The Anatomy of Pain

Trigger Point Therapy

Home Study Course
NAT Master Certification

Prepared exclusively for [email protected] Transaction: 9014

 NAT Anatomy of Pain Trigger Point Master Course for Exercise Professionals

Welcome to the Anatomy of Pain - Trigger Point Master Program. This document
contains information to help you complete the course and reflective learning
exam and receive your NAT certification.

A digital copy of your home study course book, “The Concise Book of Trigger
Points - 3rd Edition” by Simeon Niel-Asher, should have arrived by email as two
pdf documents (Part 1 & Part 2) with this exam pack. If you ordered a hard copy
of the book, it’s on its way to you and should be delivered within 7-10 business
days.

Online Reflective Learning Exam

The reflective learning exam is completed online, however we have included the
exam paper in this pack so that you have it to hand whilst you are studying.
Once you are ready, the exam can be easily accessed by clicking on the following
link or by copying and pasting it into your browser:

Anatomy of Pain Trigger Point Exam - NASM

The objective of the reflective learning exam is to ensure that you have gained a
sufficient understanding of the learning material.

Once you have registered for this course, there is no time limit for the
completion of the exam.

Prepared exclusively for [email protected] Transaction: 9014

 Frequently Asked Questions

To help you complete the course and gain your NAT Anatomy of Pain Trigger
Point Master certification, here are some answers to frequently asked questions
that we hope will help you!

1. Where do I start?

We recommend you begin the course by reading the book, “The Concise Book of
Trigger Points - 3rd Edition” and the attached reflective learning papers from
beginning to end. This will give you an overview of the material and an
understanding of what is required from the reflective learning exams.

Then read through each chapter at a slower pace, taking notes if that helps, so
that you gain a deeper understanding of the course. You may need to repeat
this more than once in order to fully grasp the material.

2. Which chapters of the course are examined?

The reflective learning exam is divided into 7 parts and correspond to the
chapters in the “Concise Book of Trigger Points - 3rd Edition” book as follows:

“Concise Book of Trigger

Points - 3rd Edition” Reflective Learning Questions
Chapter(s)
1-6 Theory

7 Face, Head and Neck

8 Trunk and Spine

9 Shoulder and Upper Arm

10 Forearm and Hand

11 Hip and Thigh

12 Leg and Foot

Prepared exclusively for [email protected] Transaction: 9014

3. When do I complete my online Reflective Learning exam?

You can choose to complete the reflective learning exam section by section as
you progress through the course. Your answers will be saved until you return to
the exam. Alternatively, you can complete the course learning first and then
work through the reflective learning exam afterwards. You should choose
whichever method suits your style of learning best.

4. Things I need to know before starting the online Reflective Learning exam:

(i) Your answers are saved as you submit each one, not at the end of the
exam. This means you will not lose any work.

(ii) Avoid using the browser back button as this will not work. Instead, use
the “Previous” button which will be under your Questions.

(iii) How to avoid being logged out of an exam:

• Stay connected to the internet during your exam.

• Do not click away from the exam until you have submitted your answers
and finished the exam.

(iv) If your exam page freezes, you can always click refresh on your web
browser and the exam will again load on the same question/s you were on.

(v) I have saved my exam but how do I resume it?

To resume your exam, go back to the exams' Start Link and select the
Resume option to log in and finish your exam. 


5. Certificates

Once you have satisfactorily completed the exam paper, you will be able to
download your certificate immediately. You may then use the initials “NAT”
after your name.

Prepared exclusively for [email protected] Transaction: 9014

Questions & Support

Please contact us at [email protected] if you require any assistance with

the course or the exams. Our team is always here to help and will respond to
every request within 24 hours (usually even quicker!).

Keep Learning. Keep Healing.

