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Chapter 3 / Body Systems 141
Urinary bladder
Prostate gland
Bulbourethral gland and duct
Scrotum
gland wraps around the beginning part of the urethra. It has smooth muscle walls that contract during ejaculation, and the force of the contraction aids the expulsion of semen.
External Genitalia
The penis is an external genital organ that is responsible for urination and delivering sperm into the female reproductive tract. There are three areas of spongy tissue that fill with blood during sexual arousal and cause the penis to become erect. The parasympathetic nervous system can trigger erec­tions unrelated to sexual stimulation.
The scrotum holds and protects the testes, maintaining their temperature below normal body temperature to avoid overheating the sperm. Muscles raise and lower the testes, as a protective mechanism; the wrinkled scrotal skin allows movement.
Functions of the Male Reproductive System
The functions of the male reproductive system are to pro­duce the male sex hormone, produce sperm that can fertil­ize a female’s egg, and deliver that sperm to the female.
Sex Hormone
Penis
B
External urethral opening
Figure 3-73. (continued ) (B) Frontal view. (Assets provided by
Anatomical Chart Co.)
Accessory Male Reproductive Organs
The accessory organs of the male reproductive system pro­duce everything in the semen except the sperm. The seminal vesicles, bulbourethral glands, and prostate gland all secrete fluids containing sugar, vitamins, or enzymes. These com­ponents of semen nourish and activate the sperm as well as cleanse the urethra prior to sperm delivery. The prostate
Testosterone is the male sex hormone produced in the tes­tes. It stimulates development and maturation of the male reproductive system, stimulates sperm production, and also results in some secondary sex characteristics of males. When testosterone production increases during the teen years, males undergo some physical changes that accompa­ny their growth: the voice deepens, the bones thicken, skel­etal muscles enlarge, and more body hair grows, especially in the axillary, facial, and pubic areas.
Sperm
Millions of immature sperm are produced daily in the tes­tes, are pushed through the testes with peristaltic smooth muscle contractions, and arrive at the epididymis to mature. Mature sperm contain mitochondria to produce ATP, chem­ical energy. Each is equipped with a flagellum that it uses to propel itself through the ducts and into the female, which it can do only with energy from ATP.
Effects of Massage on the Reproductive Systems
Massage stimulates the parasympathetic nervous system, which increases circulation to the reproductive organs to better deliver nutrients and remove cellular waste. Massage also increases the production of oxytocin and serotonin,
142 INTRODUCTION TO MASSAGE THERAPY
chemicals that regulate moods and stimulate smooth muscle contractions (as are found in the reproductive organs).
The resulting combination of increased blood flow and chemicals to the reproductive organs can unintentionally cause sexual arousal. Most massage schools teach students the physiologic responses that are responsible for sexual arousal so the students can be somewhat prepared for this kind of situation and know how to ethically and profession­ally manage the situation.

Special Senses

The special senses are not contained in a singular body sys­tem. Nonetheless, there are a variety of sensory systems that are important to massage therapy: proprioception, vision, hearing, smell, and taste.
Proprioception
The body’s ability to recognize the location and position of all of its parts at any time is called proprioception. This sensory input is necessary for the body to move in a coordi­nated and safe manner. Proprioceptors, introduced earlier as part of the nervous system section, can be found in the mus­cles, tendons, joints, and inner ear. These sensory neurons convey information to the brain regarding body position, muscle tone, and equilibrium. Muscle spindles are proprio­ceptors located in the muscles that are specifically respon­sible for sensing the length of muscle fibers. Golgi tendon organs are specialized proprioceptors in the tendons that sense tension of the muscle fibers.
Hearing
The ear and its structures provide our sense of hearing. The ear consists of three sections: external ear, middle ear, internal ear.
The external ear includes the pinna (also called the auri­cle), the auditory canal, and the tympanic membrane (also called the eardrum).
