College of Massage Therapists of British Columbia (CMTBC) Practice Exam

Which test is most likely to reproduce or intensify symptoms in a long-distance cyclist experiencing sensory loss and functional loss in specific fingers?

1. Direct pressure over pisohamate

2. Flexion of the wrist

3. Extension of the fingers

4. Compression of the arm

The correct answer is: Direct pressure over pisohamate

Direct pressure over the pisohamate is the most likely test to reproduce or intensify symptoms in a long-distance cyclist experiencing sensory loss and functional loss in specific fingers. This area is associated with the ulnar nerve, which can be impacted by prolonged activities, such as cycling. In cycling, particularly during long rides, the position of the hands can lead to compression of the ulnar nerve as it runs through the cubital tunnel at the elbow and can be affected by pressure on the pisohamate area. Applying direct pressure here can provoke or worsen symptoms of numbness and tingling, which aligns with the sensory loss the cyclist is experiencing in specific fingers. Identifying this as a focal point for compression makes it a critical area to assess in the context of the patient's symptoms. The relationship between the ulnar nerve and finger function, particularly in the pinky and half of the ring finger, supports the choice of this test in evaluating the cyclist’s condition. In contrast, other options, such as flexion of the wrist or extension of the fingers, may not specifically target the ulnar nerve or reproduce symptoms associated with this type of nerve compression as effectively as direct pressure over the pisohamate. Similarly, compression of