NCBTMB Exam Anatomy and Physiology 6

Question 1

During a deep tissue massage, a client reports numbness and tingling radiating down the medial forearm and into the ring and little fingers. Which nerve is most likely being compressed, and at which anatomical site?

Accepted Answer

Ulnar nerve at the cubital tunnel

Answer

The ulnar nerve innervates the medial forearm and the ring and little fingers (digits 4–5). It is most vulnerable to compression at the cubital tunnel (posterior to the medial epicondyle of the humerus). The median nerve serves the lateral 3½ fingers and would be compressed at the carpal tunnel. The radial nerve affects the posterior forearm and dorsal hand, and the musculocutaneous nerve does not extend into the hand.

Question 2

A massage therapist is working on a client's posterior thigh and inadvertently applies sustained pressure over the sciatic nerve where it passes through the greater sciatic foramen. Which muscle, when hypertonic, is the most anatomically precise structure that could entrap the sciatic nerve at this location?

Accepted Answer

Piriformis

Answer

The piriformis muscle lies directly over the sciatic nerve as it exits the pelvis through the greater sciatic foramen. A hypertonic piriformis can compress the sciatic nerve here, causing piriformis syndrome. The biceps femoris and other hamstrings are more distal. The obturator internus exits via the lesser sciatic foramen. The gluteus medius is superior and lateral, not in close proximity to the sciatic nerve at this foramen.

Question 3

Which of the following accurately describes the functional relationship between the sarcomere's A-band and H-zone during maximal muscle contraction?

Accepted Answer

The A-band remains constant in length while the H-zone narrows or disappears

Answer

According to the sliding filament theory, during contraction actin filaments slide toward the center of the sarcomere. The A-band (the length of the myosin filament) does NOT change because myosin itself does not shorten. However, the H-zone — the region of myosin not overlapped by actin — narrows and may disappear entirely at full contraction as actin filaments maximally overlap the myosin. The I-band also shortens, but the A-band length is fixed.

Question 4

A client presents with an inability to plantarflex the foot and loss of sensation on the sole. Imaging reveals compression at the tarsal tunnel. Which nerve is involved, and through which anatomical structure does it pass?

Accepted Answer

Posterior tibial nerve passing deep to the flexor retinaculum

Answer

The tarsal tunnel is formed by the flexor retinaculum on the medial side of the ankle. The posterior tibial nerve passes through this tunnel along with the tibial artery and several tendons. Compression here causes tarsal tunnel syndrome — characterized by plantar foot numbness and weakness in intrinsic foot muscles involved in plantarflexion support. The common fibular (peroneal) nerve passes around the fibular head. The sural nerve is cutaneous and posterior-lateral. The saphenous nerve is purely sensory and medial.

Question 5

The thoracolumbar fascia plays a critical role in force transfer during loaded movement. Which of the following accurately describes one of its biomechanical functions relevant to massage therapy assessment?

Accepted Answer

It transmits tension from the latissimus dorsi and gluteus maximus across the lumbosacral junction, coupling upper and lower extremity movements

Answer

The thoracolumbar fascia is a multi-layered connective tissue structure that connects the latissimus dorsi superiorly, the gluteus maximus inferiorly, and the contralateral extremities via the posterior oblique sling. This cross-body tensional network is critical for transferring loads across the lumbosacral junction during gait and lifting. It contains no contractile muscle fibers, is not a vascular conduit, and attaches to lumbar (not exclusively thoracic) spinous and transverse processes.

NCBTMB Exam Practice Test

NCBTMB Exam Practice Test

NCBTMB Exam Anatomy and Physiology 6