NCE PRACTICE EXAM

Abduction means to move away from the midline. Adduction means to add to the midline, or bring it closer.

The suffix "-algesia" pertains to a condition in which the client is either very sensitive to pain (hyperalgesia) or has a difficulty perceiving pain (hypoalgesia). The prefix "-asthenia" may sound similar, but it pertains to a lack of strength.

Synovial joints are characterized by synovial fluid within the joint space. Types of synovial joints include gliding, condyloid, saddle, hinge, ball and socket, and pivot joints. Rotator cuff muscles include supraspinatus, infraspinatus, teres minor and subscapularis. Inflammation of the rotator cuff tendons (tendinitis) would impede the range of motion in the shoulder, which is a ball and socket joint.

The arrow points to an area of spongy bone tissue. Spongy bone has numerous open spaces separated and connected by trabeculae. This gives it greater strength and resilience and also decreases the overall weight of the skeleton.

The floating ribs attach on the spine but do not have any sternal attachments. The 11th and 12th floating ribs cover the kidneys to protect it from damage.

The ischial tuberosity is the posterior portion of the ramus of the ischium, where body weight is supported. The hamstrings attach to the ischial tuberosity at the proximal end.

Homeostasis is the balance or stability internally sought and maintained by the body no matter the external shifts. Hemostasis is the stopping of blood flow. Hypothermia is a dangerous state when the body gets too cold and is not able to produce adequate heat. Orthostatic Hypotension is the experience of dizziness or a faint feeling when standing up or coming upright due to low blood pressure.

The left anterior, medial, distal femur describes the area that is at the bottom of the inner femur, on the front of the bone.

The organ systems of the body consist of the Respiratory, Cardiovascular/Circulatory, Digestive, Immune, Lymphatic, Skeletal, Muscular, Nervous, Reproductive, Renal, Integumentary, Urinary and Endocrine systems. Chakra names the energy wheels of the subtle body system.

A distal plane does not exist. Distal is an anatomical term meaning something away from the center of the body or the point of attachment. The sagittal plane is a plane that divides the body into left and right parts. The transverse plane divides the body into inferior and superior parts. The axial plane is the same as the transverse plane.

There are no medium or round bones, and sagittal is a plane dividing the body into left and right sides. Here are examples of each of the five types of bones:
• Flat bone - sternum, cranial bones, scapulae
• Long bone - humerus, radius, femur, tibia
• Short bone - tarsals, carpals
• Irregular bone - vertebrae, sacrum
• Sesamoid bone - patella

The lateral border of the scapula is the attachment site for the teres major and teres minor. The subscapularis attaches at the lesser tubercle and infraspinatus attaches to the anterior aspect of the scapula.

Synergists help the prime mover, or the agonist, and act on movable joints. An antagonist resists the agonist to move in the opposite direction. The fixator is a type of synergist that holds bones so tension can be used to move the agonist.

The flexor digiti minimi brevis flexes the little toe. The extensor hallucis brevis extends the great toe. The flexor hallucis brevis flexes the great toe and the abductor digiti minimi abducts the little toe.

Both latissimus dorsi and teres major perform adduction, extension and medial rotation of the glenohumeral joint. Pectoralis major and minor act on two different joints. Gluteus medius and maximus have similar actions but gluteus medius also flexes the coxal joint. Both supraspinatus and teres minor hold the glenohumeral head in the glenoid cavity, but that's the only similarity with their actions.

Biceps femoris short head performs extension at the knee while vastus lateralis only performs extension of the knee. Gracilis performs adduction and medial rotation, while rectus femoris and vastus lateralis are two of the quadriceps muscles that extend the knee.

The muscle spindles are one of the proprioceptors that tell the brain where our body is in space by detecting muscle length. There is a stretch reflex when the muscle is stretched quickly. This is when the muscle spindle innervates a motor neuron to concentrically contract the stretching muscle.

Both the teres major and latissimus dorsi adduct, medially rotate and extend the arm. The deltoids actions are abduction, flexion and medial rotation of the arm. The pectoralis major is responsible for flexion, extension, adduction and medial rotation of the arm. The rectus abdominis is responsible for flexion of the vertebral column and abdominal compression.

