Massage Manual For DoH Licensure 1
Massage Manual For DoH Licensure 1
Massage Manual For DoH Licensure 1
WORKBOOK GUIDELINES
For
LICENSURE EXAMINATION
FOR MASSAGE THERAPY
January 2014
1ST Edition
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TABLE OF CONTENTS
FOREWORD
A. Basic Terminologies
B. Body Regions
a. Head and Neck
b. Trunk
c. Upper Extremities
d. Lower Extremities
C. Body Positions
a. Supine
b. Prone
c. Side-Lying
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MODULE 2: MICROBIOLOGY AND PATHOLOGY
A. Basic Terminologies
B. Microbiology
a. Common Microorganisms
b. Infection Process
c. Signs of Inflammation
A. Basic Terminologies
B. History of Massage
a. Ancient Era
b. Modern Era
c. Latest Developments
C. Effects of Massage
a. Physiological Effects
b. Psychological Effects
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D. Indications and Contraindications of Massage
a. Indications
b. Local and Absolute Contraindications
A. Basic Terminologies
B. Massage Therapy Process
a. Pre-Massage
b. Massage Proper
i. Effleurage
ii. Petrissage
iii. Friction
iv. Tapotement
v. Vibration
c. Post-Massage
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Module 1
ANATOMY AND PHYSIOLOGY
Learning Objectives:
4. Discuss the structures and functions of the different organ systems of the
human body that affects massage practice.
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ANATOMY AND PHYSIOLOGY
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A. Basic Terminologies
Anatomy – The study of the structure of living things, from the whole
organism down to the cell level. (Pagaaral sa mga bahagi
ng katawan ng tao hanggang sa mga maliit na organismo.)
Physiology – The study of the mechanical, physical and biochemical
functions of living things. “Physio means function”, “logy
or logos” means study. (Pagaaral sa mga gawain o
tungkulin ng isang bahagi ng katawan ng tao)
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B. Human Body
Notes:
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ORIENTATION/
MEANING
DIRECTION
Superior (Taas) – above or towards the head
Example: The brain is superior to the heart.
Inferior (Baba) – below or toward the lower part of the body
Example: The nose is inferior to the forehead.
Anterior/Ventral – towards the front of the body
(Harapan) Example: Breasts are on the anterior surface.
Posterior/ Dorsal – towards the back of the body
(Likod) Example: Buttocks are on the posterior surface
Medial/ (Gitna) – at or nearer to the center plane; or in the inner
side of the body
Example: The mouth is medial to the ears.
Lateral (Tagiliran) – away from the center plane of the body
Example: The lungs lie lateral to the heart.
Proximal (Malapit) – nearer to the center of the body
Example: The hip is proximal to the knee.
Distal (Malayo) – farther the center of the body
Example: The foot is distal to the hip.
Notes:
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Fig.5. Orientation/Direction
When viewed externally, the whole body is divided into four (4) regions:
C. Body Positions
No matter what the position of the client, the therapist will describe the location
of the anatomical parts as if the client is always in anatomical position.
T T
Fig. 2 – Anatomic
Locations of Body
Regions
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Anatomical position is described as:
body erect and facing forward
arms at the side
palms are facing forward with thumbs on the side
feet about a hip distance apart with toes pointing forward
The next illustrations are the various positions used in massage therapy, it is
important for massage therapists to recognize the different positions and understand
its rationale (kadahilanan) during the massage in order to minimize (mabawasan), if
not totally prevent or control (mapigilan o kontolin), the possible injury to the client.
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D. Body Planes - Planes are imaginary lines - vertical or horizontal - drawn through
an upright body. The terms are used to describe a specific body part.
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E. Major Organ Systems
The human body has organ systems that work together in close coordination
with one another. Its functions include support and movement, transport system,
integration and coordination, absorption, excretion and reproduction.
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Name : Date :
Topic : Score :
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II. Enumeration
Body System
1. ____________________ 9. ____________________
2. ____________________ 10. ___________________
3. ____________________
4. ____________________
5. ____________________
6. ____________________
7. ____________________
8. ____________________
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1. SKELETAL SYSTEM
The nervous system coordinates with muscle movements. Without our skeleton,
we would not be able to stand and walk and move around. Many blood cells are
formed in marrow found in the central opening of certain bones.
Axial Bone (80 bones) - The axial skeleton consists of bones that form the axis of the
body and support and protect the organs of the head, neck, and trunk the skull, the
sternum, the ribs, the vertebral column.
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Fig. 6. Skeletal System
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TABLE 2. MAJOR BONES AND BONE GROUPS OF THE BODY
FUNCTIONS
BONES OF THE HEAD
This is the cranium, the bony framework of the head composed of
the cranial and facial bones plus the maxilla and mandible (upper
and lower jaws). The skull houses and protects the brain.
a. Skull(29)
VERTEBRAL COLUMN
b. Vertebrae (26) The vertebrae are any of the 33 bones of the vertebral column,
comprising 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and coccygeal
vertebrae. The sacral and coccygeal vertebrae are fused into single
units. The spinal cord passes through and is protected by the
vertebrae.
THORACIC CAGE
c. Ribs (2x12) Twelve pairs of narrow curved bones that extend from the
vertebrae to the sternum. The upper seven enclose the thoracic or
chest cavity and protect the heart and lungs. The lower five enclose
part of the abdominal cavity.
d. Sternum (1) The sternum is found on the midline of the anterior chest wall. It
extends from the throat down to the upper abdominal area. The
anterior end of each rib is attached to the sternum.
PECTORAL GIRDLE
e. Clavicle (2) This is the elongated, slender curved bones of the anterior shoulder
known as collarbone. It extends laterally from the top of the
sternum to the scapula. The connection of the sternum and the
clavicle is an important landmark in locating the internal carotid
artery.
f. Scapula (2) The shoulder blade provides for attachment of the clavicle (collar
bone) and the humerus (upper arm bone). The blade portion
extends downward over the dorsal surface of the rib cage.
g. Humerus (2) This is the long bone of the upper arm.