The middle ear contains the auditory (eustachian) tube and three small bones called ossicles that amplify incoming sound waves. The ossicles are named for their shape: the malleus is similar to a hammer, the incus resembles an anvil, and the stapes is shaped like a stirrup.
The inner ear is mostly a bony labyrinth of canals that can be divided into three sections. The cochlea is located toward the front and is the hearing center of the ear. It con­tains the organ of Corti, which transmits sound waves to the brain. The vestibule is the next part of the ear, which responds to up-and-down changes in head position and gravity. The semicircular canals are the third portion of the inner ear, and they are sensitive to rotational movement of the head.
Smell
Our sense of smell is made possible by the olfactory mem­brane toward the roof of the nose. Olfactory cells, sensitive to chemicals, are located within the olfactory membrane. The axons of all of the olfactory cells come together to form the olfactory nerve, or cranial nerve I. The olfactory nerve passes through a thin sheet of bone and then comes in contact with the olfactory bulb. From there, the chemical signals are converted into electrical signals and pass down neurons, through the olfactory tract, and to the brain.
Vision
The vision system, or the eye, comprises the following pri­mary structures:
• Cornea—the clear covering that protects the front of the eye
• Iris—the colored part of the eye
• Pupil—the hole in the center of the iris that dilates or constricts in response to light levels
• Lens—the clear, curved part of the eye behind the iris that focuses light onto the retina
• Retina—a light-sensitive layer of tissue lining the back of the eye that transmits the image to the brain
• Sclera—the white, outer layer of the eye
• Vitreous body—the spherical part of the eye behind the lens filled with a gel called vitreous humor
• Extrinsic muscles—muscles that move the eye in all directions
Taste
There are three types of papillae on the tongue that contain taste buds. Fungiform papillae, located near the front of the tongue, contain three to five taste buds each. Circumvallate papillae are found toward the back of the tongue, and each contains over 100 taste buds. Foliate papillae can be found along the sides of the tongue, and they also have over 100 taste buds apiece. Each taste bud has between 30 and 100 taste receptors that transmit information to the brain. Contrary to past teachings and popular belief, each taste receptor is sensitive to each of the five taste sensations: bit­ter, salty, sour, sweet, and umami.
Effects of Massage on the Special Senses
Massage impacts the special senses by invoking the parasym­pathetic nervous system response. The pupils constrict and hearing becomes more acute.
Chapter 3 / Body Systems
is often the goal of massage therapy. Understanding the attachment points and actions of the muscles in this chapter
Knowing the structures and functions of the body and knowing how massage can affect these structures can help you deliver safe and effective treatment. Massage affects the basic unit of life and, ultimately, the organism. It also gives you an opportunity to educate clients about how anatomical and physiological changes affect their health and well-being.
The main function of the skeletal muscles is to create
movement, and restoration of the most functional movement
is especially important because it means you know the struc­tures you are manipulating, both to create benefit and avoid damage. Although massage focuses on the muscular system, massage therapy deals with the whole body. All of the body systems must cooperate for a person to function normally, and the interrelationships between the body systems are a critical part of the big picture of health. The effects of mas­sage on the different body systems are outlined in Table 3-6.
