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Trigger Point Exam-Quiz: It's Origin, History, Theory & Hypothesis, Anatomy & Physiology 12 hr

(Non-Technique Continuing Education Course to know Principles, Chronology & Science: Not massage Therapy Techniques or Manipulation of Soft Tissue)

Online CE Class for Texas Massage Therapists. Texas Department of State Health Services DSHS Massage Therapy TX Licensed Continuing Education Provider TX DSHS Massage CEU Provider License Number: CE 1608 provided by TX Licensed Instructor: Daniel C. PhD EMT LMT MTI, Integrity Services, Granbury, TX 76048

Click here to retake Trigger Point Exam or review class notes. You can review course material and retake exam (unlimited attempts) until you pass!

Question 1: What is a Trigger Point?
places in the body where muscles do not function properly because they have been damaged on the cellular level
places in the body where the joints are painful due to the onset of arthritis, which is typically a part of the aging process
places in the body where the skin is damaged on the cellular level because of a previous injury
Development of muscle knots which always happens due to spraining a tendon or pulling a muscle


Question 2: A trigger point will have
redness and a surficial bump on the surface of the skin close to the joint
intense contractile activity without any sort of nerve stimulation
stress and strain at the origin and the insertion of the muscle
a rich flow of oxygen and nutrients to exasperate the pain


Question 3: A band of muscle that has a trigger point will have normal muscle fibers and
abnormal muscle fibers differentiated by the paleness of the skin above the trigger point
a network of veins and arteries along with millions of capillaries that get inflamed due to the constant pressure
a taut band of muscle fibers, which bunch up in a knot and cause stretching and elongation of muscle fibers to either side of the trigger point
interconnectivity to tendons and adjacent muscle fibers which also get painful with time


Question 4: Muscle fibers associated with trigger points
have severe damage at molecular and sub-cellular levels because of the intense contractile activity in the trigger point area
bunch up in a knot and cause stretching and elongation of muscle fibers resulting in the release of calcium at the subcellular level
will have intermittent onset of pain and wil become triggered and inflamed just by constant exposure to ultraviolet rays
stop functioning thereby affecting the balance of the skeletal system and lead to Parkinsons Disease in the elderly population


Question 5: When a muscle contracts
potassium is absorbed by the surrounding cells
calcium is released into the muscle
sodium is adsorbed by the neurons to provide energy for movement
phase 1 of the human body movement is initiated respective to the limbs attached to the constracting muscle


Question 6: In a resting muscle cell
energy is conserved to prepare for the next contractile activitiy and associated movement of the body part involved
the muscles fibers expand to allow room for rushing oxygen and nutrients into the surrounding cells
the co-enzyme ATP, which is responsible for energy transfer between cells, is bound to myosin, a motor protein
lactic acid is released onto surrounding muscle fibers until the onset of the next contractile activity


Question 7: The _____________ has to wait for calcium to be released by the cells before it can contract or release a fiber of muscle
limb
joint
tendon
myosin


Question 8: Dr. Janet Travellís personal success
with one particular joint release technique had a far-reaching effect on trigger point history
with one particular muscle fiber had a far-reaching effect on trigger point history
with one particular trigger point technique had a far-reaching effect on trigger point history
with one particular patient had a far-reaching effect on trigger point history


Question 9: Janet Travell was the 1.__________ Physician during the 2._______________
1. Myofascial Trigger Point 2. Dark ages in Chiropractic History
1. only Alternative Medicine 2. Early 1900s
1. first Woman Massage Therapist 2. time when massage therapists first regained their position as alternate medical professionals in the early 1900s
1. White House 2. Kennedy and Johnson administrations


Question 10: 1.__________________ honored her with an esteeemed position in gratitude for her treatment of the 2._______________
1. President Kennedy 2. debilitating myofascial pain
1. The World Health Organization WHO 2. muscle fibers with newly developed trigger point techniques
1. The Queen of England 2. Paralysis in her grandson
1. The Medical Board 2. Holistic Human through Alternative Medicine


Question 11: Dr. Travell was past 1.________ when the first volume of her Myofascial Pain and Dysfunction The Trigger Point Manual was published, and past 2.________ when the second volume appeared
1. fifty 2. seventy
1. eighty 2. ninety
1. seventy 2. eighty
1. forty 2. sixty