Team NAT

Prepared exclusively for [email protected] Transaction: 9014

 NAT® Anatomy of Pain Trigger Point Master Course
Reflective Learning

Please check all answers that apply

Theory:

1. At what week of foetal development are the ‘proto bones’, ligaments and
muscles in place?
(a) 5
(b) 7
(c) 9

(d) 12

2. Which one of these is NOT a characteristic of a Trigger Point?

(a) Pain, often exquisite, is present at a discrete point
(b) A nodule is embedded within a taut band in the muscle

(c) Pressure reproduces the pain symptoms, with radiations in a specific

and reproducible distribution (map) – often remote from the pressure point
(d) Pain in the distribution of a dermatome

3. Trigger Points make the host muscle shorter and fatter and reduce its mechanical
efficiency
(a) TRUE

(b) FALSE

NAT® Anatomy of Pain Trigger Point Master Course 1

Prepared exclusively for [email protected] Transaction: 9014

4. Trigger Points may cause skin rashes

(a) TRUE
(b) FALSE

5. Trigger Points may cause facial paralysis

(a) TRUE

(b) FALSE

6. What is the ‘defining symptom’ when a trigger point is pressed?

(a) Local Pain
(b) Referred Pain Map

(c) Tingling
(d) Loss of sensation

7. What is the name of the main chemical that activates the electrical voltage across
the ‘synaptic cleft’ of the nerve synapse?
(a) Acetylcholine
(b) Noradrenaline
(c) Nicotine

(d) Sodium

8. What does the Latin word “Myo-“ mean?

(a) Bone

(b) Hair
(c) Tooth
(d) Muscle

NAT® Anatomy of Pain Trigger Point Master Course 2

Prepared exclusively for [email protected] Transaction: 9014

9. A multipennate muscle may have several trigger points at the same time?

(a) TRUE
(b) FALSE

10. Which of the following possible mechanisms put forward by Dommerholt for
trigger point genesis is NOT correct?
(a) Low-level muscle contractions
(b) Uneven intramuscular pressure distribution
(c) Direct trauma

(d) Tendon under-loading

(e) Unaccustomed eccentric contractions
(f) Eccentric contractions in unconditioned muscle
(g) Maximal or submaximal concentric contractions

11. Which of the following chemicals was NOT present in a trigger point milieu as
analysed by Shah et al. (2003)?
(a) Prostaglandins
(b) Substance P

(c) Cytokines
(d) Bradykinin (BK)
(e) Sodium Chloride
(f) Hydrogen (H+)

(g) Calcitonin gene-related peptide (CGRP)

(h) Tumor necrosis factor (TNF-α)

(i) Interleukins IL-1 beta, IL-6, and IL-8 Serotonin
(j) Norepinephrine

NAT® Anatomy of Pain Trigger Point Master Course 3

Prepared exclusively for [email protected] Transaction: 9014

12. What does LTR stand for?

(a) Local Twitch Response

(b) Loaded T-Cell receptor
(c) Laminated Thoracic Receptor
(d) Local Terminal Receptor

13. Which of the following Autonomic Symptoms has NOT been found to be
associated with trigger point activity?
(a) Hypersalivation—increased saliva production

(b) Epiphora—abnormal overflow of tears down the cheek

(c) Conjunctivitis—reddening of the eyes
(d) Ptosis—drooping of the eyelids
(e) Blurring of vision
(f) Inability to alter heart rate with exercise (exercise intolerance)

(g) Increased nasal secretion

(h) Goose bumps

14. What is the name of the chemical released from nociceptors terminals in
Peripheral sensitization?
(a) Substance A
(b) Substance B
(c) Substance P
(d) Substance Z

15. What is the name of the chemical that has been shown to increase sensitivity of
receptors in the spinal cord during Central Sensitization?
(a) Dopamine

(b) Seratonin
(c) N-Methyl-D-Aspirate (NMDA)
(d) 5 Hydroxy-Triptamine (5HT)

NAT® Anatomy of Pain Trigger Point Master Course 4

Prepared exclusively for [email protected] Transaction: 9014

16. Which one of these tight muscles is NOT part of the upper crossed pattern (Janda
1996)?
(a) Upper Trapezius
(b) Levator Scapulae

