounding tissues.

The cerebral cortex is divided into two halves or hemispheres. Each hemisphere consists of four lobes: the frontal lobe, parietal lobe, occipital lobe and temporal lobe. The lobes relate not to brain function but rather to the bones that underlie the cerebral cortex. The borders of these lobes are dictated by sutures in the skull with the exception between the frontal and parietal lobes which follow a deep fold in the brain called the central sulcus and this is just behind the frontal and parietal sutures.

Communication is a very important component of the client/therapist relationship. A therapist who prefers the feedback and open communication from a client is justified to decline work if the client cannot communicate with the massage therapist.