AMTA MBLEx (English) Exam Questions

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1.

Which of the following is not a physiologic response to hydrotherapy cold applications?

  • Decreased muscle tone

  • Increased tissue stiffness

  • Decreased inflammation

  • Decreased digestive processes

Correct answer: Decreased muscle tone

There are many physiologic responses to cold and ice application. The application of cold hydrotherapy increases muscle tone. Other responses include increased tissue stiffness, decreased digestive processes, decreased pain and inflammation, increased white blood cell production, and decreased respiration.

2.

To practice as a physician's assistant (PA), one must complete a 2-year post-graduate physician's assistant program, pass a national exam, and obtain a credential to practice. What type of credential is this?

  • License

  • Government certification

  • Voluntary verification

  • Master's degree

Correct answer: License 

Obtaining a license follows the process outlined in the question. In many regions of the United States, licensure is required for massage therapists. This is done to protect the public from any potential harm done by licensed professionals. 

Government certification is not quite as strict as licensure and is voluntary. It does still require specific education. Voluntary verification is even less stringent than government certification and does not necessarily require a specific education. A Master's degree is a two- or three-year degree obtained after an undergraduate degree. 

3.

Which term best describes inflammation of a bursa?

  • Bursitis

  • Tendonitis

  • Tenosynovitis

  • Cystitis

Correct answer: Bursitis

Bursitis is an inflammation of a bursa. Trochanteric bursitis is a very common form of this condition. Trochanteric bursitis can be related to tightness over the iliotibial band and is often caused by excessive running. The suffix "-itis" means inflammation.

Inflammation of a tendon is tendonitis. Inflammation of a tendon sheath is tenosynovitis. Cystitis is inflammation of the bladder, and often the result of a urinary tract infection.

4.

What is a technique used to normalize the motor tone of muscles?

  • Oscillation

  • Kneading

  • Percussion

  • Friction

Correct answer: Oscillation

Oscillation (shaking) is a technique used to normalize the motor tone of muscles. This is the rhythmic or dysrhythmic movement of tissues on a body part. This technique warms and prepares the body for deeper work. It intentionally confuses the positional proprioceptors, causing the surrounding muscle tissue to reflexively relax.

Kneading is used to stretch the tendons, release tension in the muscle belly, and mechanically soften superficial fascia.

Percussive techniques stimulate nerve responses.

Friction can be used to break up scar tissue.

5.

Which condition is associated with diabetes and causes pain and tingling in the lower legs and feet?

  • Neuropathy

  • Plantar fasciitis

  • Bursitis

  • Myelitis

Correct answer: Neuropathy

Neuropathy is a condition of inflammation or degeneration of the peripheral nerves. Diabetic neuropathy is a specific form that is associated with poorly controlled diabetes. This condition causes nerve pain that is difficult to manage. Massage can provide short-term, symptomatic pain relief through stimulation of alternative nerve pathways.

Plantar fasciitis is the inflammation of the plantar fascia on the sole of the foot. Bursitis is an inflammation of the bursae, usually caused by trauma. Myelitis is an infection of the spinal cord, brainstem, or both.

6.

Which muscles make up the rotator cuff?

  • Supraspinatus, infraspinatus, teres minor, and subscapularis

  • Supraspinatus, infraspinatus, deltoid, and subscapularis

  • Supraspinatus, deltoid, triceps brachii, and biceps brachii

  • Supraspinatus, infraspinatus, rhomboids, and subscapularis

Correct answer: Supraspinatus, infraspinatus, teres minor, and subscapularis

The four muscles that make up the rotator cuff off the shoulder are supraspinatus, infraspinatus, teres minor, and subscapularis. They are sometimes referred to by the acronym SITS. 

Although the deltoid, triceps brachii, and biceps brachii all act on the shoulder joint, they are not considered part of the rotator cuff. The rhomboids attach to the scapula, but do not act on the glenohumeral joint itself. 

7.

Torticollis is muscle condition that is often seen in the pediatric population. What symptom characterizes this condition?

  • Tilting of the neck

  • Lateral curvature of the spine

  • Thoracic curvature

  • Lumbar curvature

Correct answer: Tilting of the neck

Torticollis is a muscle condition that causes the neck to tilt to one side. It is caused by the shortening and tightness of one of the sternocleidomastoid muscles. It is also known as wry neck. Massage can relax the muscles, stretch contracted muscles, and improve range of motion.

Scoliosis is the pathological lateral curvature of the spine. Kyphosis and lordosis are both natural curvatures of the spine; when these curves are exaggerated to the point of pathology, they become hyperkyphosis and hyperlordosis, respectively. The healthy thoracic spine exhibits a thoracic curve, and the healthy lumbar spine exhibits a lordotic curve.