(c) Pectoralis
(d) Serratus Anterior

17. Which one of these tight muscles is NOT part of the lower crossed pattern (Janda
1996)?
(a) Erector Spinae
(b) Psoas

(c) Quadratus Lumborum

18. Which of the following postural structures commonly manifests trigger points?
(a) Upper Trapezius
(b) Levator Scapulae
(c) Sternocleidomastoideus (SCM),

(d) Erector Spinae

(e) musculo-ligamentous apparatus of the lumbar spine
(f) Gluteus Medius
(g) Gastrocnemius/soleus complex

(h) All of the above

NAT® Anatomy of Pain Trigger Point Master Course 5

Prepared exclusively for [email protected] Transaction: 9014

19. Trigger points are described according to location, tenderness, and chronicity.
Which one of the following is NOT a trigger point classification?
(a) Central

(b) Satellite
(c) Attachment
(d) Degenerative
(e) Diffuse
(f) Latent

NAT® Anatomy of Pain Trigger Point Master Course 6

Prepared exclusively for [email protected] Transaction: 9014

NAT® Anatomy of Pain Trigger Point Therapy Master Course
Reflective Learning

Please check all answers that apply

Face, Head and Neck:

20. Which of the following muscles is NOT related to headaches?

(a) Sternocleidomastoid

(b) Lateral Pterygoid

(c) Semispinalis capitis
(d) Temporalis

21. Which of the following muscles is related to pain in the eye region?
(a) Sternocleidomastoid
(b) Digastricus
(c) Orbicularis oculi

(d) Splenius cervicis

22. Which of the following muscles is related to neck pain?

(a) Sternocleidomastoid
(b) Multifidus
(c) Trapezius

(d) Infraspinatus

NAT® Anatomy of Pain Trigger Point Master Course 7

Prepared exclusively for [email protected] Transaction: 9014

23. What can cause trigger points to form in the occipitofrontalis muscle?

(a) Frowning
(b) Anxiety
(c) Computer use
(d) Wearing a tight hat or helmet

24. A complex and extremely important muscle, the orbicularis oculi is composed of
how many parts?
(a) One

(b) Two
(c) Three
(d) Four

25. What syndrome can be related to pain in the orbicularis oculi muscle?
(a) Marfan’s Syndrome
(b) Iridocorneal endothelial Syndrome

(c) Ptosis-Horner’s Syndrome

(d) Pigment Dispersion Syndrome

26. When is the masseter muscle most easily felt?

(a) When the jaw is clenched

(b) When the mouth is wide open

(c) When the jaw is relaxed
(d) When chewing soft foods

27. Trigger points in the masseter muscle cause referred pain patters in what areas?

(a) Eyebrows
(b) Jaw
(c) Molar teeth
(d) Neck

NAT® Anatomy of Pain Trigger Point Master Course 8

Prepared exclusively for [email protected] Transaction: 9014

28. What causes trigger points to form in the temporalis muscle?

(a) Chewing gum

(b) Tooth grinding/bruxism
(c) Emotional tension
(d) Nail biting

29. Bite plates may be used in order to help ease pain in which muscle?

(a) Occipitofrontalis
(b) Pterygoideus lateralis
(c) Digastricus
(d) Sternocleidomastoid

30. In what areas is the digastricus muscle located?

(a) Chin area

(b) Neck area

(c) Nose area
(d) Jaw area

31. Trigger points in the scalenus anterior, medius and posterior muscles cause pain
patterns in what areas of the body?
(a) Arms
(b) Fingers

(c) Chest
(d) Shoulder

NAT® Anatomy of Pain Trigger Point Master Course 9

Prepared exclusively for [email protected] Transaction: 9014

32. What can cause pain in the scalenus anterior, medius, and posterior muscles?

(a) Smoking
(b) Pillow height
(c) Anxiety
(d) Chronic lung problems

33. The Sternocleidomastoid muscle is involved in which basic functional movement?

(a) Frowning

(b) Clenching jaw

(c) Raising Eyebrows
(d) Turning head to look over shoulder

34. Why do people often clench their jaw muscles?

(a) Stress
(b) Speech

(c) Laughter
(d) Tiredness

35. What are the main symptoms of Temporomandibular Joint Disorder (TMJ)??
(a) Facial pain
(b) Popping sounds
(c) Headaches