Golgi tendon organ detects increases in tension of a muscle to prevent injury. If muscle tension is substantial in relation to the amount of force the muscle can generate it inhibits the muscle's ability to contract. Utilizing this reflex allows one to increase a stretch without the muscle resisting it. The muscle spindle when stimulated contracts the muscle. The Meissner corpuscle detects slippage of skin. And the Pacinian corpuscle detects pressure and high vibration frequency in the skin.

Many people on the autism spectrum suffer from sensory overload so the therapist should consider soft music, low lighting and possible visual communication. With the risk that the client's nervous systems could be overloaded with heightened sensations, the therapist should use proper pressure according to what the client can tolerate.

Olecranon Bursitis is an inflammation of the bursa at olecranon process of the proximal aspect of the ulna. The function of the bursa is to cushion the structures around it, especially during movement. Stress to this area is typically caused by acute or repetitive trauma. The symptoms of Olecranon bursitis include pain, tenderness, local swelling, decreased movement and warmth of skin over the elbow.

Hypoglycemia is a condition where a person's blood sugar level goes below normal levels. It is usually related to diabetes, but can be caused by other conditions. Treatment of the condition includes the eating of foods with a high sugar content or the taking of medications, to quickly return the blood sugar level to a normal range. Hyperglycemia is high blood sugar often associated with diabetes. Its main symptoms are being thirsty and frequent need to urinate.

While both men and women can be at risk for osteoporosis, women are at a much higher risk after menopause when estrogen and progesterone levels drop, reducing the amount of periosteum production on bones.

A hiatal hernia occurs when the stomach bulges through the muscles separating the abdomen from the diaphragm due to weakened abdominal muscles. A small hiatal hernia usually does not cause problems but a large one can cause food and reflux to back up in the esophagus. The other types of hernias occur in other locations torso - umbilical (navel), inguinal (groin) and incisional (lower in the abdomen area).

MRT is effective for those muscles and relaxing neck tension (which may indirectly help) but it is not necessarily a specific treatment for COPD. Tapotement of the posterior rib cage is good for helping break up and release some of the potential mucus build up. Working with the breathing muscles mentioned in answer option D will help loosen the muscles involved with breathing. During the advanced stages of COPD, lymphatic massage may help to move stagnant lymph and ease breathing.

Cataplexy is an autoimmune disorder that results in temporary episodes of muscle weakness typically triggered by emotional reactions. Cataplexy is not related to pressure behind the eyes, weakness of the joints or with trouble breathing.

During a massage the parasympathetic nervous system is activated suppressing the production of cortisol. During times of stress the sympathetic nervous system is active releasing the hormones adrenaline and cortisol preparing one to either fight or run - "Fight or Flight". Cortisol prepares the body by flooding it with glucose, supplying an immediate energy source to large muscles. It narrows arteries increasing blood pressure. It also inhibits insulin production to prevent glucose from being stored, favoring its immediate use. This leads to blood sugar imbalances and diabetes, weight gain and obesity, immune system suppression and gastrointestinal problems.

The inflammatory phase has ended when the repair phase starts. In the repair phase, granular substance, collagen, and fibrinogen fill in the lesion and the formation of the scar begins, but it's too fragile for any vigorous techniques. So mild stretching and range of motion combined with MICE (movement, ice, compression, elevation) are indicated to help organize the fibers linearly. It's during the remodeling phase when more vigorous techniques are applied and the focus is to break down the scar tissue a little and create functional inflammation to strengthen the scar.

Massage reduces blood pressure by stimulating the parasympathetic nervous system and getting a relaxation response. This innervates the vagus nerve and slows heart rate down while causing vasodilation reducing blood pressure over all.

The feelings of wellbeing are believed to result from the release of endorphins stimulated by the safe and caring touch of massage. While the other three answer options ring true, they are not the best answer for this question.

Deep friction massage during the remodeling stage of healing helps form strong mobile scar tissue and break apart any inter fiber adhesions to help regain full painless ROM. Massage is generally locally contraindicated during the inflammation phase. During the repair or regeneration stage, it is important to work on range of motion which can help with oxygenation and circulation. Deep friction massage may create more or exacerbated injury as new fibers are still being created.

S stands for "subjective", what your client tells you, like their chief complaint. Observations by the therapist would be placed in the Objective section. Any assessment techniques used by therapist and the results would be put in the Assessment section. Plan is what the therapist will do to treat the client, including the initial treatment and follow-up treatment.