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UPPER EXTREMITIES
h. Radius (2) The shorter and the lateral two bones of the forearm. It attaches on
the thumb side of the wrist.
i. Ulna (2) The medial and longer bone of the forearm. It attaches on the little
finger side of the wrist.
j. Carpals (16) The wrist bones.
k. Metacarpals (5x2) The five long bones of the hand. They are slightly concave on the
palmar surface.
PELVIC
l. Pelvic girdle (2) Three pairs of bones: the ilium, ischium and pubis, fused to form
the pelvic girdle. It attaches to the lower spine, provides support to
the internal organs and has sockets where the upper leg bones
(femur) are attached.
LOWER EXTREMITIES
m. Femur (2) The longest, strongest, and heaviest bone of the body located in
the thigh area.
n. Fibula (2) The lateral and smaller two bones of the lower leg.
o. Patella (2) The kneecap
p. Tibia (2) The medial and larger two bones of the lower leg.
q. Tarsals (14) The bones in the ankle.
r. Metatarsals The five long bones of the foot that are concave on the plantar or
(5x2) lower surface.
s. Phalanges The bones of the toes and fingers.
(14x2x2)
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Name : ___________________________ Date : __________ Score : ___________
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2. MUSCULAR SYSTEM
Muscles produce movement of, and inside the body. Muscle tissue is made up of
cells called fibers that have the ability to contract ( kakayahang umikli) or shorten, in
order to produce a pulling force. Muscles are also extensible, and are elastic
(maaring naibabanat) so that they can be stretched and then recoil and resume their
normal resting length. Muscles are also electrically excitable, so that they can be
stimulated to contract by a nerve impulse. There are three types of muscles in the
body – skeletal, smooth and cardiac.
CHARACTERISTICS OF MUSCLE
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Fig. 7. Muscular System
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TABLE 3. MUSCULAR SYSTEM
TYPE OF MUSCLE DESCRIPTION WHERE FOUND
1. Skeletal muscle Voluntary muscles attached to the bones of the
skeletons
2. Smooth muscle Involuntary muscles hollow organs like small
intestine, blood vessels
3. Cardiac muscle Involuntary muscle heart
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Name : Date :
Topic : Score :
I. ENUMERATION
Characteristics of Muscle
1. __________________
2. __________________
3. __________________
4. __________________
Quadriceps Muscle
1. __________________
2. __________________
3. __________________
4. __________________
Types of Muscle
1. __________________
2. __________________
3. __________________
Muscles in the Forearm
1. __________________
2. __________________
3. __________________
Muscles in the Arm
1. __________________
2. __________________
3. __________________
Muscles of the Upper Thigh
1. __________________
2. __________________
3. __________________
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3. INTEGUMENTARY SYSTEM
The skin is the largest organ of the body. As a physical barrier (pisikal na
harang), skin stops water from leaking (tagas) out of or into the tissues; prevents the
entry of bacteria (pinipigil ang pagpasok ng bakterya) and other disease-causing
microorganisms; filters out the harmful (mapaminsala) and potentially carcinogenic
ultraviolet (UV) radiation in sunlight; and repairs itself if cut or torn. Skin also helps
maintain the body’s temperature (panatilihin ang temperature ng katawan) at a
constant 37°C (98.6°F); and contains a range of sensory receptors.
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TABLE 5. SKIN LAYERS AND COMPONENTS
SKIN LAYERS DESCRIPTION COMPONENTS
Keratin
1. Epidermis Upper layer of the skin
Melanin
blood vessels
sensory nerve endings and
receptors
Lower, thicker part of
2. Dermis sebaceous glands
the skin
sweat glands
adipose cells
tiny veins and arteries
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Name : Date :
Topic : Score :
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II. Enumeration
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4. CIRCULATORY SYSTEM
The circulatory or cardiovascular system consists of the blood vessels and the
blood that is pumped along them by the heart. The circulatory system plays a vital
role (gumaganap ng isang mahalagang papel) in maintaining homeostasis by
controlling the concentration and composition of tissue fluid, by supplying cells with
essential materials and removing their wastes, by helping to keep the body warm,
and by protecting the body against attack by pathogens. A vast (malawak) network
of blood vessels carries blood from the heart to the tissues and back to the heart
once again in an unending circulation of this life-giving fluid.
aorta
main vein
Right Left
liver
digestive system
kidneys
legs
Circulatory System
Fig.8. Circulatory System Pathway
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Fig. 9. Major Arteries of the Body
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Fig. 10. Major Veins of the Body
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TABLE 6. BLOOD PRESSURE RANGE FOR ADULTS
RANGE STATUS
70/40 ~ 90/60 Low blood pressure
Over 90/60 ~ 120/80 Normal blood pressure
Over 120/80 ~ 140/90 Pre-high blood pressure
Over 140/90 ~ 190/100 High blood pressure
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TABLE 8. CIRCULATORY SYSTEM ORGANS, STRUCTURE AND FUNCTIONS
ORGANS STRUCTURE FUNCTIONS
Red blood cells transport oxygen through
(Erythrocytes) hemoglobin
White blood cells antibodies that deals with foreign
(Leukocytes) materials like disease organisms
1. Blood
Platelets blood clotting (pamumuo ng dugo)
(Thrombocytes)
Plasma and plasma carries foods and wastes from
proteins tissues
Arteries carries blood away from the heart
2. Blood Capillaries exchange of materials between
vessels blood and tissue cells
Veins carries blood towards the heart
Arch of the aorta carries oxygenated blood to the
rest of the body
Abdominal aorta and supplies blood to the abdominal
3. Heart
thoracic aorta and thoracic area
Inferior and superior carries deoxygenated blood from
vena cava the rest of the body to the heart
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Name : Date :
Topic : Score :
I. IDENTIFICATION
1. It transports oxygen through hemoglobin.
2. Other term for White blood cells.
3. Range for High blood pressure.
4. Medical terminology for high blood pressure.
5. Largest artery in the body.
6. Antibodies that deals with foreign materials like disease organisms.
7. It carries blood towards the heart.
8. It carries foods and wastes from tissues.
9. Other term for Red blood cells.
10.Heart rate range for an infant.