Integumentary System
• Mechanically warms the skin with friction
• Increases circulation of blood and lymph within the skin
• Stimulates sebaceous gland secretions, which make skin more supple and pliable
• Stimulates sweat production, which cools the body upon evaporation of sweat
• Breaks down fascial adhesions in the subcutaneous layer (superficial fascia) to restore circulation and movement to skin
143
Skeletal System
• Joint movement stimulates synovial fluid production, which cushions and lubricates synovial joints
• Increases the health of skeleton by enhancing circulation of blood and lymph to and from the bones
Muscular System
• Increases nutrition and development of muscles by enhancing circulation of blood and lymph to and from the muscles
• Increases the excitability of muscles, making them more sensitive to nerve impulses
• Increases heat in and around muscles to loosen fascia and restore movement and circulation to the muscles
• Decreases hypertonicity in muscles and tendons
Nervous System
• Increases production of dopamine, a pain-relieving chemical involved in voluntary movement and clear thinking
• Increases production of endorphins, strong pain-relieving chemicals
• Increases parasympathetic nervous system activation
• Increases production of enkephalins, strong pain relievers involved in sensory integration
• Increases secretion of oxytocin, a chemical that increases the pain threshold, stimulates smooth muscle contractions, decreases sympathetic nervous system activity, and has sedative effects
• Increases production of serotonin, which generally diminishes pain and appetite, regulates moods and sleep patterns, and stimulates smooth muscle contractions
• Decreases production of cortisol, a natural anti-inflammatory produced in response to stress that can accelerate tissue breakdown and prevent tissue repair
• Decreases substance P, a neurotransmitter that triggers the pain response
Cardiovascular System
• Increases circulation of blood in and around the area being addressed
• Reduces the symptoms of ischemia by increasing circulation to capillaries with poor blood flow
• Increases permeability of capillary walls, enhancing delivery of oxygen and nutrients
• Sustained percussion can cause vasodilation deep within the area being addressed to increase blood flow
Lymphatic System
• Increases circulation of lymph in and around the area being addressed
• Increases circulation of lymph to help the body fight germs
• Increases circulation of lymph, which increases removal of metabolic waste
• Reduces edema
continues on following page
144 INTRODUCTION TO MASSAGE THERAPY
Respiratory System
• Encourages slow, deep contractions of the diaphragm, which helps remove carbon dioxide waste via the lungs
• Percussive techniques can relieve chest congestion by loosening mucus within lungs
Digestive System
• Enhances the digestive process reflexively by stimulating the parasympathetic nervous response
• Mechanically pushes indigestible waste through the intestines
Urinary System
• Increases cellular and chemical waste excreted via urine
• Encourages constriction of the smooth muscle of the urinary bladder to eliminate more urine as a reflexive response of the parasympathetic nervous system
Endocrine System
• Increases delivery of hormones and other chemicals as a result of increased circulation of blood
• Reduces levels of cortisol and epinephrine, stress-related hormones
Reproductive System
• Increases circulation to the reproductive organs
• Increases production of oxytocin and serotonin, which stimulate smooth muscle contractions
• Increases production of serotonin, which regulates moods
Special Senses
• Constricts the pupils
You may want to supplement this text with a book that is dedicated to anatomy and physiology for more thorough information. Countless anatomy and physiology texts are available in libraries and stores; some are listed in the sug­gested readings section at the end of the chapter.
1. Define the following:
Anatomy
Homeostasis
Muscle
Muscle cell
Nerve
Neuron
Osmosis
Peristalsis
Physiology
Tissue
2. Describe where fascia can be found.
3. Define muscle origin and muscle insertion.
4. Identify at least 10 bony landmarks on yourself or
a partner.
5. Name the five functions of the muscular system.
6. List the structures of a whole skeletal muscle.
7. Identify at least four functions of the integumen-
tary system.
8. Compare and contrast the organization and bun-
dled arrangements of the structures of a muscle, bone, and nerve.
9. Describe at least five of the body’s parasympa-
thetic nervous system responses.
10. Describe the difference between the stretch reflex
and the tendon reflex.
11. Name at least five different kinds of sensory receptors.
12. Describe the similarities between the venous sys-
tem and the lymphatic system.
13. Identify at least three effects of massage on the
lymphatic system.
14. Describe at least three different functions of the
respiratory system.
15. Name the five special senses.
Chapter 3 / Body Systems 145
SUGGESTED READINGS
Allen L. Plain & Simple Guide to Therapeutic Massage & Bodywork Examina-
tions . 2nd ed. Baltimore: Lippincott Williams & Wilkins, 2010.
Ashton J, Cassel D. Review for Therapeutic Massage & Bodywork Exams . 3rd ed.
