TCM #2

ST 39

back of knee toward lateral end of popliteal crease depression medial to tendon of biceps femoris . lower he-sea point ST 39 regulates the bladder & treats urinary difficulties. BL 40 command point that treats any type of lumbar area disorders.

popliteal artery

behind the knee

Du 4

below spinous process of 2nd lumbar vertebra . can treat for cold bi syndrome of the hands and feet.

DU 20

can treat for propapse of the rectume or uterus,

DU 16

can treat leg numbness one method of selecting points includes selecting point above to treat below ..or selecting points below to teat above (that is distal points)

in the context of the channels, using the theory of root and manifestation to select acupuncture points for treatment, which part of the body has root points?

choosing distal points is most frequently used selection method for acupuncture treatment. . The Ode to Elucidates Mysteries it is referred to as "the four origins and the three ends. the four origins refers to the limb and the three ends refers to the abdomen, chest, and head, .. the points on the limb (the four ends), particularly below the elbows and knees treat disorders of the three heads (abdomen, chest, and head). ..in relation to roots and branches (ben & biao) theory, the root is the lower and the manifestation is the upper, .. front point of view of channels the extremities are the root and the head, shoulder, back and chest are seen as the manifestation.

what is the needling caution or SI 12, SI 14, SI 15?

deep perpendicular insertion, especially in thin pt carries a substantial risk of inducing a pneumothorax

SI 18. Meeting point of the outer canthus, in the depression at the lower border of the zygomatic bone

directly below outer canthus in depression on lower border of zygoma

TB 3, LU 3, LI 14

empirical points for goiter and scrofula

in treating chronic hemiplegia (3-6 months duration), which modern clinical practice is used

first reduce points on healthy side, then reinforce points on affected side

ST 16

in 3rd intercostal space 4 cun lateral to anterior midline . deep or perpendicular insertion carries a substantial risk of puncturing the lung . needle: transverse -oblique insertion along the intercostal space or with a transverse insertion superiorly or inferiorly along the channel

SP 14, SP 15, & SP 16 Needling caution

in thin pt deep needling may penetrate the peritoneal cavity.

point selection requires a good knowledge of the channel LR 3 is selected to treat vertex headache because of the

internal pathway of the liver channel. . LR channel connects with the brain at the DU 20 which is the uppermost acupuncture point in the body.

GB 38

jing river, sedation point . jing river point: where the qi flows. can treat cough, dyspnea, chills & ever. GB 38 treat: chills, fever, sweating with shivers, disease of the sinew and bones. wandering joint pain, hemiplegia, lumbar pain sedation point (treat excess as it is a fire point on a wood meridian (fire is the son of wood) . GB 38 clears GB channel heat, harmonises shaoyang benefits the sinews and bones, activates the channel & stops pain.

ST 4

lateral to the corner of the mouth, directly below the pupil . can treat atrophy leg disorder with an inability to walk .

Ulna nerve

nerve that affects the little finger side of the arm and the palm of the hand

SI 4

on ulnar side of palm in depression between base of 5th metacarpal bone and hamate bone empirical point for jaundice

medula oblongata

part of the brain that controls breathing, heartbeat, and the size of blood vessels

radial collateral artery

radial recurrent artery

ST 38

shoulder pain empirical point for shoulder pain

GB 8

to treat incessant vomiting and stomach cold.

ST 29

warms the lower jiao; regulates menstruation and benefits the genital region 4 cun below the umbilicus, 2 cun lateral to Ren 3 . ST 29 treats the uterus ST 25 & RN 8 treat diarrhea RN 17: teats chest tightness. LI 20 treats the nose BL 1: treats the eye SI 19 treats the ears.

which distal point would you add to ST 18 & LR 14 to treat breast disease?