II. ENUMERATION
Structure of Blood
1. __________________
2. __________________
3. __________________
1. __________________
2. __________________
3. __________________
1. __________________
2. __________________
3. __________________
4. __________________
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5. LYMPHATIC SYSTEM
As blood passes through capillary beds (maliliit na ugat), some of the fluid
portions leak through the capillary walls into the spaces between cells. While much of
the fluid diffuses back (lumalaganap pabalik) into the capillaries, a portion remains in
the interstitial spaces between the cells. The lymphatic system collects this fluid
(called lymph) and returns it to the circulatory system. Lymphatic vessels are thin-
walled vessels in close contact with most tissues. Lymph vessels join together to
eventually form the thoracic duct which empties the lymph from the lower part of
the body into the subclavian vein. This is an essential function (mahalagang
tungkulin) because without it, the lymphatic system will die from the resulting edema
(fluid accumulation) within 24 hours.
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TABLE 9. LYMPHATIC SYSTEM ORGANS, DESCRIPTION AND FUNCTIONS
ORGANS DESCRIPTION FUNCTIONS
1. Lymph Swellings in the lymphatic lymphocytes or white blood cells
nodes system are stored here
2. Spleen Largest organ in the lymphatic removes worn out red cells,
system bacteria and cell fragments from
the blood
3. Thymus Lies top of the thorax and partly generates t-cells lymphocytes
over the heart and lungs
4. Tonsils Small masses of lymphoid tissue provides protection against
on side of the pharynx pathogens that enters body
through mouth or nose
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Name : Date :
Topic : Score :
I. ENUMERATION
II. IDENTIFICATION
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6. NERVOUS SYSTEM
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TABLE 10. THE NERVOUS SYSTEM
1. Central Nervous System (CNS)- Brain
represents the largest part of the Spinal Cord
nervous system, including the brain
and the spinal cord
2. Peripheral Nervous System (PNS)- Somatic System
refers to parts of the nervous Autonomic System
system outside the brain and spinal
cord. It includes the cranial nerves,
spinal nerves and their roots and
branches, and peripheral nerves.
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Name : Date :
Topic : Score :
I. MATCHING TYPE
Match Column A to Column B
Column A
_______ 1. Somatic System Column B
_______ 2. Brain A. Central Nervous System (
_______ 3. Sympathetic Nervous CNS )
System B. Peripheral Nervous System
_______ 4. Spinal Cord ( PNS )
_______ 5. Parasympathetic
Nervous System
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7. RESPIRATORY SYSTEM
The respiratory system takes air into the body, and facilitates the
entry of oxygen into the bloodstream which carries it to all body cells. At
the same time, the respiratory system removes carbon dioxide which
would poison the body (nakalalason sa katawan) if allowed to
accumulate and expels it from the body into the atmosphere.
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TABLE 11. RESPIRATORY SYSTEM STRUCTURE, ORGAN AND
FUNCTIONS
STRUCTURE ORGAN FUNCTIONS
Nose where air passes and organ of
1. Upper
smell
Respiratory
Pharynx serves both digestive and
Tract
respiratory system
Trachea wind pipe; transport air to and
from lungs
2. Lower
Bronchi, where the air entering the lungs
Respiratory
Bronchioles are sent to each lung
Tract
Lung transport air to alveoli for gas
exchange
3. Accessory Diaphragm muscular partition that separates
abdominal and thoracic cavities
PHYSIOLOGY OF RESPIRATION
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Fig. 16. The Breathing Cycle
TABLE 12. RESPIRATORY RATE CHART: BABIES TO ADULT
AGE BREATHS PER MINUTE (RR)
0–1 30 – 40
1+ – 3 23 – 35
3+ – 6 20 - 30
6+ – 12 18 – 26
12+ – Adults 18 – 20
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Name : Date :
Topic : Score :
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II. Fill out the table with the correct respiratory ranges.
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8. DIGESTIVE SYSTEM
Fig. 17.
The Digestive System
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TABLE 13. DIGESTIVE SYSTEM DIVISION, ORGAN AND FUNCTIONS
DIVISION ORGAN FUNCTIONS
Mouth chewing and breaking down of
food
Pharynx swallowing mechanism of food
(lalamunan) (paglunok ng pagkain)
Esophagus serves as passage (daanan) of
1. Alimentary
food
Canal
Stomach digestion takes place
Small Intestine absorption takes place
Large Intestine food further processed and ends
up as feces
Anus exit of waste products
Liver (atay) detoxifies drugs and alcohol
2. Accessory Gall bladder serves as reservoir (imbakan)of
Digestive (apdo) bile
Organs Pancreas produces the digestive enzyme
(lapay)
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RUQ LUQ
Small bowel Small bowel
Liver and Gall bladder Left lobe of liver
Pylorus Spleen
Duodenum Stomach
Head of Pancreas Body of pancreas
Portion of ascending and Portion of transverse
transverse colon and descending colon
Right adrenal gland Left adrenal gland
Portion of right kidney Portion of left kidney
RLQ LLQ
Small bowel Small bowel
Cecum and appendix Sigmoid colon
Portion of ascending Portion of descending
colon colon
Lower pole of right Left pole of left kidney
kidney Left ureter
Right ureter
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Fig. 18. The Digestive Process
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Name : Date :
Topic : Score :
I. MATCHING TYPE
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9. URINARY SYSTEM
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Fig. 20. The Urinary Cycle
TRIVIA : Did you know that Female has a shorter Ureter than the Male?
That is why they are more prone on acquiring Urinary Tract Infection
(UTI).
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Name : Date :
Topic : Score :
2.
3.
4.