Baltimore: Lippincott Williams & Wilkins, 2011. Balch PA, Balch JF. Prescription for Nutritional Healing . New York: Avery, 2000. Benjamin B, Borden G. Listen to your Pain: The Active Person’s Guide to Understanding,
Identifying, and Treating Pain and Injury . New York: Penguin Books, 1984. Biel A. Trail Guide to the Body . Boulder, CO: Books of Discovery, 1997. Buchholz D. Heal Your Headache: The 1•2•3 Program for Taking Charge of your
Pain . New York: Workman Publishing, 2002. Calais-Germain B. Anatomy of Movement . Seattle, WA: Eastland Press, 1993. Chaitow L. Fibromyalgia and Muscle Pain: Your Self-Treatment Guide . London:
Thorsons, 2001. Chaitow L. Fibromyalgia Syndrome: A Practitioner’s Guide to Treatment . London:
Churchill Livingstone, 2000. Chaitow L, Bradley D, Gilbert C. Multidisciplinary Approaches to Breathing
Pattern Disorders . London: Churchill Livingstone, 2002. Chikly B. Silent Waves: Theory and Practice of Lymph Drainage Therapy: An Os-
teopathic Lymphatic Technique . 2nd ed. Scottsdale, AZ: I.H.H. Publishing,
2004.
Clemente C. Gray’s Anatomy . 30th ed. Philadelphia: Lippincott Williams &
Wilkins, 1985. Cohen BJ, Wood DL. Memmler’s Structure and Function of the Human Body . 7th
ed. Philadelphia: Lippincott Williams & Wilkins, 2000. Cohen BJ, Wood DL. Memmler’s Structure and Function of the Human Body . 9th
ed. Philadelphia: Lippincott Williams & Wilkins, 2009. Crowley LV, Abrams C. Physiology . Springhouse, PA: Springhouse Corpora-
tion, 1993. Gray H, Lewis WH. Anatomy of the Human Body . 23rd ed. Philadelphia: Lea
& Febiger, 1936. Guinness AE, ed. ABC’s of the Human Body: A Family Answer Book . Pleasantville,
NY: Readers Digest Association, 1987. Hendrickson T. Massage for Orthopedic Conditions . Philadelphia: Lippincott
Williams & Wilkins, 2003. Johnston CA. Anatomy . Springhouse, PA: Springhouse Corporation, 1993. Kendall FP, McCreary EK, Provance PG. Muscle Testing and Function . 4thed.
Baltimore: Williams & Wilkins, 1993. Lowe WW. Functional Assessment in Massage Therapy . 2nd ed. Corvallis, OR:
Paci c Orthopedic Massage, 1995. Fortin J. Major Systems of the Body . Milwaukee, WI: World Almanac Library, 2002. Marieb EN. Essentials of Human Anatomy and Physiology . 5th ed. Menlo Park,
CA: Benjamin/Cummings, 1997. Mauskop A, Fox B. What your Doctor May Not Tell You About Migraines: The
Breakthrough Program that Can Help End Your Pain . New York: Warner
Books, 2001. Melloni JL, Dox I, Melloni HP, Melloni BJ. Melloni’s Illustrated Review of
Human Anatomy . Philadelphia: JB Lippincott, 1988. Moyer C, Rounds J, Hannum JW. A meta-analysis of massage therapy re-
search. Psychol Bull 2004;130(1):3–18. Northrup C. Women’s Bodies, Women’s Wisdom . New York: Bantam Books, 1998. Paulino J, Gri th CJ. The Headache Sourcebook . New York: Contemporary
Books/McGraw Hill, 2001. Physicians’ Desk Reference Pocket Guide to Prescription Drugs . 5th ed. New York:
Pocket Books, 2002. Persad RS. Massage Therapy and Medications General Treatment Principles .
Toronto: Curties-Overzet, 2001. Premkumar K. Anatomy & Physiology: The Massage Connection . 3rd ed.
Baltimore: Lippincott Williams & Wilkins, 2012.