Question 12: Trigger Point Therapy was first practised successfully in _________ to treat myofascial pain
1979
1922
1955
1909


Question 13: Scientists have confirmed that the majority of health problems are
stress-related
food-related
from pathogens
None of the Above


Question 14: Janet G. Travell, MD and David G. Simons, MD first met when Dr. Travell lectured about
myofascial pain and the influence it had on an important patient in 1955
trigger points and myofascial pain at the Air Forceís School of Aerospace Medicine
Trigger Point Anatomy and Physiology at the Air Force's Aerospace School
None of the Above


Question 15: Dr. Simonsís career is the world altitude record for manned balloon flight he set in 1957 as a young Air Force Flight Surgeon. Dr. Simon later became a renown
Aerospace Physician
Research Scientist
Trigger Pont Therapist and was Dr. Janet G. Travell's student in the Air Force
None of the Above


Question 16: Who are the two pioneers of trigger points and the diagnosis and treatment of myofascial pain
Dr. Travell and President Kennedy
Dr.Simons and Dr. Bartlett
Janet G. Travell, MD and David G. Simons MD
None of the above


Question 17: Dr. Travell lectured about trigger points and myofascial pain at the
National Physican's Association Conference in Utah
White House
Air Forceís School of Aerospace Medicine
None of the above


Question 18: Dr. David Simons latest book on Muscle Pain Understanding its Nature, Diagnosis, and Treatment with coauthor Doctor Siegfried Mense, seeks to impart a better understanding of
the proper application of Trigger Point Therapy
the scientific proofs related to trigger point therapy
the anatomy and physiology of muscles
the neurophysiology of muscles


Question 19: The part of a muscle fiber that actually does the contracting is a microscopic unit called a
ligament
cell
sarcomere
trigger point otherwise commonly called a muscle knot


Question 20: A trigger point exists when
over stimulated sarcomeres are chemically prevented from releasing from their interlocked state
millions of sarcomeres have to contract in your muscles to make even the smallest movement
contraction occurs in a sarcomere when its two parts come together and interlock like fingers
a muscle fiber in a normal resting state, is neither stretched nor contracted


Question 21: When sarcomeres in a trigger point hold their
position, the muscles are interlocked and all motion stops
contraction, blood flow essentially stops in the immediate area
axis, the surrounding tissue stretches to align itself parallel to this established axis
calcium, contraction cannot occur thereby preventing any body movement and hence the myofacial pain


Question 22: The resulting immobility and associated oxygen starvation and accumulation of the waste products of metabolism
is a knot in a muscle fiber consisting of a mass of sarcomeres in the state of maximum continuous contraction that characterizes a trigger point
causes the greater distance between the Z bands, which displays how the muscle fiber is being stretched by tension within the contraction knot
irritates the trigger point. The trigger point responds to this emergency by sending out pain signals.
defines the length of the individual sarcomeres. The sarcomeres run lengthwise in the fiber, perpendicular to the Z bands


Question 23: A knot in a muscle fiber consists of a mass of sarcomeres in the state of maximum continuous contraction that characterizes a trigger point. The bulbous appearance of the contraction
knot indicates how that segment of the muscle fiber has drawn up and become shorter and wider
is a characteristic knot that is senstive to pressure
in the muscle if untreated can lead to serious consequences
related to the release of calcium can also be a tumour and so skilled therapists need to refer their patients to a licensed physician


Question 24: Normally, when a muscle is working
the muscle fiber extends from the contraction knot to the muscleís attachment
its sarcomeres act like tiny pumps, contracting and relaxing to circulate blood through the capillaries that supply their metabolic needs
the greater distance between the Z bands display how the muscle fiber is being stretched by tension within the contraction knot
the distance between the short crossways lines (Z bands) within the fiber defines the length of the individual sarcomeres. The sarcomeres run lengthwise in the fiber, perpendicular to the Z bands.