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10. ENDOCRINE SYSTEM
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TABLE 15. EXOCRINE VS. ENDOCRINE GLANDS
EXOCRINE ENDOCRINE
Have ducts to carry hormones Do not have ducts to carry
hormones
Hormones released outside of the Hormones released inside of the
body body
Have sub-classifications Do not have sub-classifications
Response is slower due travels Response is faster as it travels
through the blood then released directly into the bloodstream
outside
Transmission duration prolonged Transmission duration is shorter as
as hormones passes through the hormones no longer passes
kidney to filter blood through the kidney
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Name : Date :
Topic : Score :
I. MATCHING TYPE
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II. IDENTIFICATION
________ 1. It influences the rate of body metabolism
________ 2. Female organ which produce sex female hormones and ova
________ 3. Secretes insulin when carbohydrates are being digested
________ 4. Produces hormones that balance electrolytes and water in
the body
________ 5. It is the master gland
________ 6. Important in the control of calcium metabolism
________ 7. Stimulate the immune system
________ 8. Male organ which produce male sex hormones and
spermatozoa
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Name : Date :
Topic : Score :
Guideline Questions
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6. It distributes the nutrients to the body.
a. Digestive System
b. Circulatory System
c. Integumentary System
d. Urinary System
7. All are included in the pectoral girdle EXCEPT
a. Clavicle
b. Scapula
c. Humerus
d. Sternum
8. Number of bones found in the skull.
a. 26
b. 27
c. 28
d. 29
9. It extends laterally from the top of the sternum to the
scapula.
a. Ribs
b. Humerus
c. Clavicle
d. Scapula
10. It divides the body into anterior and posterior portion.
a. Coronal Plane
b. Sagittal Plane
c. Plantar Plane
d. Transverse Plane
11. Component of the skin that is responsible for sebum
production.
a. Melanin
b. Keratin
c. Sebaceous gland
d. Eccrine gland
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12. All are normal heart rate of an infant EXCEPT
a. 120 bpm
b. 130 bpm
c. 100 bpm
d. 90 bpm
13. It carries oxygenated blood EXCEPT
a. Radial Artery
b. Ulnar Artery
c. Pulmonary Artery
d. Brachial Artery
14. Respiratory Range of a 5 year old child
a. 30-40
b. 23-35
c. 20-30
d. 18-26
15. It produces the digestive enzyme
a. Liver
b. Gall bladder
c. Pancreas
d. Adrenal
16. The largest organ in the lymphatic system.
a. Tonsil
b. Spleen
c. Thymus
d. Lymph node
17. It serves as a reservoir for urine.
a. Kidney
b. Ureter
c. Urinary bladder
d. Urethra
18. Have ducts to carry hormones.
a. Endocrine
b. Exocrine
c. Urinary
d. Digestive
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19. It influences the rate of body metabolism.
a. Pituitary gland
b. Adrenal gland
c. Thyroid gland
d. Parathyroid gland
20. It is the process of breaking down of complex nutrients into
simple substances that can be absorbed by the body.
a. Absorption
b. Ingestion
c. Digestion
d. Infestation
II. Identification
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Module 2
MICROBIOLOGY AND PATHOLOGY
Student Objectives:
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MICROBIOLOGY AND PATHOLOGY
A. Basic Terminologies
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4. Disease (sakit) – this refers to a condition of illness that impairs
bodily functions, associated with specific signs and symptoms. It
may be caused by external factors such as invading organisms or
internal factors such as cancer.
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B. Common Microorganisms
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the only
treatment
without
further
medications
C. Infection Process
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D. Signs and Symptoms of Inflammation
CHAIN OF
INFECTION
Infectious Agent
Mode of
Transmission
Causative Agent
Agents that cause disease ( Eg. Mycobacterium Tuberculae,
Helicobacter Pylori )
Reservoir
Where the causative agent stay ( Eg. Sick or infected person )
Portal of Exit
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A port where the agent exit or escape ( Eg. Respiratory Tract,
mucous membrane, Gastrointestinal Tract or urinary tract )
Mode of Transmission
A way on how the causative agent transferred to another either
direct contact or indirect contact.
Direct contact – skin to skin contact
Indirect contact – things used by the infected person like
handkerchief, spoon and fork
Portal of Entry
Where the causative agent enter and get inside the body ( Eg.
Respiratory tract, mucous membrane, Gastrointestinal Tract or
urinary tract )
Susceptible host
If the organism has escaped and entered another organism, the
persons must be susceptible to have an infection.
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Name : Date :
Topic : Score :
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6. A simple fungus reproduces by budding.
a. Fungi
b. Parasites
c. Bacteria
7. An organism living in or on and obtaining nourishment
from another organism.
a. Bacteria
b. Virus
c. Parasites
8. A tiny organism that can only grow in the cells of another
animal.
a. Virus
b. Fungi
c. Protozoans
9. Small one-celled microorganisms of the class
Schizomycetes.
a. Fungi
b. Virus
c. Bacteria
10. Single- celled, tiny living things that are lowest form of
animal life.
a. Protozoans
b. Bacteria
c. Virus
ENUMERATION
The Chain of Infection (in PROPER ORDER)
1. ____________________
2. ____________________
3. ____________________
4. ____________________
5. ____________________
6. ____________________
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E. Pathology of Systems Relevant to the Practice of Massage Therapy
1. Musculoskeletal System
IS MASSAGE
WHAT IS / HOW IS IT
CONDITION NAME INDICATED OR
ARE THEY? RECOGNIZED?
CONTRAINDICATED?
Dislocations Dislocations Acute (New) Massage is indicated in
are traumatic dislocations are the sub-acute stage for
injuries to extremely dislocations, as long as
joints in which painful. The work is conducted
the bones may be within pain tolerance.
articulating visibly separated As the area heals,
bones are and a total loss massage may be useful
forcefully of function for managing scar
separated. occurs at the tissue accumulation
joint. and muscle spasm
around the affected
joint.
Fatigue (pagod) Fatigue is a A person In the absence of other
state of less suffering from contraindicated
than optimal mental or conditions, massage is
performance physical fatigue systemically indicated
because the feels tired, move for fatigue.
body has had inefficiently and
inadequate may be more
rest and prone to injury.
recovery time.
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IS MASSAGE
WHAT IS / ARE HOW IS IT
CONDITION NAME INDICATED OR
THEY? RECOGNIZED?
CONTRAINDICATED?
Fibromyalgia Fibromyalgia is Fibromyalgia is Massage is indicated
a condition diagnosed when for fibromyalgia. Care
that involves other diseases must be taken not to
chronic muscle have been ruled over treat, however
pain, trigger out and seven to because patients are
points tender ten active extremely sensitive to
points and trigger points pain and may have
nonrestora-tive are identified. accumulations of waste
sleep. products in the tissues
that are difficult to
flush out adequately.