Rattray F, Ludwig L. Clinical Massage Therapy: Understanding, Assessing and
Treating over 70 Conditions . Toronto: Talus, 2000.
Scanlon VC, Sanders T. Essentials of Anatomy and Physiology . 2nd ed.
Philadelphia: FA Davis, 1991.
Sieg KW, Adams SP. Illustrated Essentials of Musculoskeletal Anatomy . 2nd ed.
Gainesville, FL: Megabooks, 1985. Sloane E. Anatomy and Physiology: An Easy Learner . Boston: Jones and Bartlett, 1994. Starlanyl D, Copeland ME. Fibromyalgia and Chronic Myofascial Pain: A
Survival Manual . 2nd ed. New York: New Harbinger Publications, 2001. Takahashi T (editorial supervisor). Atlas of the Human Body . New York:
HarperCollins, 1994. Theodosakis MD, Adderly B, Fox B. The Ar thritis Cure . New York: St. Martin’s
Press, 1997. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Tri er Point
Manual. Vol 1. Philadelphia: Lippincott Williams & Wilkins, 1983. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Tri er Point
Manual . Vol 2. Philadelphia: Lippincott Williams & Wilkins, 1992. Utting, B. Lecture notes presented at: Utting School of Massage; 1994; Seattle, WA. Watkins J. Str ucture and Function of the Musculoskeletal System . Champaign, IL:
Human Kinetics, 1999. Werner R. A Massage Therapist’s Guide to Pathology . Baltimore: Lippincott
Williams & Wilkins, 1998. Willis MC. Medical Terminology: The Language of Healthcare . Baltimore:
Lippincott Williams & Wilkins, 1996. http://nccam.nih.gov/health/massage/massageintroduction.htm, accessed
9.5.11.
http://nccam.nih.gov/health/massage/massageintroduction.htm#funded,
accessed 9.5.11. http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/T/Taste.html,
accessed 8.29.11. http://www.ahealthyme.com, accessed 3.5.06. http://www.allaboutvision.com/resources/anatomy.htm, accessed 8.29.11. http://www.bartleby.com/107/pages/page502.html, accessed 3.5.06. http://www.cancer.gov, accessed 3.5.06. http://www.cancer.org, accessed 3.10.06. http://www.cdc.gov, accessed 3.5.06. http://www.cell-biology.com, accessed 3.5.06. http://www.dermnet.org.nz/index.html, accessed 3.5.06. http://www.e-histology.net, accessed 3.5.06. http://www.estrellamountain.edu/faculty/farabee/biobk/biobooktoc.
html, accessed 3.5.06. http://www.factmonster.com/ce6/sci/A0843878.html, accessed 3.5.06. http://www.infoplease.com/ce6/sci/A0818305.html, accessed 3.5.06. http://www.intelihealth.com/IH/ihtIH, accessed 3.5.06. http://www.massagetherapyfoundation.org/research.html, accessed 9.5.11. http://www.mayoclinic.com/invoke.cfm?objectid~43CB5F79-2B33-4F96-
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12
4
Stephanie Simonson
Objectives
Objectives
After reading this chapter, you should be able to . . .
Upon completion of this chapter, the student will be
Name the three types of circulatory
able to:
enhancement massage
Describe 10 directional terms
Describe at least three ways to enhance the
Name the three main types of joints
flow of lymph
Demonstrate at least five pairs of antagonistic
Name and locate the major lymphatic ducts on
body movements on self or partner
an illustration of the skeleton
Demonstrate the difference between concentric and eccentric muscle contractions
Key Terms
Key Terms
Acupressure (AK-yoo-preh-sher): a bodywork modal-
ity in which firm fingertip pressure is applied to points along the energy meridians to regulate the
Anatomical position: Describes a person standing up,
flow of Qi
feet shoulder-width apart, arms at the sides, and palms
Acupressure points: specific points along all of the
facing forward.
meridians where the Qi can be most easily affected
Antagonist: A muscle that moves in opposition to the
by pressure
prime mover.