8.

Which of the following muscles extends the elbow?

  • Triceps brachii

  • Brachialis

  • Biceps brachii

  • Brachioradialis

Correct answer: Triceps brachii

The triceps are extensor muscles that move the elbow. The long head originates at the infraglenoid tubercle of the scapula. The lateral head originates on the lateral and posterior surfaces of the proximal humerus. The medial (deep) head originates on the distal half of the medial and posterior humerus. The three heads blend together into one muscle belly, which inserts on the posterior surface of the olecranon process of the ulna. 

The brachialis, biceps brachii, and brachioradialis muscles all work concentrically to flex the elbow, which makes them elbow flexors. They are antagonists to the triceps brachii. 

9.

What does a ribosome assemble, and to create what?

  • Amino acids; proteins

  • Proteins; amino acids

  • Lipids; a bilayer

  • Proteins; muscle tissue

Correct answer: Amino acids; proteins

A ribosome is a type of organelle which assembles amino acids to create proteins. Organelles are the basic structures found in a cell that play specific roles during mitosis and interphase. Amino acids are the building blocks of proteins. In most cells, the ribosome combines amino acids into proteins, which are then stored with lipids by the Golgi apparatus. Proteins are essential for cellular function and especially important for muscular health.

Amino acids form proteins, not the other way around.

The cell membrane is composed of a lipid bilayer.

Although muscle tissue is indeed made up of proteins, the process of organizing these proteins into muscle tissue is not performed by the ribosome.

10.

Blood is composed of red and white blood cells and plasma. What is plasma mostly composed of?

  • Water

  • Gases

  • Electrolytes

  • Hormones

Correct answer: Water

Plasma is mostly composed of water. 90% of plasma is water. The remaining 10% of plasma consists of gases, hormones, electrolytes, and nutrients.

11.

Which type of sensory nerves respond to change in position and movement?

  • Proprioceptors

  • Mechanoreceptors

  • Nociceptors

  • Chemoreceptors

Correct answer: Proprioceptors

Proprioceptors respond to changes in position and movement. The main proprioceptors influenced by massage are the muscle spindle and Golgi tendon organs. Proprioceptors (and mechanoreceptors) are located in the fascia, muscles, tendons, and joints.

Soft tissue consists of four basic categories of sensory nerves:

  1. Mechanoreceptors respond to touch, pressure, and movement.
  2. Proprioceptors respond to changes in position and movement.
  3. Chemoreceptors respond to chemical changes such as oxygen levels and acid-base balance.
  4. Nociceptors respond to irritation and pain.

12.

Significant acute damage to the inner layer of the periosteum might cause what to occur?

  • Difficulty forming new bone

  • Excess bone formation

  • No changes in bone formation

  • A bone spur

Correct answer: Difficulty forming new bone

The inner layer of the periosteum is where osteoblasts form new bone. Significant damage to this area, therefore, would result in difficulty forming new bone. 

Low-level repetitive stress could result in the formation of excessive bone (a bone spur) in response to the stress. However, this would not occur with a sudden acute injury to the inner layer of periosteum.

13.

Which of the following ligaments spans the lateral aspect of the knee from the femur to the fibula?

  • The LCL

  • The MCL

  • The ACL

  • The PCL

Correct answer: The LCL

The LCL stands for the Lateral Collateral Ligament and works to stabilize the lateral aspect of the knee. It connects the lateral side of the femur to the lateral side of the fibula.

The MCL stands for the Medial Collateral Ligament and works to stabilize the medial aspect of the knee. It connects the medial side of the femur to the medial side of the tibia. The ACL stands for Anterior Cruciate Ligament and stabilizes the joint by attaching the superior surface of the tibia (connecting to the anterior portion of that surface) to the inferior surface of the femur (towards the posterior portion of that surface). The PCL stands for Posterior Cruciate Ligament and stabilizes the joint by attaching the superior surface of the tibia (connecting to the posterior portion of that surface) to the inferior surface of the femur (towards the anterior portion of that surface). The ACL and PCL form an X-shape between the tibia and femur.

14.

Which patient population may present with decreased soft tissue pliability, thinner skin, and decreased muscle and fat tissue?

  • Geriatric

  • Pediatric

  • Athletes

  • Pregnant women

Correct answer: Geriatric

The geriatric population consists of individuals that are 65 years and older. As individuals age, there is a greater tendency for age-related changes and diseases. Massage therapists should note these age-related changes and accommodate them. Geriatric clients may have diminished muscle tissue and decreased fat tissue. Connective tissue is less pliable and joints are less mobile. The skin is thinner and circulation is not as efficient.