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joints sudden onset. times.
especially in
the feet.
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Spasms (pasma), Spasms and Cramps are Massage is locally
cramps (pulikat) cramps are extremely contraindicated for
involuntary painful with acutely cramping
contractions of visible muscle bellies through
skeletal shortening of origin/insertion work
muscle. muscle fibers. can trick the
Spasms are Long term proprioceptors into
considered to spasms are achy letting go. Subacute
be low grade, and cause cramps respond well to
long lasting inefficient massage, which can
contractions, movement, but reduce residual pain
while cramps may not have and clean up chemical
are short-lived, acute waste. It is indicated
very acute symptoms. for long term spasm
contractions. because it can break
through the spasm
pain cycle
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pain will be
present on
passive
stretching of the
affected
ligament.
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Tenosynovitis Tenosynovitis Pain, heat and Massage is locally
is the stiffness will be contraindicated for
inflammation present in the tenosynovitis in the
of a tendon acute stage. In acute stage and very
and or the sub-acute much indicated in the
surrounding stage, only subacute stage.
synovial stiffness and
sheath. it can pain may be
happen present. The
wherever tendon may feel
tendon pass or sound creaky
through these (crepitis) as it
sheaths, but is moves through
especially the sheath. It is
common in the difficult to bend
forearm, fingers with
particularly in tenosynovitis,
the extensor but even harder
muscle. to straighten
them.
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trigger points headaches, jaw
can be painful pain, neck pain,
when touched. low back pain,
And the pain pelvic pain, and
can spread arm and leg
throughout the pain.
affected
muscle
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porosity of the
bones happens
throughout the
body.
2. Integumentary System
Boils (pigsa) Boils are local Boils look like Boils at least locally
staphylococcus acne, too, contraindicate massage
infections except that the and care should be taken
similar to acne, lesions are to make sure the
but they are bigger and they infection is not systemic
not related to usually occur (screen the client for
adolescence or singly rather other symptoms such as
liver than being welling, fever or
dysfunction. spread over a discomfort other than at
large area. the site of the lesion).
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Burns (paso) Burns are First degree Massage is locally
caused by burns involve contraindicated for all
damage to the mild burns (except perhaps
inflammation.
skin that mild sunburns) in the
Second degree
causes the cells burns include acute stage. In the sub-
FIRST DEGREE to die. They blistering and acute and post-acute
can be caused damage at the stages, massage may
by fire, deeper levels of be performed around
overexposure the epidermis. the damaged area
to the sun, dry Third degree within pain tolerance
burns penetrate
heat, wet heat, of the client.
the dermis itself
SECOND DEGREE electricity, and will often
radiation, show white or
extreme cold black charred
and toxic edges. In the
chemicals. post acute stage,
serious burns will
THIRD DEGREE often develop
shrunken
contracted scar
tissue over the
area of affected
skin.
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Dermatitis/ Eczema Dermatitis is an Dermatitis The appropriateness of
umbrella term presents itself in massage depends
for various ways completely on the
source of the problem
inflammation depending on
and the condition of
of the skin. what type of skin the skin. If the skin is
Eczema is a reactions are very inflamed or has
type of atopic elicited. Exposure blisters or other
dermatitis a to poisons oak or lesions, massage is at
Sakit sa balat na non-contagious poison ivy results least locally
may pangangati at skin rash in large inflamed contraindicated until
pamumula. the acute stage has
usually brought wheals, metal
Pamamaga ng balat. passed. If signs indicate
about by an allergies tend to a rash could spread
allergic be less inflamed (e.g. with poison oak)
reaction. and more massage is systemically
Contact isolated in area. contraindicated while
dermatitis is a the irritation is present.
Eczema usually Dry, flaky eczema
related but
appears as one of indicates massage. If
slightly
two varieties; the skin is not itchy and
different type the affected area is
of very dry and
highly isolated as with
hypersensitivit flaky skin a metal allergy to a
(seborrheic watch band or earrings,
y reaction.
eczema) or massage is only locally
. blister weepy contraindicated.
skin (dyshidrotic
eczema)
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hours. skin, massage would
only make a bad
situation worse.
Lice & Mites Lice and mites Mites that cause Massage is
are tiny scabies are too contraindicated for all
arthropods small to see, but three infestations, until
that drink leaves itchy trails infestation has been
blood. They are where they completely eradicated.
highly burrow under If a massage therapists
contagious and the skin. Prefers is exposed to any of
spread through warm, moist these parasites, every
close contact places such as client subsequently
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with skin or the axillae or works on will also be
infested sheets between fingers. exposed even before
or clothing. the therapist shows
Head lice are any symptoms.
easy to see, but
they can hide. A Parasitic infestations
more reliable are something every
sign is their eggs. massage therapist fears
Nits are small, as they are very
white, rice – vulnerable to whatever
shaped flecks is crawling around on
that cling client’s skin.
strongly to hair
shafts.
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in the shaped growths. and shedding skin cells
epidermis, they they usually and it is possible to get
are caused by occur on the warts from another
extremely slow hands. They can person.
acting viruses. affect anyone,
but teenagers
are especially
prone to them.
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3. Circulatory System
IS MASSAGE
CONDITION HOW IS IT
WHAT IS IT? INDICATED OR
NAME RECOGNIZED?
CONTRAINDICATED?
Edema Edema is the Edematous is Massage is
retention of puffy or boggy. If contraindicated for
the interstitial associated with most edemas,
fluid either local infection or particularly pitting
because of quite cool, if it is edema, where tissue
electrolyte or cut off from local won’t immediately
protein circulation. spring back from a
imbalances or touch.
because of
mechanical Indicated edemas
obstruction in include those due to
Di- the circulatory subacute soft tissue
pangkaraniwang or lymphatic injury or temporary
dami ng tubig sa systems. immobilization
mga himaymay ng
katawan, gaya ng
sa mga binti
Embolism or Thrombi are Venous emboli Massage is
Thrombus stationary land in the lungs, systematically
clots; emboli causing contraindicated in the
are clots that pulmonary presence of diagnosed
travel through embolism. thrombi or emboli, as it
the circulatory symptoms of PE is for any disorder
system. include shortness involving potential
of breath, chest blood clots.