Contrast therapy: heat application followed by cold
Asymmetric stance (also one-foot-forward stance):
application, also called alternating therapy
Standing position in which both feet areon the ground,
Hydrotherapy: the external or internal use of water for
shoulder-width apart, one foot is in front of the other,
therapeutic use
and the back foot is laterally rotated.
Lymph: interstitial fluid leaked into the tissues via
Biomechanics: The study of how movement of living
capillaries carrying arterial blood
creatures is affected by both internal and external
Meridians: precise and orderly channels or pathways
factors.
through which Qi flows
Body mechanics: The efficient and effective use ofyour
Polarity (poh-LAIR-ih-tee) therapy: a modality in
body when performing massage.
which very light massage strokes are applied on
Concentric contraction: A muscle contraction in which
and off the client’s body to balance electromagnetic
the muscle shortens and the attachment sites of the
fields
muscle move closer together.
Re exology (REE- eks-AH-loh-jee): a modality in
Deep: Refers to something farther from the surface of
which fingertip compression is applied to reflex
the skin, or deeper inside the body.
Demonstrate an abdominal massage
Describe the function of proprioceptors
Name at least four benefits of reflexology
Name the three primary components of good
Demonstrate a basic reflexology treatment
body mechanics
Describe the Oriental concept of energy
Demonstrate the asymmetric stance while
meridians
leaning into a partner on the massage table
Describe the concept of polarity therapy
List at least five ways to minimize your risk forinjury
points on the hand, foot, or ear that affect other parts of the body
Right lymphatic duct: a major drain that collects all
Distal: Refers to something that is farther away from
of the lymph from the upper right quadrant of the
the torso, toward the fingers or toes.
body, including everything on the right side of the
Eccentric contraction: A muscle contraction in which
body above the diaphragm, and empties it into the
the distance between the muscle attachments in-
right subclavian vein
creases and the muscle effectively gets longer.
Shiatsu (shee-AHT-soo): a form of bodywork that
Inferior (also caudad): Refers to something more
uses a combination of acupressure with stretching,
toward the feet, or below.
range of motion, and massage strokes
Insertion of a muscle: The point of attachment thatmoves
Thoracic duct: a major drain that collects the lymph
most during contraction, often at the distal end.
from everywhere in the body except the right side
Joint: The mechanical structure where neighboring bones
of the head and thorax and empties it into the left
are attached, often with connective tissue and cartilage.
subclavian vein
Kinesiology: The study of human movement.
Yang (YAHNG): energy that flows down from the sun
Lateral: Refers to something farther away from the
and is associated with the active, bright, warm,
midline of the body
consumptive, and outward activities of the body
Medial: Refers to something closer to the midline of
Yin (YIHN): energy that flows upward from the earth
the body.
and is associated with the passive, dark, cool,
Origin of a muscle: The attachment on the bone or
supportive, and inward activities of the body
connective tissue structure that is more stationary during muscle contraction.
146
Chapter 4 / Kinesiology and Biomechanics 147
Prime mover (also agonist): The muscle that performs
most of the intended movement.
Proprioceptor (PROH-pree-oh-SEP-tor): Sensory
neuron responsible for detecting body position, muscle tone, and equilibrium.
Proximal: Describes something toward the attachment
point of the limb to the body.
Range of motion (ROM): The end-to-end distance
of a specific joint movement that is structurally possible.
ow that you have a fundamental understanding of the structures and functions of the body systems, it is impor-
N
tant to develop a working knowledge of how movement occurs in the body. Once you understand how the body moves, you will have the foundation to assess your client’s movement patterns and design the appropriate treatment plan.
Kinesiology is the study of human movement.