(d) Decreased appetite

NAT® Anatomy of Pain Trigger Point Master Course 10

Prepared exclusively for [email protected] Transaction: 9014

36. What are the primary muscles associated with Temporomandibular Joint Disorder
(TMJ)?
(a) Temporalis

(b) Masseter
(c) Sternocleidomastoid
(d) Pterygoideus medialis

37. What are the secondary muscles associated with Temporomandibular Joint
Disorder (TMJ)?
(a) Temporalis
(b) Masseter
(c) Mylohyoid

(d) Anterior digastricus

38. Symptoms of Temporomandibular Joint Disorder (TMJ) are rarely seen in which
age group?

(a) Under 20
(b) Under 30
(c) Under 40
(c) Under 50

NAT® Anatomy of Pain Trigger Point Master Course 11

Prepared exclusively for [email protected] Transaction: 9014

NAT® Anatomy of Pain Trigger Point Therapy Master Course
Reflective Learning

Please check all answers that apply

Trunk and Spine:

39. Which muscles are involved in abdominal pain?

(a) Diaphragm
(b) External oblique

(c) Rectus abdominis

(d) Quadratus lumborum

40. Which muscles are involved in chest pain?

(a) Diaphragm
(b) External oblique
(c) Latissimus dorsi

(d) Transversus abdominis

41. Which muscles are involved in back pain?

(a) Iliopsoas
(b) Multifidus
(c) Longissimus Thoracis

(d) Iliocostalis Thoracis

NAT® Anatomy of Pain Trigger Point Master Course 12

Prepared exclusively for [email protected] Transaction: 9014

42. The erector spinae is comprised of how many sets of muscles organized in parallel
columns?
(a) Two

(b) Three
(c) Four
(d) Five

43. What is the basic functional movement of the erector spinae?

(a) Bending sideways, to pick up objects

(b) Brings the back straight from flexion

(c) Helps turn head back
(d) Important during sneezing and coughing

44. The posterior cervical muscles are comprised of which muscles?

(a) Longissimus capitis
(b) Semispinalis cervicis

(c) Erector Spinae

(d) Semispinalis capitis

45. What can cause pain in the multifidus/rotatores muscles?

(a) Poor posture

(b) Depression
(c) Poor glasses
(d) Scoliosis

NAT® Anatomy of Pain Trigger Point Master Course 13

Prepared exclusively for [email protected] Transaction: 9014

46. What is the meaning of capitis in latin?
(a) Neck
(b) Spine
(c) Head

(d) Back

47. The splenius capitis and splenius cervicis are involved in the movement of which
part of the body?
(a) Shoulders

(b) Back
(c) Spine
(d) Neck

48. Where is the origin of the external oblique muscle?

(a) Upper 4 ribs
(b) Lower 4 ribs
(c) Lower 8 ribs
(d) Upper 8 ribs

49. What is the major action of the transversus abdominis?

(a) Compresses abdomen
(b) Helps rotate neck
(c) Extension of vertebral column

(d) Stabilizes pelvis when walking

NAT® Anatomy of Pain Trigger Point Master Course 14

Prepared exclusively for [email protected] Transaction: 9014

50. What are some of the symptoms related to trigger points in the transversus
abdominis?
(a) Groin pain

(b) Testicular pain

(c) Nausea
(d) Bedwetting in children

51. In what areas of the body are trigger points formed in the rectus abdominis
muscle?
(a) Chest
(b) Abdomen

(c) Pelvis
(d) Neck

52. What advice can be offered regarding pain in the quadratus lumborum muscle?
(a) Correct any leg length discrepancy
(b) Change mattress
(c) Refrain from any exercise

(d) Strengthen abdominal core

53. What are some causes of trigger points in the Iliopsoas?

(a) Pregnancy
(b) Disc problems in lower back
(c) Gardening

(d) Soft mattress

NAT® Anatomy of Pain Trigger Point Master Course 15

Prepared exclusively for [email protected] Transaction: 9014

54. The diaphragm produces what percentage of our breathing capacity?
(a) 40%
(b) 50%
(c) 60%

(d) 70%

55. How many people are affected by lower back pain at least once in their lifetime?

(a) 5 out of 10
(b) 7 out 10
(c) 9 out 10
(d) Everyone

56.. Chronic lower back pain is defined as pain that lasts more than:
(a) 6 weeks