Emboli are pain and
usually coughing up
composed of sputum that is
blood but may streaked with
also be blood. Arteries
fragments of (heart attack),
plague, fat the brain
globules air (transient
bubbles, ischemic attack
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tumors or bone or stroke),
chips. kidneys, legs or
some other
organ.
Heart Attack A heart attack Symptoms of Massage is
(atake sa puso) or myocardial heart attacks contraindicated for
infarction (MI), include angina, patients recovering
is damage to shortness of from heart attacks.
the breath, feeling of After complete
myocardium great pressure on recovery, heart attack
caused by a the chest, pain patients may be good
clot or plague around the left candidates for massage
fragment shoulder, pain but not without
getting lodge around the left medical clearance.
somewhere in shoulder and
a coronary arm, jaw and
artery, back.
depriving the
cardiac muscle
of oxygen.
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perimeter of the area
and hydrotherapy can
be helpful. Watch for
signs of
thrombophlebitis or
deep vein thrombosis
and if there is any
doubt, consult a
doctor.
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dahil sa pagkakaroon pitting edema
ng pamumuo. distal to the site,
often with
discoloration
Varicose veins Varicose Varicose veins are Massage is locally
veins are ropey,slightly contraindicated for
distended bluish, elevated extreme varicose veins
veins, veins that twists and anywhere distal to
usually in and turn out of them. Mild varicose
the legs, their usual course. veins contraindicate
caused by they happen most deep, specific work,
valvular in frequently on the but are otherwise safe
competence medial side of the for massage.
and a calf, although they
backup of are also found on
blood the posterior
returning to aspects of the calf
the heart. and thigh.
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4. Nervous System
IS MASSAGE
HOW IS IT
CONDITION NAME WHAT IS IT? INDICATED OR
RECOGNIZED?
CONTRAINDICATED?
Carpal Tunnel Carpal CTS will cause Massage is indicated
Syndrome Tunnel pain, tingling, with extreme caution
Syndrome numbness and for CTS. Work on
(CTS) is weakness in the around the wrists
irritation of part of the hand must stop immediately
the median supplied by the if any symptoms are
nerve as it median nerve. elicited. Some types of
passes under CTS will respond well
transverse to massage. It is
carpal necessary to get a
ligament into medical doctor’s
the wrists. diagnosis in order to
know which type of
CTS’s is present.
Headaches (sakit sa Headaches Tension Massage is
ulo) are pain headaches may systematically
caused by be bilateral and contraindicated for
any number headache due to
generally painful.
of sources. infection or CNS
muscular Vascular disturbance. Massage
tension is the headaches are is indicated for
most often unilateral vascular headaches in
common and have a the subacute stage.
source of distinctive Massage is indicated
pain; “throbbing” pain for tension headaches.
congestive
from blood flow
headaches
are less into the head.
common and Headaches
headaches brought about by
due to central nervous
serious system disease
underlying
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pathology are extreme,
are the rarest severe and
of all. prolonged. they
can have a
sudden or gradual
onset.
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5. Endocrine System
IS MASSAGE
HOW IS IT
CONDITION NAME WHAT IS IT? INDICATED OR
RECOGNIZED?
CONTRAINDICATED?
Diabetes Mellitus Is a group of Early symptoms Massage is indicated
metabolic of diabetes for people with
disorders include diabetes as long as
characterized frequent
their tissue is healthy
by glucose urination,
intolerance or thirstiness, and and they receive
deficiency and increased medical clearance.
disturbances appetite along
in with weight
carbohydrate, loss, nausea
fat and protein and vomiting.
metabolism.
6. Excretory System
IS MASSAGE
HOW IS IT
CONDITION NAME WHAT IS IT? INDICATED OR
RECOGNIZED?
CONTRAINDICATED?
Kidney stones A kidney Small stones Massage is
(bato sa bato) stone is a may show no contraindicated for
deposit of symptoms at all, someone experiencing
crystalline renal colic (a kidney
but larger
substances stone attack) although
inside the stones can it is appropriate for
kidney or the cause extreme people with a history of
ureters. pain that may stones, but no current
be accompanied symptoms.
by nausea and
vomiting. Pain
may refer from
the back into
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the groin and
hips
Renal failure Renal failure is Symptoms of Massage is
a situation in acute and systematically
which the chronic renal contraindicated for
kidneys are failure differ in both acute and chronic
incapable of severity and renal failure.
functioning at type of onset,
normal levels. but they have in
it may be an common
acute or a reduced urine
chronic output,
problem, but systemic edema
it can be life and changes in
threatening. mental state
brought about
by the
accumulation of
toxins in the
blood.
Urinary tract A urinary tract Symptoms of Circulatory massage is
infection infection (UTI) the UTI’s include systematically
(impeksyon sa ihi) is an infection pain and contraindicated during
of the urinary burning acute UTI’s as it is for
tract, usually sensations all acute infections.
by bacteria during Massage may be
that live urination, appropriate in the sub-
normally and frequency, acute stage. Although
harmlessly in urgency and deep work on the
the digestive cloudy or blood abdomen is still locally
tract. – tinged urine. contraindicated until
In the acute signs of infection are
stage fever and gone.
general malaise
may also
present.