Question 25: Myofascial pain signals will continue
until there is a better understanding of the neurophysiology of muscles and associated trigger point pain alerts
to the segment of the body that translates these pain signals to pin point the exact location of the pain
unless trigger points are located, deactivated, and the associated tissue flushed to help the trigger pointís contracted sarcomeres begin to release
unless hydrotherapy in combination with massage is used to enhance the healing process


Question 26: Trigger Points in the Sternocleidomastoid
would cause a headache over your left forehead and left ear
cause pain in both eyes and the jaw
would cause a headache over your left eye and sometimes at the very top of your head
result in vision and hearing problems


Question 27: Conventional treatments for pain so often fail
because referred pain is felt most often as an oppressive deep ache, although movement can sharpen the pain
because referred myofascial pain can be as intense and intolerable as pain from any other cause, including surgery
because trigger points usually send their pain to some other site
because myofascial pain can do a very good job of mimicking a heart attack


Question 28: Stiffness and pain in a joint
is felt most often as an oppressive deep ache, although movement can sharpen the pain
can be as intense and intolerable as pain from any other muscular segment
should always make you think first of possible trigger points in nearby muscles that have been subjected to strain or overwork
is due to the depletion of lubricants in the joint cavity, a common part of the aging process


Question 29: Pain in such joints as the knuckles, wrists, elbows, shoulders, knees, and hips are almost always nothing more serious than
referred pain from healthy sarcomeres
muscle fibers that have got entangled during an extensive workout
referred pain from myofascial trigger points
referred pain from neurological terminations related to the axxon and myelin sheaths


Question 30: The easiest theory to accept regarding referred
pain is that the signals simply get mixed in your neurological wiring. Sensory inputs from several sources are known to converge into single neurons (nerve cells) at the spinal level, where they are integrated and modified before being transmitted to the brain
sensations is the incapacitating stitch in the side that comes from running too hard
neurological symptoms is that the source of the pain is hidden to promote more detailed analysis with X-rays and CT Scans
None of the Above


Question 31: Trigger points and referred pain pattern in the masseter muscle of the jaw can cause
you to think first of possible trigger points in nearby muscles that have been subjected to strain or overwork
a frontal headache and pain in the sinuses, teeth, ears and temporomandibular joints (TMJ disorder). They can be responsible for a sense of sinus pressure or congestion. These trigger points are also the cause of that familiar maddening itch deep inside the ear.
convergence into single neurons (nerve cells) at the spinal level, where they are integrated and modified before being transmitted to the brain
be felt most often as an oppressive deep ache, although movement can sharpen the pain


Question 32: Trigger points in the extensor carpi radialis longus muscle of the forearm
are known to converge into single neurons (nerve cells) at the spinal level, where they are integrated and modified before being transmitted to the brain
cause astigmatism, allergies, antihistamines, CPM, cirrhosis of the liver, jaundice and myopia
are the most common cause of pain in the outer elbow, commonly called tennis elbow, elbow tendinitis, or lateral epicondylitis
can be responsible for a sense of sinus pressure or congestion


Question 33: You may never find back pain's real cause if you look for it only in the back muscles or the spine. Back pain very often comes from
trigger points in stomach muscles, for instance. For example, gluteus medius trigger points are one of the most common causes of low back pain
a condition related to fluid in the lungs
a condition related to swelling of the feet
None of the Above


Question 34: Ankle pain is referred from
trigger points in the upper leg muscles
trigger points in the lower leg
muscular distortions around the knee
radiations in the calf muscles


Question 35: The trigger point
is the activity that triggers the pain
causes discomfort when isolated from the rest of the body
is not an inflamed area of the muscle
is not associated with muscle cramps


Question 36: Bunching of muscle tissue at the trigger point zone
causes stimulation of all organs in the body
results in invigoration and release of neurons to regulate autonomic body functions
increases local levels of lactic acid, which can be detrimental to cellular function
if untreated can lead to long term paralysis


Question 37: Shooting pain in the gluteus and legs is often caused by
prolonged driving without breaks and recirculation
lack of Vitamin D and Vitamin B12
pain in the piriformis or other gluteal muscles, and not by irritation of the sciatic nerve
Varicose Veins


Question 38: Earaches, sinusitis, toothaches, ringing in the ears (tinnitus), and dizziness may be
due to cavities in the wisdom tooth
improper massage without the prior consideration of contraindications
due to lack of Vitamin B and C
symptoms of trigger points in the muscles around the jaw, face, head and neck


Question 39: Tightness of the iliopsoas and hamstring muscles
can affect normal functioning of the digestive system
cause skeletal defects in the hip and knee joints
can also seriously disrupt balanced posture
result in lengthening of the femur bone in human development