. GB 41. . GB 41 Spread LR qi & benefits the chest, lateral costal areas, and the breast, .. the GB Primary channel descends through the chest area and the GB muscle channel links with the breast and nippels. . effective in treating breast distention de to qi stasis preceding the menstrual period, gb 41 also treat breast abscess, . a modern prescription combines GB 41 with GB 37 to stop lactation

which distal points would you add to GB 8 & GB 20 to treat temporal headache

. GB43 . GB 43 clears heat & benefits the head, ears, and eyes. GB 43 is ying spring point that clears liver and GB heat that ascends along the primary channel to the head (headaches, deafness, tinnitus, ear pain or painful outer canthus)

One point is base on channel connections. Which of the flowing point treats nausea and vomiting because of the channel connection to the middle burner?

. LU 1 regulated the function the ST to treat nausea and vomiting because the lU primary channel starts in the middle burner. DU 14: meets all yang primary channel to release external internal pathogenic factors. ST 8 treas headache, in the forehead, vertex or in the occiput because it it a meeting point of the ST channel, GB channel, the Yang linking vessel with connects all of the yang channels (including the Du Mai and Bladder channel which control the top fo the head)

LR 2

. fire, ying-spring, sedation point . ying-spring: where qi glides, clear heat . treats eyes, throat, painful genitals. Yin Ying spring: LR 2 treats excess clears liver fire, spreads liver qi, pacifies liver wind, clears heat & stops bleeding & benefits the lower burner

Which of the following treats too much sweating?

. many point combinations have been handed down through the centuries; many of them appeared in acupuncture prescriptions from classical texts and some from family lineages; one such point combinations LI 4 and KI 7 in the treatment of sweating. Little sweating reinforce LI 4 and reduce KI 7, **much sweating first reduced LI 4 and reinforce KI 7

in Cross needling points to treat painful disorders which points would you select if the pt has pain near TB 4

. select right GB 40. . cross needling is often used with painful disorders particularly in painful disorders you treat the ankle by needling the opposite wrist or vice versa. ..You treat the knee by needling the opposite elbow or vice versa , .. you treat the shoulder by needling the opposite hip or vice versa. in this method the relationship between the six channels are considered in this example ..the right foot-shaoyang channel point (GB 40) is selected to treat left wrist pain near TB 4 the hand-shaoyang channel. a classical point selection for this is the used of LU 5 that is traditionally selected to treat a swollen and painful knee.

Which statement is accurate regarding the meridians?

. the qi of the six yin primary channels reaches the head via divergent channels. only Luo-connecting channels that reach the neck are the ST and HT Luo channels. Six yang primary channel begin or terminate on the face . the qi of Six yin channel reaches the head via different channels . most extraordinary channels ascend to the head except for the dai mai (Girdle vessel).

what lies below BL 40 that should be avoided when needling

. the tibial nerve and the popliteal artery and vein . the point is needled with a perpendicular insertion or prick to bleed the superficial vein

BL 40

. treats eczema, urticaria . benefits the lumbar area and knees activates the channel and stops pain, cools the blood , clears summer-heat & stops vomiting and diarrhea and benefits the bladder.

Crossing channels around the eyes

.UB 1: ST, SI, Yang Qiao, YIn Qiao ST 1: Ren, Yang Qiao GB 1: SI, SJ.

ST perpendicular insertion

0.2 or 0.3 perpendicular or oblique insertion.'' . shallowist insertion

Yin divergent channels

1. Separate from the yin primary channels on the limbs 2. Sometimes enter their pertaining zang 3. Converge with their internally-externally related divergent channel 4. Then join the primary yang channel itself

SI 15

2 cun lateral to the lower border of the spinous process of C7

SP 16

3 cun above center of umbilicus, 4 cun lateral to anterior midline . DEEP needling can injure an enlarged SP

RN 4

3 cun inferior to the umbilicus . can treat hand tremors

BL 52

3 cun lateral to the midline, level with the lower border of the spinous process of L2 and level with BL-23. . DEEP perpendicular needling carry a risk of injuring KD

GB 38

4 cun above the tip of the external malleolus, slightly anterior to the anterior border of the fibula, between the m. extensor digitorum longus and the m. peroneus brevis

SP 15

4 cun lateral to center of umbilicus lateral to rectus abdominis . Deep needling can injure an enlarged SP, LR,

SP 15

4 cun lateral to center of umbilicus lateral to rectus abdominis can treat for inabiltiy to raise the arms.