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THINGS TO REMEMBER :
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Open wounds and sores ( if skin injury is connected to a
contraindicated underlying condition such as diabetes )
Embolism or Thrombus
Thrombophlebitis or Deep Vein Thrombosis (DVT)
Headaches (due to infection or CNS disturbance)
Renal failure
Urinary tract infection (acute stage)
Absolutely Contraindicated – means massage is TOTALLY not given to
the body
Locally Indicated – means massage is indicated on the affected area
Dislocations (sub-acute stage)
Fibromyalgia
Fractures (in later stage of recovery from fracture)
Systematically Indicated – means massage is indicated in any parts of
the body
Fatigue (in the absence of other contraindicated conditions)
Insomnia
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Name : Date :
Topic : Score :
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a. Tenosynovitis
b. Strains
c. Tendinitis
d. None of the above
6. It is an inflammation of a tendon, due to injury at the
musculotendinous junction.
a. Tendinitis
b. Strains
c. Osteoarthritis
d. None of the above
7. Bacterial infection usually found on the face, neck and upper
back.
a. Burns
b. Boils
c. Acne
d. None of the above
8. An inflammatory skin reaction to an allergen.
a. Hives
b. Eczema
c. Burns
d. None of the above
9. It is a chronic characterized by inflamed lesions covered with
silvery-white scabs of dead skin.
a. Psoariasis
b. Scar tissue
c. Warts
d. None of the above
10. It is a deep bruise between muscle sheaths.
a. Varicose veins
b. Hematoma
c. Hypertension
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d. None of the above
11. The inability to attain adequate amounts of sleep.
a. Insomnia
b. Headaches
c. Hypertension
d. None of the above
12. It is a deposit of crystalline substances inside the kidney.
a. Diabetes Mellitus
b. Kidney stones
c. Headaches
d. None of the above
13. This are distended veins, usually in the legs caused by valvular in
competence.
a. Varicose veins
b. Renal failure
c. Urinary tract infection
d. None of the above
14. An infection of the urinary tract, usually by bacteria that live
normally in the digestive tract.
a. Renal failure
b. Urinary tract infection
c. Carpal Tunnel Syndrome
d. None of the above
15. The growth of new tissue, skin or fascia after injury.
a. Psoarisis
b. Warts
c. Scar Tissue
d. None of the above
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F. INFECTION CONTROL PROGRAM COMPONENTS
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c. Organize regular training program for the staff for essential
infection control practices.
2. EXPOSURE PREVENTION
Treating all clients in a massage facility with the same basic level of
“standard” precautions involves work practices that are essential to
provide a high level of protection to clients, other massage therapists
and other people they get in contact with. Sanitation guidelines for
massage therapist professionals include the following
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Factors to consider when choosing antiseptic agent:
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when hands are visibly soiled
before leaving the facility for the day
b. Use of Lotions
c. Jewelry
d. Fingernails
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h. Environmental cleaning
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4. RECORDS MANAGEMENT
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I. ENUMERATION
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GUIDELINE QUESTION
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Student Objectives:
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A. Basic Terminologies
B. History of Massage
Ancient World
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Latest Developments
C. Effects of Massage
SYSTEM EFFECT OF
DESCRIPTION
AFFECTED MASSAGE
Circulatory Dilates blood Aids in the widening or stretching
System vessels of superficial blood vessels
(napapaluwang
ang mga ugat)
Improves blood Deep stroking improves blood
circulation circulation by mechanically
assisting venous blood flow back to
the heart (nakakatulong sa
pagdaloy ng dugo sa ugat papunta
sa puso)
Decreases blood When blood vessel dilates the
pressure blood pressure decreases
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SYSTEM EFFECT OF
DESCRIPTION
AFFECTED MASSAGE
Urinary Increase urine Massage activates dormant capillary
system output beds and recovers lymphatic fluids
for filtration by the kidney, which, in
turn increases the frequency of
urination and amount of urine
produced.
Promotes the Levels of metabolic wastes like
excretion of nitrogen, inorganic phosphorus and
metabolic wastes sodium chloride in urine are
increased after massage
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Local Contraindications
AREA/S TO BE
CONDITION DESCRIPTION
AVOIDED
Abdominal An abnormally large separation avoid
diastasis between associated bones, as abdomen
between the ribs.
Abnormal lumps Unusual swelling as in skin lumps avoid area
Acne vulgaris A skin disease characterized by avoid infected
(chronic acne) pimples on the face, chest, and area
back. It occurs when the pores of
the skin become clogged with oil,
dead skin cells, and bacteria.
Athlete’s foot A common fungus infection avoid infected
(Tinea Pedis or between the toes in which the skin area
Foot Ringworm) becomes itchy and sore, cracking
and peeling away
Blister A local swelling of the skin that avoid area
contains watery fluid and is caused
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Guideline Questions
Multiple Choices
1. It is a method of healing that applies various techniques like fixed
or movable pressure, holding, vibration, rocking, friction, and
kneading.
a. Massage
b. Swedish Massage
c. Shiatsu Massage
d. Reflex
2. This refers to the presence of a disease or physical condition
making therapy in the usual manner impossible or undesirable.
a. Indications
b. Physiological Effects
c. Psychological Effects
d. Contraindications
3. This is a fitting therapeutic treatment for a given condition, has
beneficial effects and promotes healing.
a. Indications
b. Wellness Massage
c. Psychological Effects
d. Contraindications
4. Refers to results from activities which affect organs and systemic
functions without regard to a particular disease after undergoing
a massage.
a. Wellness Massage
b. Physiological Effects
c. Therapeutic Massage
d. Psychological Effects
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Student Objectives:
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A. Basic Terminologies
10. Vital Signs – This refers to the basic indicators of body function,
usually meaning heartbeats per minute, breaths per minute,
blood pressure, body temperature, and weight.
1
See details of MT Process in the Licensure Performance Protocols (LPP)
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Accesses
deeper
structures as
hip rotators
Reduces trigger
and tender
point activity
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1. Assessment.
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Purpose:
1. To observe the general condition of the client.
2. To serve as a guide in meeting the needs of the client.
3. To aid the massage therapist in planning the client’s therapy
program.
4. To prevent possible injury and complication to the client.
Types:
1. Blood Pressure
2. Pulse Rate
3. Respiratory Rate
4. Temperature
General Considerations:
a. Before vital signs are taken, be sure that the client has
rested and is placed on a comfortable position.
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Blood Respiratory
Dimension Pulse Rate Temperature
Pressure Rate
Normal 120/80 60 – 100
15 – 20 cpm 37.5 ° C
Value mmhg bpm
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5. See to it
that the
size of the
cuff is
appropria
te to the
diameter
of the
limb on
which it is
used.
6. Allow 20 –
30
seconds
for
circulation
to
stabilize if
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b. VISUAL ASSSESSMENT
Purpose:
1. To provide information regarding the conditions of the soft
tissues for any variations of skin coloration.