Biomechanics is the study of how the movement of living crea­tures is affected by both internal and external factors, such as neurological input, muscle–tendon interactions, gravity, and physical strain on the body. Body mechanics is the efficient and effective use of your body while performing massage. It is important to be concerned with body mechanics for two reasons. First, many clients have muscular and soft tissue pain and tension as a result of poor posture, restricted movement, or repetitive stress injuries (RSIs). Understanding how clients have developed their pain patterns allows you to help them pre­vent the development of pain patterns in the future. Ask clients about excessive or restricted movement patterns they encoun­ter on a daily basis and how they move their body repetitively. Their answers will provide you with information about how the clients’ bodies have compensated as a result of these move­ment patterns and give you clues for target areas for massage treatment. Second, in order to achieve longevity in your mas­sage career, you must move your body in an efficient and effec­tive manner to minimize the risk of discomfort, pain, or injury.
There is a lot of terminology in both kinesiology and body mechanics. Learning and using the terms comfortably is necessary to communicate accurately. The best way to learn a new skill is to learn the language from the beginning, so this chapter starts out with the terminology.
Super cial: Refers to something closer to the surface
of the skin.
Superior (also cephalad): Refers to something closer
to a person’s head, or above.
Symmetric stance (also parallel stance): Standing posi-
tion in which both feet face forward about shoulder­width apart, hips face forward, and knees are bent.
Synergist: Assists the prime mover by contracting
at the same time to facilitate more effective movement, also called an accessory muscle.
You will find yourself using this terminology regularly when communicating with clients and other healthcare profession­als as well for keeping accurate and professional records. These terms are a large part of the language of massage.
Anatomical Position
The anatomical position of the body describes a person standing up on both feet, with the feet shoulder-width apart, arms at the sides, and palms facing forward (Fig. 4-1). The

Anatomical Terminology

As a massage therapist you will make observations while looking at a client’s body during assessment, treatment, and documenta­tion. This makes it important for you to know the terminology for anatomical position, planes, directions, and body regions.
Figure 4-1. Anatomical position.
148 INTRODUCTION TO MASSAGE THERAPY
Figure 4-2. Planes of division.
(A)Frontal plane. (B) Sagittal plane. (C)Transverse plane.
Frontal
(coronal) plane
A
anatomical position is used as a reference when describing the locations of structures on the body. When being evaluated for posture, clients stand in the anatomical position as a standard reference point for present and future observations.
Sagittal
plane
BC
Transverse
(horizontal) plane
Superior (cranial)
Planes
The anatomical position is also used in determining the three planes of division: the sagittal, frontal, and transverse. These imaginary planes are like thin walls that divide the body or a specific organ into two parts, and they are used by anatomists as a reference tool. Any kind of physical observa­tion is made in reference to these planes.
A frontal plane (also called a coronal plane) runs verti­cally down the body, dividing the body into front and back parts (see Fig. 4-2A).
A sagittal plane (SA-jih-tuhl) plane also runs vertically down the body, dividing the body into left and right parts (Fig. 4-2B). A sagittal plane can occur anywhere along the body, but if it runs exactly down the midline of the body, creating equal left and right halves, this plane is called the midsagittal or medial plane.
A transverse plane runs horizontally through the body, dividing it into top and bottom parts (Fig. 4-2C).
Directional Terms
Directional terms also refer to the anatomical position, offering specific locational information. These terms are fre­quently used in massage therapy (Fig. 4-3).
Using the medial plane as a reference, two direction­al terms are generated: medial and lateral. Medial refers to something closer to the midline, and lateral refers to
Anterior (ventral)
Medial
Lateral
Figure 4-3. Directional terms.
Proximal
Posterior (dorsal)
Distal
Inferior
(caudal)
Chapter 4 / Kinesiology and Biomechanics 149
something farther away from it. For instance, the ear is lateral to the eye because it is farther away from the midline.
Bilateral is a term that means two sides. In massage, bilateral refers to something on both sides of the body. Amassage therapist’s session notes might include a comment regarding bilateral temporomandibular joint (TMJ) pain, meaning that the client has pain on both sides of the jaw.
Conversely, unilateral refers to something on only one side of the body. Massage session notes that say a client has unilateral TMJ pain would suggest that jaw movement only hurts on one side.