(b) 4 months
(c) 6 months
(d) 1 year

NAT® Anatomy of Pain Trigger Point Master Course 16

Prepared exclusively for [email protected] Transaction: 9014

NAT® Anatomy of Pain Trigger Point Therapy Master Course
Reflective Learning

Please check all answers that apply

Shoulder and Upper Arm:

57. Which muscles are involved in shoulder pain?

(a) Triceps brachii
(b) Biceps brachii
(c) Latissimus dorsi
(d) Supraspinatus

58. Which muscles are involved in arm pain?

(a) Scalenes
(b) Infraspinatus
(c) Supraspinatus
(d) Anterior deltoid

59. What are some causes of trigger points in the trapezius muscle?
(a) Telephone to ear
(b) Scoliosis
(c) Tennis
(d) Playing musical instruments

NAT® Anatomy of Pain Trigger Point Master Course 17

Prepared exclusively for [email protected] Transaction: 9014

60. Where are referred pain patterns noticed for trigger points in the levator scapulae
muscle?
(a) Neck area
(b) Shoulder area

(c) Abdomen
(d) Lower back

61. What is a major action of the levator scapulae muscle?

(a) Depresses scapula
(b) Helps extend flexed arm

(c) Elevates scapula

(d) Rotates shoulder joint

62. What are some indications of trigger points in the rhomboideus muscle?
(a) Localized pain
(b) Grinding/grating joints

(c) Chest pain

(d) Shoulder clicking or snapping

63. Where are referred pain patterns noticed for trigger points in the serratus anterior
muscle?
(a) Ribs 6 to 8
(b) First 3 ribs
(c) Last 8 ribs
(d) Chest

NAT® Anatomy of Pain Trigger Point Master Course 18

Prepared exclusively for [email protected] Transaction: 9014

64. What must be avoided when suffering from trigger points and pain in the serratus
anterior?
(a) Typing

(b) Stress
(c) Cars with heavy steering
(d) Too many push-ups and heavy bench pressing

65. Where are the referred pain patterns noticed for trigger points in the pectoralis
muscle?
(a) Abdomen
(b) Arm
(c) Shoulder

(d) Chest

66. What is important when considering lifestyle changes for patients suffering from
pain and trigger points in the pectoralis major muscle?

(a) Posture when sitting

(b) Sleeping posture
(c) Bra type
(d) Pillow type

67. The deltoideus muscle is made up of how many parts?

(a) One

(b) Two
(c) Three
(d) Four

NAT® Anatomy of Pain Trigger Point Master Course 19

Prepared exclusively for [email protected] Transaction: 9014

68. What can cause trigger points in the supraspinatus muscle?

(a) Carrying heavy objects

(b) Carrying with arms above head
(c) Sleeping positions with arm above head
(d) Dog pulling on leash

69. What is an important action of the infraspinatus muscle?

(a) Helps flex the humerus

(b) Helps prevent dislocation of the shoulder joint
(c) Extends flexed arm
(d) Flexes elbow joint

70. Which of the following muscles is part of the rotator cuff?

(a) Teres minor
(b) Supraspinatus

(c) Infraspinatus
(d) Subscapularis

71. What is an example of the basic functional movement of the subscapularis

muscle?
(a) Reaching above your head

(b) Reaching down to your toes

(c) Reaching to grab an object in front of you
(d) Reaching into back pocket

NAT® Anatomy of Pain Trigger Point Master Course 20

Prepared exclusively for [email protected] Transaction: 9014

72. Which muscle is an antagonist of the biceps brachii?

(a) Teres major

(b) Triceps brachii
(c) Subscapularis
(d) Teres minor

73. Shoulder pain affects what percentage of the population?

(a) 20%
(b) 25%
(c) 30%
(d) 35%

NAT® Anatomy of Pain Trigger Point Master Course 21

Prepared exclusively for [email protected] Transaction: 9014

NAT® Anatomy of Pain Trigger Point Therapy Master Course
Reflective Learning

Please check all answers that apply

Forearm and Hand:

74. Which muscles are involved in elbow/forearm pain?

(a) Triceps brachii
(b) Pectoralis major/minor
(c) Opponens pollicis
(d) Adductor pollicis

75. Which muscles are involved in wrist pain?

(a) Opponens pollicis
(b) Supinator
(c) Flexor carpi ulnaris

(d) Pronator teres

76. Which muscles are involved in thumb pain?

(a) Brachioradialis

(b) Wrist flexors

(c) Palmaris longus

(d) Supraspinatus

NAT® Anatomy of Pain Trigger Point Master Course 22

Prepared exclusively for [email protected] Transaction: 9014

77. Where are the referred pain patters for trigger points in the pronator teres?

(a) Shoulder
(b) Wrist
(c) Forearm
(d) Fingers

78. The plamaris longus muscle is absent in what percentage of the population?

(a) 10
(b) 11
(c) 13
(d) 15

79. Which muscles comprise the wrist flexors?

(a) Flexor carpi ulnaris

(b) Flexor carpi radialis

(c) Flexor digitorum superficialis
(d) Flexor digitorum profundus

80. Which lifestyle changes must be considered for those suffering from trigger points
and pain in the brachioradialis muscle?
(a) Avoid prolonged standing and carrying objects (e.g. briefcase)
(b) Change sleeping position

(c) Take regular brakes when typing

(d) Use wrist supports

81. Which muscles comprise the wrist extensors?

(a) Extensor carpi radialis longus

(b) Extensor carpi radialis brevis

(c) Extensor carpi ulnaris
(d) Flexor carpi radialis

NAT® Anatomy of Pain Trigger Point Master Course 23

Prepared exclusively for [email protected] Transaction: 9014

82. Which lifestyle changes are advised for people with trigger points in the extensor
digitorum muscle?

(a) Take regular breaks from typing

(b) Change mouse every 6 months
(c) Avoid stretching

(d) Avoid sustained gripping

83. What is a main action of the extensor digitorum muscle?

(a) Flexes elbow joint

(b) Extends wrist joint
(c) Extends fingers
(d) Adducts wrist joint

84. In which areas are referred pain patters noticed for trigger points in the wrist
flexors?

(a) Lower arm

(b) Wrist
(c) Hand
(d) Elbow

85. What causes trigger points and pain in the wrist extensors?

(a) Computer mouse/keyboard

(b) Wrist fractures
(c) Prolonged repetitive writing
(d) Playing the violin

NAT® Anatomy of Pain Trigger Point Master Course 24

Prepared exclusively for [email protected] Transaction: 9014

86. Where does pain become more intense in the referred pain patterns for trigger
points in the extensor digitorum?
(a) In specific fingers

(b) Wrist
(c) Lower arm
(d) Palm of hand

87. Where are pain patterns noticed for trigger points in the supinator muscle?
(a) Elbow

(b) Inner arm

(c) Wrist
(d) Thumb

88. What are some symptoms of trigger points in the opponent pollicis/adductor
pollicis muscles?
(a) Thumb pain
(b) Loss of fine motor control
(c) Wrist pain

(d) Forearm pain

89. Which of the following muscles is NOT included in the small hand muscles?

(a) Extensor digitorum

(b) Dorsal interossei
(c) Abductor digiti minimi
(d) Lumbricales

NAT® Anatomy of Pain Trigger Point Master Course 25

Prepared exclusively for [email protected] Transaction: 9014

90. In which finger is the first dorsal interosseus muscle located?
(a) Thumb

(b) Index finger

(c) Middle finger
(d) Ring finger

91. When analysing a wrist condition, pain in which areas of the body must be
considered?
(a) Head
(b) Neck

(c) Shoulder
(d) Elbow

NAT® Anatomy of Pain Trigger Point Master Course 26

Prepared exclusively for [email protected] Transaction: 9014

NAT® Anatomy of Pain Trigger Point Therapy Master Course
Reflective Learning

Please check all answers that apply

Hip and Thigh:

92. What is unique about the gluteus maximus muscle?

(a) Most coarsely fibered muscle

(b) Heaviest muscle in the body
(c) Consists of multiple muscles
(d) Largest muscle in the body

93. How many strong zones of pain are noticed in the buttocks for trigger points in the
gluteus maximus muscle?
(a) 1-2
(b) 2-3

(c) 3-4
(d) 4-5

94. What lifestyle change may help ease the pain of trigger points in the gluteus
medius muscle?

(a) Stretching
(b) Cycling
(c) Daily long walks
(d) Placing a pillow between knees at night

NAT® Anatomy of Pain Trigger Point Master Course 27

Prepared exclusively for [email protected] Transaction: 9014

95. The gluteus minimus muscle is obstructed by the fibers of which muscle?
(a) Gluteus medius
(b) Gluteus maximus
(c) Tensor fasciae latae (TFL)

(d) Piriformis

96. The pain from trigger points in the gluteus minimus can extend down to the:
(a) Toes
(b) Foot
(c) Ankle
(d) Knee

97. What can cause trigger points and pain in the piriformis muscle?

(a) Prolonged driving

(b) Sitting cross-legged
(c) High heeled shoes
(d) Childbirth

98. The piriformis muscle resembles the shape of a:

(a) Tennis ball

(b) Cylinder
(c) Pear
(d) Trapezoid

NAT® Anatomy of Pain Trigger Point Master Course 28

Prepared exclusively for [email protected] Transaction: 9014

99. The hamstrings consist of how many muscles?

(a) 2
(b) 3
(c) 4
(d) 5

100. Which muscle acts as an antagonist to the hamstrings?

(a) Flexor hallucis longus

(b) Lateral rotator group
(c) Quadriceps
(d) Tibialis anterior

101. Which muscle is the largest of the adductor group of muscles?

(a) Adductor brevis

(b) Adductor magnus

(c) Adductor longus
(d) They are all about the same size

102. What can cause trigger points and pain in the adductor muscles?
(a) Hip surgery
(b) Leg splint/cast

(c) Horse riding

(d) Sitting cross-legged

103. The pectineus muscle is sandwiched between which two muscles?

(a) Psoas major and adductor brevis
(b) Psoas major and adductor major

(c) Psoas major and adductor longus

(d) Psoas major and hamstrings

NAT® Anatomy of Pain Trigger Point Master Course 29

Prepared exclusively for [email protected] Transaction: 9014

104. What should those suffering from trigger points and pain in the pectineus muscle
avoid?
(a) Repetitive hip adduction/flexion
(b) Stretching techniques

(c) Yoga positions

(d) Sitting cross-legged

105. What is unique about the sartorius muscle?

(a) Heaviest muscle in body
(b) Most coarsely fibered muscle

(c) Longest strap muscle in the body

(d) Most superficial muscle in the body

106. What type of symptoms may be felt in the thigh by those suffering from trigger
points in the sartorius muscle?
(a) Ache
(b) Sharp pain
(c) Tingling
(d) Immobility

107. Which muscles comprise the quadriceps?

(a) Rectus femoris
(b) Vastus lateralis
(c) Vastus medialis

(d) Vastus intermedius

NAT® Anatomy of Pain Trigger Point Master Course 30

Prepared exclusively for [email protected] Transaction: 9014

108. Which quadricep muscle has two heads of origin and crosses the hip joint as well
as the knee joint?
(a) Rectus femoris

(b) Vastus lateralis

(c) Vastus medialis
(d) Vastus intermedius

NAT® Anatomy of Pain Trigger Point Master Course 31

Prepared exclusively for [email protected] Transaction: 9014

NAT® Anatomy of Pain Trigger Point Therapy Master Course
Reflective Learning

Please check all answers that apply

Leg and Foot:

109. Which of the following muscles is NOT related to ankle pain?

(a) Fibularis group of muscles

(b) Adductor longus

(c) Abductor hallucis
(d) Flexor digitorum longus

110. Which of the following muscles are related to heel pain?

(a) Gastrocnemius

(b) Quadratus plantae

(c) Abductor hallucis
(d) Tibialis posterior

111. Which of the following muscles are related to leg pain?

(a) Gluteus minimus

(b) Tibialis posterior
(c) Adductor brevis
(d) Soleus

NAT® Anatomy of Pain Trigger Point Master Course 32

Prepared exclusively for [email protected] Transaction: 9014

112. Where do the referred pain patterns for trigger points in the tibialis anterior
muscle culminate and cause great pain?
(a) Shin
(b) Ankle joint

(c) Heel
(d) Toe

113. What is a basic functional movement of the extensor digitorum muscle?

(a) Walking up stairs
(b) Sitting cross-legged
(c) Standing on tiptoes

(d) Taking the first leg out of a car

114. Which muscles are antagonists of the extensor digitorum longus muscle?
(a) Flexor digitorum longus
(b) Flexor digitorum brevis
(c) Flexor hallucis longus

(d) Flexor hallucis brevis

115. What are some causes of pain and trigger points in the fibularis longus, brevis,
and tertius muscles?

(a) Direct trauma

(b) Ill fitting boots/shoes
(c) Walking on uneven surfaces
(d) Tight socks

NAT® Anatomy of Pain Trigger Point Master Course 33

Prepared exclusively for [email protected] Transaction: 9014

116. The composite muscle known as the triceps surae is composed of which
muscles?
(a) Popliteus

(b) Gastrocnemius
(c) Soleus
(d) Plantaris

117. What are some symptoms of trigger points in the gastrocnemius muscle?

(a) Calf pain/stiffness

(b) Toe pain
(c) Flat footed
(d) Claw toe

118. The tendon in the plantaris muscle in the leg is equivalent to the tendon of which
muscle in the arm?
(a) Brachioradialis
(b) Opponens pollicis

(c) Palmaris longus

(d) Pronator teres

119. The soleus muscle resembles what shape?

(a) Pear
(b) Fish

(c) Tennis ball

(d) Trapezoid

NAT® Anatomy of Pain Trigger Point Master Course 34

Prepared exclusively for [email protected] Transaction: 9014

120. Which muscle is an antagonist of the soleus muscle?

(a) Abductor hallucis

(b) Gastrocnemius
(c) Plantaris
(d) Tibialis anterior

121. The referred pain patters for trigger points in the popliteus muscle are noticed in
which parts of the body?
(a) Knee
(b) Ankle

(c) Toes
(d) Calf

122. Where is pain strongly felt for trigger points in the flexor digitorum longus
muscle?
(a) Thumb
(b) Calf
(c) Forefoot

(d) Ankle

123. What is unique about the tibialis posterior muscle?

(a) Strongest muscle on the back of the leg
(b) Longest muscle in the leg
(c) Largest muscle in the leg

(d) Deepest muscle on the back of the leg

NAT® Anatomy of Pain Trigger Point Master Course 35

Prepared exclusively for [email protected] Transaction: 9014

124. Which muscles belong to the superficial muscles of the foot?

(a) Abductor hallucis

(b) Flexor digitorum brevis
(c) Abductor digiti minimi
(d) Extensor digitorum brevis

125. Which muscles belong to the deep muscles of the foot?

(a) Adductor hallucis

(b) Quadratus plantae

(c) Abductor digiti minimi
(d) Extensor digitorum brevis

126. Where are referred pain patterns noticed for trigger points in the quadratus
plantae muscle?
(a) Forefoot
(b) Heel
(c) Thumb

(d) Ankle

Congratulations! You have now completed the NAT Anatomy of Pain Trigger Point
Course Reflective Learning Exam.

If you need any help with submitting your exam online, please contact
[email protected].

Keep Learning. Keep Healing.

Team NAT

NAT® Anatomy of Pain Trigger Point Master Course 36

Prepared exclusively for [email protected] Transaction: 9014

Prepared exclusively for [email protected] Transaction: 9014