Question 40: Fibromyalgia may be a more clearly neurological disease, while myofascial pain syndrome MPS
may be more of a dysfunction of muscle tissue
can be relieved quickly by excercise
may radiate to other parts of the body
None of the Above


Question 41: A ____________ factor is an activity/position/condition that will continue to activate a trigger point, even if the pain is temporarily relieved by massage or other techniques
chronic
perpetuating
knot
inflammatory


Question 42: The taut band that can be felt around a myofascial trigger point is due to overstretched __________
ligaments
tendons
muscle fibers or sarcomeres
muscles


Question 43: A ___________ trigger point may only produce pain when palpated
latent
painful
neurological
inflamed


Question 44: Trigger points can be caused by many things, including trauma, overuse, ____________, disease, systemic factors, mechanical factors, and perpetuating factors
lack of vitamins
underuse or atrophy
stress
shock


Question 45: A lack of ____________ to muscle fibers creates the local "energy crisis" that leads to the formation of a myofascial trigger point
excercise and massage
rest and vitamins
oxygen and nutrients
None of the Above


Question 46: A _____________ trigger point may be activated by a trigger point in another area of the body
critical
swollen
satellite
red and inflamed


Question 47: Practitioners claim to have identified reliable ________ patterns, allowing practitioners to associate pain in one location with trigger points elsewhere
chronic pain
Substance P
referred pain
Allodynia


Question 48: The main innovation of Travell's work was the introduction of the myofascial pain syndrome concept (myofascial referring to the combination of ________ and fascia)
Torso
Head and Neck Anatomy
Human Leg
muscle


Question 49: The wire like nerve cells ________ are the actual structures that link the Central Nervous System to the Peripheral Organs
nerves
composed of spinal fluid
neurons
None of the above


Question 50: The bony anatomy of the foot and ankle involves the
Tibia, Figula, Calcaneous, Talus, Cuboid, Navicular, Cuniform Bones, Metatarsals, and Phalanges
carpal tunnel, toes, sole and tibia
joints, ligaments, muscles and blood vessels
None of the Above


Question 51: What is the common cause of a trigger point
Drinking too much water
Musculoskeletal Dysfunction
Food Allergies
Eating Carbohydrates


Question 52: Carpal Tunnel Syndrome
is a result of prolonged typing with a computer keyboard
onset is due to unbalanced lifting of heavy objects
is pressure on the median nerve causing pain over the wrist and fingers
None of the Above


Question 53: The most recent and well-respected research on trigger point therapy is from which of the following people:
Simons and Travell
Froriep and Schade
Ida B. Rolf
Alder and Ling


Question 54: Osteoarthritis is
more prominent in aging adults due to lack of excercise and multivitamins
pain typically affecting the interphalangeal joints of the fingers and the thumb
a hereditary disease that is prevalent among females with a history of hypertension
None of the Above


Question 55: Rheumatoid Arthritis
caused when streptococci infections are untreated and can impact the heart
is more prevalent in colder countries due to the lack of sunlight responsible for vitamin D generation in our bodies
pain located at the knuckles of the fingers and the wrist bone
None of the Above


Question 56: The body can be divided into two major sections
posterior and the anterior sections
voluntary and the involuntary organs
axial portion and the appendicular portion
None of the above


Question 57: The axial portion comprises of the
face, chest and abdomen
legs, stomach, and the face
head, neck and trunk
None of the above


Question 58: The appendicular portion comprises of
the appendix, liver and the spleen
duodenum, small intestine and the colon
ribs, trunk and femur
the upper limbs (arms) and lower limbs (legs)


Question 59: What 4 muscles mimic heart attack pain?
1. Suboccipitals 2. Splenuis Capitis & Cervicis 3. Trapezius 4. Levator Scapulae-SCM
1. Semitendinosus 2. Gluteus Maximus 3. Illiopsoas 4. Quadriceps
1. Pec. Maj. & Min. 2. Serratus Anterior 3. Latissimus Dorsi 4. Teres Major
1. Sternocleidomastoic 2. Trapezius 3. Rectus Femoris 4. Latissimu Dorsi


Question 60: A trigger point is defined as a firm, palpable, highly irritable spot within a muscle characterized by
A highly irritable neuron and ischemia
Constriction and tender point
Body sensitivity and increase in range of motion
Tenderness, referred pain and loss of range of motion


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