Pectoralis major and Latissimus dorsi would not only slump the shoulders forward (rounded shoulders) but would also internally rotate the arm to the point that the palms are facing the front of the thigh. Your client's palms are facing the sides of the leg like they should, so the slump forward would indicate it is a spinal curve issue.

When a client is holding their breath they are not allowing their body to accept the treatment of deep pressure, and their body is actually resisting the work.

Pes planus is the condition of having flatfoot, where the longitudinal arch is lower than in normal development. Having flat feet means there may be a collapse of the arch which will at some point likely cause an unstable gate and possible chronic back pain. The likelihood of it having positive effects is low. Pes planus creating a tendency toward plantar flexion or tiptoes is counterintuitive. Later in life, it may bring some more serious challenges, like making it difficult to walk or sit up in a serious stretch.

The best way to assess a client's is to observe them without them knowing, like on the way to the treatment room. Answer options A, B and D would likely to create a bit of nervousness and a forced or unnatural footing and/or balance.

When a therapist projects feelings and/or memory from their past onto their client, this is a situation of countertransference.

Having clear and consistent draping policies for all bodywork sessions in accordance with the standards of practice is necessary to avoid crossing the physical (or sexual) boundaries of the client as well as maintaining privacy and maintaining the trust within the therapist/client relationship.

The principles of beneficence and non-maleficence are obligations of the massage therapist to maximize the possible benefits of massage (beneficence) and to avoid or minimize possible harms to the client (non-maleficence). Both principles are based on what's in the client's best interest. Non-maleficence requires a massage therapist to refrain from something that goes against the client's interest.

A dual relationship arises when a client is a friend, family member or business associate. These relationships make it difficult to keep social boundaries. A problem with such relationships is that the massage therapist and client can start having feelings about the situation which are beyond professional.

The massage therapist's scope of practice is being broken. Scope of Practice includes everything that the therapist is trained to do under the specific certificate/license with which they are currently working. Physical boundaries related to physical environment of the client, like draping or touching. A dual relationship describes a scenario where the massage therapist and client may also be family, friends or colleagues, which in turn may mar or confuse the professional boundaries. Emotional boundaries related to transference, countertransference and the power differential.

Processing is not a part of informed consent. Informed consent requires the disclosure or the presentation of all relevant information needed to make informed consent, an understanding in the client of the information and consent where the client (usually signs a waiver) agrees and/or gives permission to the treatment protocol.

The two main stances to deliver a massage are the straddle and archer stances. The straddle stance is with feet hip width apart, knees slightly bent, toes straight ahead and weight evenly distributed on both feet. The archer stance is with toes pointing in same direction, one foot in front asymmetrically with the most weight on the back foot. These two stances allow the most versatility in providing even, full and smooth technique delivery with the least amount of stress to the therapist and the most efficient treatment for the client.

It is important to have a good first impression with clients to instill trust and to lay the ground work for a long-term relationship. Choosing a work uniform which is comfortable to work in, allows freedom of movement, and gives the impression that your office is professional and dedicated to the health and well-being of the client is most important.

As an independent contractor, the therapist would receive a 1099 statement from the wellness center.

A massage therapist does not have to form a corporation or even start a business to practice as a massage therapist. A massage therapist can work as an employee for massage therapy business. However, a massage therapist must follow HIPAA's confidentiality rules and regulations, have liability insurance for his or her practice and carry a state license for massage therapy and/or bodywork.

As long as the massage treatment qualifies for coverage, massage therapy can be paid for by a client' health insurance, auto insurance or with worker's comp coverage. The massage therapy may have to be for medically necessary treatment that is prescribed by a physician or primary healthcare provider.

A person acts with autonomy if one acts with intention and understanding, making one's own choices, free from any controlling interference from others that prevents meaningful choice.

Mezger was from Holland. After he presented massage to fellow physicians in Holland, the physicians and other followers began to use the French terms effleurage, petrissage and tapotement. It is not clear why French terms were adopted for the techniques.

Tuina uses the theory of acupuncture where the practitioner uses finger pressure to stimulate the acupuncture points. Originally, it was used to treat pediatric medical conditions with poke-pinch and push-grasp techniques to stimulate a child's natural healing processes.