ST-20 (Cheng Man) Assuming Fullness

5 cun above the umbilicus, 2 cun lateral to Shangwan (REN-13). Needling Method: Puncture perpendicularly 0.5-1.0 inch. Moxibustion is applicable. caution in thin pt. deep needling ma penetrate the peritoneal cavity ST 20-ST 30

ST 30

5 cun below the umbilicus, 2 cun lateral to Ren 2

DU 10

Alleviates cough and wheezing Clears heat and detoxifies poison . empirical point for carbuncles and furuncles

Neck region acupuncture points

Anterior of the SCM: SI 17, ST 9, ST 10 Between 2 heads of the SCM: LI 18, ST 11 Posterior of the SCM: SJ 16, SI 16, LI 17

SJ 22

Approximately 0.5 cun anterior to the upper border of the root of the ear, in a slight depression on the posterior border of the hairline of the temple. caution: superficial temporal artery and vein

Du 15

Approximately 0.5 cun directly superior to the midpoint of the posterior hairline, in the depression between the spinous process of C2 and the body of C1.

LR 13

At the free end of the 11th rib. Spleen MU-point. can treat inability to raise arm

ST-13 (Qi Hu) Qi Door

At the lower border of the middle of the clavicle, 4 cun lateral to the anterior midline. Needling Method: Puncture obliquely 0.3-0.5 inch. Moxibustion is applicable.

ST 10

At the midpoint of the line joining St 9 and St 11, on the anterior border of the SCM . should avoid carotid artery

ST-11 (Qi She) Qi Abode

At the superior border of the sternal extremity of the clavicle, between the sternal head and clavicular head of m. sternocleidomastoideus. Needling Method: Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable. . Avoid puncturing the subclavian vein

which of the following points have a needling caution for causing a possible pneumothorax?

BL 48, BL 43, BL 46

BL 57

BL divergent channel separates from he primary channel in the popliteal fossa, goes up & winds around anus then continues ascending to connect with BL & KI before terminating at the occipital area. BL 57 has been primary distal point for the treatment of all different types of hemorrhoids.

ST 27

Benefits kidneys Firms essence Regulates qi Promotes urination On the lower abdomen, 2 cun lateral to the midline and 2 cun inferior to the umbilicus, level with REN-5 . can treat hemiplegia

ST 18

Benefits the Breasts Reduces Swelling Unbinds the Chest Alleviates Cough & Wheezing Can treat for painful & swollen arms

DU 26

Can treat for lumbar sprain and stiffness.

GB-43 ACTIONS

Clears heat and benefits the head, ears and eyes Clears damp-heat from the channel and reduces swelling Indications: Headache, dizziness and vertigo, pain of the outer canthus, tinnitus, deafness, swelling of the cheek, pain in the hypochondriac region, distending pain of the breast, febrile diseases.

LU 7

Command point of the head/neck . empirical poitn for headache

cubital vein

Connect cephalic and basilic in cubital foss

BL 22 OR BL 23

DEEP perpendicular needlign carries a risk of injuring the kidney. two points should be needled with an oblique or a perpendicular oblique insertion towards the spine

BL 40

He-Sea/Lower He-Sea Point of the Bladder. heavenly star point . He-sea points are where qi goes in ward . her-sea points treat counterflow qi, diarrhea, or disease arising from irregular, diet . tx sudden turmoil disorder with abdominal pain, vomiting & diarrhea, tx urinary symptoms, .

SI 8 (Small Sea)

In the depression between the tip of the olecranon process of the ulna and the tip of the medial epicondyle of the humerus Caution: the ulnar nerve lies deep to this point

SP 5

In the depression distal and inferior to the medial malleolus, midway between the tuberosity of the navicular bone and the tip of the medial malleolus.