2. To observe the differences in bilateral symmetry of tissues.
3. To check for any kind of marks or wounds on the skin.
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Purpose:
1. To locate the target muscle that is being palpated.
2. To assess its health by feeling for its tone and texture.
e.g.
Is it tight or loose?
Is it inflamed or tender to touch?
Are there trigger points located within it?
Are fascial adhesions present?
d. SENSORY ASSESSMENT
Purpose:
1. To provide information regarding the conditions of client on
pain tolerance.
2. To assess the clients’ pain through a pain scale.
e.g.
When does the pain occur?
What type of pain is experienced (local or referring)?
What is the level of intensity?
What aggravates / relieves the pain?
Purpose:
1. To help maintain clients’ awareness of movement
2. To decrease or inhibit pain.
3. To determine the joints affected.
Types:
1. Active Range of Motion (AROM) – Limb is actively moved ;
WITH MUSCLE CONTRACTION
2. Passive Range of Motion (PROM) – limb is passively moved;
NO MUSCLE CONTRACTION
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Spinal Column
Flexion Extension
Lateral Flexion
Rotation
Shoulder Girdle
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The elbow joint has the following normal ranges of movement: Flexion,
Extension, Pronation and Supination.
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The wrist joint has the following normal ranges of movement: Flexion,
Extension, Adduction, Abduction and Circumduction.
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The hip joint has the following normal ranges of movement: Flexion,
Extension, Adduction, Abduction Medial Rotation and Lateral Rotation.
Knee Joint
The knee joint has the following normal ranges of movement: Flexion
and Extension.
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The ankle joint has the following normal ranges of movement: Plantar
Flexion, Dorsi Flexion, Inversion and Eversion.
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Inversion – This occurs when the foot moves medially so the sole
faces inward or if the foot is positioned so toes turn in.
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Purpose:
– Preserves basic patient information
– Records changes in patient condition
– Justifies treatment
– Allows continuity of care
– Satisfies regulatory requirements
– Provides data for quality control
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Guideline Questions
Identification
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Student Objectives:
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PREAMBLE/Pambungad
GENERAL RESPONSIBILITIES
DUTIES TOWARD THE CLIENT – The client's health and wellbeing are the
paramount concern of the Massage Therapist.
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DUTIES TO EMPLOYERS
1. A Massage Therapist shall not enter into any agreement with any
institution or enterprise of suspicious or ill repute, or which is in any
manner involved in illegal activities, or whose terms of agreement
violate any provision in this Code.
2. A Massage Therapist employed under a duly registered training
institution or wellness enterprise shall faithfully and wholeheartedly
abide by all legal agreements entered into therewith.
4. A Massage Therapist shall avoid any conflicts of interest, and shall not
engage in any activity that competes with or in any way jeopardizes
the legitimate goals of the wellness enterprise or Training Institution
which the Therapist is bound by mutual agreement to serve.
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EFFECTIVITY
Approved as per
CEMT Resolution No. 2010-001.
jhh/cdmd/hhrdb/11-101
(a) Masseur
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Specific:
1. Upgrade the quality of health services being accorded to the
public;
2. Delineate the scope of functions of massage therapists and
offices responsible in the management of the practice;
3. Recognize the specific offices responsible relative to the
management of facilities providing massage services; and
4. Instill the essence of compassionate service to the
public/clients.
SCOPE
These implementing rules and regulations shall apply to all
facilities providing massage services, and the practitioners.
DEFINITION OF TERMS
I. GENERAL GUIDELINES
Article 1
Organization, Structure and Functions
1.1. Membership
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1.3 Allowance
2.1 Composition
2.3 Honoraria
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Article 2
Examination, Registration and Practice
SECTION 3 Examination
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3.6.1 Only those who have passed the theoretical examination shall
qualify to take the oral/practical examination.
4.1 Issuance
4.1.1 All examinees who have passed the required examination shall
be issued a certificate of registration duly signed by the
chairperson of the committee and approved by the Secretary
of Health.
4.1.2 The certificate of registration shall bear the recent picture and
signature of the successful examinee and will be valid for three
(3) years from the date of issuance. Payment of registration
and miscellaneous fees shall be paid to the Department of
Health.
a. Health certificate;
b. Current professional tax receipt;
c. Current community tax certificate;
d. Receipt as payment of registration and miscellaneous fees
for three (3) years in the amount prescribed by the
Department of Health
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4.2.3 The regional health director concerned shall submit the list of
renewed licenses of massage therapists to the Committee
every last quarter of the year.
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5.1.8 The health certificate shall be clipped visibly in the upper left
portion of the uniform worn while working;
Article 3
Penal Provisions
7.1 Any person who shall violate, disobey, refuse, omit or neglect to
comply with any of the provisions of these rules and regulations,
interfere with or hinder, or oppose any officer, agent or member of
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7.2 All massage therapist and other personnel who shall violate the
provision of P.D. 856 and the IRR shall be punished by revocation or
suspension of license to practice the profession or shall be
prosecuted under Section 103 (a) and (b) of P.D. 856.
These rules and regulations shall take effect after fifteen (15)
days from date of publication in the official gazette or newspaper of
general circulation.
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Guideline Questions
Multiple Choices
1. The client’s health and wellbeing are the paramount concern of the
Massage therapist.
a. Duties Toward The Profession
b. Duties Toward The Client
c. Duties Toward The Co-Practitioners
d. Duties Toward Employers
2. The Massage Therapist shall strive for excellence and advance the
moral reputation of the profession by conducting himself/ herself
with honor and integrity.
a. Duties Toward The Client
b. Duties Toward Employers
c. Duties Toward Co-Practitioners
d. Duties Toward The Profession
3. The Massage Therapist shall obey the laws of the land and all
governing the practice of the profession, as enforced by the duly
constituted authority.
a. Duties Toward The General Public
b. Duties Toward Allied Professionals
c. Duties Toward Employers
d. Duties Toward The Client
4. The Massage Therapist shall strive for excellence and advance the
moral reputation of the profession by conducting himself/ herself
with honor and integrity.
a. Duties Toward The Profession
b. Duties toward The Client
c. Duties Toward Employers
d. Duties Toward Co- Practitioners
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