The frontal plane is used as a reference for the terms anterior and posterior. Although these terms are preferred in massage therapy, the terms ventral and dorsal are some­times used. Anterior (ventral) indicates something on the front side of the body or more toward the front. Posterior (dorsal) indicates something on the back side of the body or more toward the back. For example, the nose is anterior to the ear because it is more toward the front side of the body.
The transverse plane generates the terms superior and infe­rior. Superior (sometimes called cephalad) refers to something closer to a person’s head, or above. Inferior (also called caudad) refers to something more toward the feet, or below. The knee is superior to the ankle because it is closer to the head.
Proximal and distal are terms that describe relative loca­tion on the extremities (limbs). Proximal describes some- thing closer to the limb’s attachment point on the body, and distal refers to something that is farther away from the torso, toward the fingers or toes. For example, the elbow is proximal to the wrist, and the wrist is distal to the elbow.
Superficial refers to something closer to the surface of the skin, and deep refers to something farther from the surface of the skin, or deeper inside the body. Superficial and deep are often used in massage therapy to describe the relative position of specific muscles in the body or to describe the depth to which the strokes are being applied. For example, the rhomboids are deep to the trapezius, and compression can access tissues that are too deep to reach with effleurage. Table 4-1 lists all the directional terms, defi­nitions of each, and examples of their usage.
Body Regions
The body is divided into different regions for orientation purposes. The terminology is helpful when you want to refer to a general area of the body. Nearby landmarks are often used as identifiers for these body regions, as shown in Figure 4-4.
Term Definition Example
Term Definition Example
anterior (ventral) pertaining to the front side or toward the front of the
anterior (ventral) pertaining to the front side or toward the front of the
body
body
deep more internal, deeper into the body the lungs are deep to the ribs
deep more internal, deeper into the body the lungs are deep to the ribs
distal farther from the point of attachment or farther from
distal farther from the point of attachment or farther from
the torso
the torso
inferior (caudad) located lower or toward the feet the xiphoid process is inferior
inferior (caudad) located lower or toward the feet the xiphoid process is inferior
a
a
lateral
lateral
a
a
medial
medial
Posterior (dorsal) pertaining to the back side or toward the back of the
Posterior (dorsal) pertaining to the back side or toward the back of the
proximal closer to the point of attachment or closer to the torso the knee is proximal to the
proximal closer to the point of attachment or closer to the torso the knee is proximal to the
superficial closer to the surface of the skin the epidermis is superficial to
superficial closer to the surface of the skin the epidermis is superficial to
superior (cephalad) located higher or toward the head the nose is superior to the navel
superior (cephalad) located higher or toward the head the nose is superior to the navel
a
a
Remember that the body must be in anatomical position (palms forward).
Remember that the body must be in anatomical position (palms forward).
farther away from the midline or toward the sides the ear is lateral to the eye
farther away from the midline or toward the sides the ear is lateral to the eye
closer to the midline or toward the middle of the body the eye is medial to the ear
closer to the midline or toward the middle of the body the eye is medial to the ear
body
body
the nose is anterior to the ears
the nose is anterior to the ears
the fingers are distal to the
the fingers are distal to the elbow
elbow
to the sternal notch
to the sternal notch
the spine is posterior to the
the spine is posterior to the sternum
sternum
ankle
ankle
the muscles
the muscles
150 INTRODUCTION TO MASSAGE THERAPY
Cranial
Cephalic (head)
(cranium)
Facial (face)
Thoracic (chest)
Upper Extremity
Lower extremity
Brachial (arm)
Antebrachial (forearm)
Carpal (wrist)
Femoral (thigh)
Axillary (armpit)
Abdominal (abdomen)
Pelvic (pelvis)
Inguinal (groin)
Phalangeal (fingers)
Patellar (kneecap)
A
Figure 4-4. (A) Anterior body regions.
Tarsal (ankle)
Phalangeal (toes)