15.

If abductor muscles are being used as agonists during the movement of the humerus, what is most likely occurring?

  • The arm is moving away from the body.

  • The arm is being straightened.

  • The arm is being raised forward over the head.

  • The arm is being brought towards the body.

Correct answer: The arm is moving away from the body.

If abductor muscles are working as agonists during the movement of the humerus, the arm is most likely moving away from the body. Abduction is the lateral movement of a limb away from the midline of the trunk, occurring in the frontal (or coronal) plane.

Extensor muscles straighten the arm. Flexor muscles raise the arm forward over the head. Adductor muscles bring the arm towards the body.

16.

Which muscle helps the primary muscle move?

  • Synergist

  • Agonist

  • Antagonist

  • The secondary muscle

Correct answer: Synergist

The synergist is the muscle that assists the prime mover by holding a part of the body steady, thereby providing leverage.

The agonist is the prime mover, which shortens to create movement. The antagonist is the muscle that opposes the action of the agonist by lengthening and controlling the movement. The secondary muscle is not a commonly used term.

In elbow flexion, for example, the biceps muscle is agonist, the triceps muscle is the antagonist, and the brachioradialis and brachialis are the synergists.

17.

Which of the following correctly pairs the muscle and its position in relation to the spine of the scapula?

  • Supraspinatus; above

  • Infraspinatus; above

  • Supraspinatus; below

  • Levator scapula; medial to

Correct answer: Supraspinatus; above

As you can tell from the name, the supraspinatus is above the spine of the scapula. The Latin root "supra/o" means "above," and "spinatus" refers to the spine of a bone.

The infraspinatus is below (inferior to) the spine of the scapula; "infra" means "below," or "inferior to."

The levator scapula also contains valuable information in its name, as "levator" means "lifter," like the word "elevator." However, this gives information about the muscle's action (to pull upward on the scapula) and not its location in relation to the spine of the scapula.

18.

Muscles work in pairs of agonists and antagonists with the help of synergists to create muscle contraction. Which classification of muscle is responsible for the primary movement?

  • Agonist

  • Antagonist

  • Synergists

  • Contractors 

Correct answer: Agonist

The agonists are muscles that are responsible for the primary movement. The agonist is the prime mover, which shortens to create movement.

The antagonist is the muscle that opposes the action of the agonist by lengthening and controlling the movement. The synergist is the muscle that assists the agonist by holding a part of the body steady, providing leverage.  Although muscles do contract, they are not called contractors.

In elbow flexion, for example, the biceps muscle is agonist, the triceps muscle is the antagonist, and the brachioradialis and brachialis are the synergists.

19.

What is a fascicle?

  • A bundle of muscle fibers, wrapped together by fascia

  • A broad, flat sheet of fascia

  • A single cell of fascia

  • A layer of deep fascia

Correct answer: A bundle of muscle fibers, wrapped together by fascia.

A fascicle is a bundle of muscle fibers, wrapped together by fascia.

An aponeurosis is a broad, flat sheet of fascia. Single cells of fascia are not called fascicles. Deep fascia is a coarse sheet of fibrous connective tissue that binds whole muscles into groups, rather than surrounding a smaller number of muscle cells.

20.

Five months after right sentinel lymph node removal (in the axilla) and radiation therapy for breast cancer, a client has persistent swelling in her right arm. She has seen her physician and has been cleared for massage therapy. What drag level should be applied when working with this client’s right arm?

  • Level 2

  • Level 1

  • Level 0

  • Level 3

Correct answer: Level 2

Clients who have had lymph node removal and radiation therapy are at high risk for developing lymphedema in the affected limb. Lymphedema is the buildup of lymphatic fluid, leading to swelling. For this condition, a gentle technique like lymphatic drainage massage is appropriate. Level 2 drag is a moderate level of drag that is commonly used for lymphatic drainage and relaxation. It provides enough stretch to encourage the movement of lymph without causing damage to the tissues, making it ideal for managing lymphedema.

Level 1 drag is too light to effectively stimulate lymphatic flow, so it is typically reserved for general relaxation or circulation enhancement without addressing specific conditions like lymphedema.

Level 0 drag is the gentlest level and is often used with fragile clients, such as those with osteoporosis or bleeding disorders, but it would not be effective for lymphatic drainage.

Level 3 drag is much stronger and is used for myofascial release or breaking down adhesions, which would be too intense for lymphedema and could potentially cause harm.