ST-43 (Xian Gu) Sunken Valley

In the depression distal to the junction of the 2nd and 3rd metatarsal bones. . wood point & shu stream point, . shu -stream points are where the qi pours through. . ST 43 treat fu organ, abdominal distention, borborygmus, belching, . regulates spleen, dispels edema & regulates & harmonises the ST and intestines.

ST-16 (Ying Chuang) Breast Window

In the third intercostal space, 4 cun lateral to the anterior midline.

an example of the chain & lock point association method of point selection?

LI 15, LI 11, & LI 4 . this method is frequently used to teat atrophy disorder & hemiplegia, the chain & lock generally refers to selection of the three points or near major joint, all from the same affected channel; often just one limb other examples are St 31, st 36, st 41, or SI 10, SI 8, SI 3

which point is often selected for genital disorders?

LR 5 . LR 5 the luo-connecting point whose channel ascends to the genitals. indicated for itching of the genitals, swelling and painful genitals, due to liver qi stasis or liver chanel dmap-heat, also indicated for priapism

ST 9

Level with the tip of and 1.5 cun lateral to the laryngeal prominence, in the depression between the anterior border of the sternocleidomastoid muscle and the lateral border of the thyroid cartilage . Can treat lumbar pain or vomiting

SP 5

Metal and River point of the Spleen . jing river points where the qi flows, . treat cough dyspnea chills & fever. . treats fever without sweating, cough, treat diseases of the voice. . treat loss of voice, halting speech, manic raving, sinews and bones. bone painful obstruction,heavy body with painful joints. . sedation point: treats excess, strengthens the SP, revolves dampness, begefits the sinews and bones, calms the spirit.

LU 5

On the cubital crease of the elbow, in the depression at the radial side of the tendon of biceps brachii.

ST 42

On the dome of the instep of the foot, between the tendons of long extensor muscle of the great toe and long extensor muscle of toes, where the pulsation of the dorsal artery of foot is palpable.

GB 44 - Yin Portals of the Foot

On the lateral side of the 4th toe, approximately .1 cun from the corner of the nail . treat high fever, headache, dizziness, sudden deafness, tinnitus, painful eyes & throat. . treat the upper most reaches of the channel, headache, dizziness, sudden deafness, tinnitus painful eyes, throat

LI 13

On the lateral side of the upper arm, on the line connecting LI 11 and LI 15, 3 cun superior to LI 11. Needling LI 13, should be cautious needling radial collateral artery

Du 3

On the midline of the lower back, in the depression below the spinous process of the fourth lumbar vertebra Can treat inability to move knee

LI 5

On the radial side of the wrist, in the center of the hollow formed by the tendons of extensor pollicis longus and brevis (anatomical snuffbox) . should avoid hitting the cephalic vein

LI 16 Jugu Great Bone

On the upper aspect of the shoulder, in the depression medial to the accordion process and between the lateral extremity of the clavicle and the scapular spine. *Pneumothrorax

anterior tibial artery

One of the popliteal arteries (the other is the posterior tibial artery) that supplies blood to the lower leg muscles and to the muscles and skin on the top of the foot and adjacent sides of the first and second toes. This artery continues to the foot where it becomes the dorsalis pedis artery.

WHICH Of the following points have a needlign caution for causing a possible pneumothorax?

PC 1, SI 14, SI 12

GB 10

Posterior and superior to the mastoid process, at the junction of the superior 1/3 and middle 1/3 of the curved line connecting GB 9 and GB 12. **can treat shoulder or arm pain

ST Divergent Channel

ST divergent channel starts at the upper thigh, ascends and enters the abdomen, goes to the ST organ and SP & ascends to HT. . after entering the HT it goes up along the esophagus, emerges at the mouth area, goes up to the nose, and connects to ST primary channel at the eyes, moreover, ST primary channel connects with DU 24, DU 26 both points can affect the spirit. penetrates the stomach, spleen and heart

BL 21

Stomach Shu. 1.5 Cun lateral to Governing Vessel, between the spinous processes of T12 and L1. . points should be needle with an oblique insertion towards the spine or transverse oblique insertion. BL 22 & BL 23 can injure the KD with deep perpendicular needling.

ST 12 Acuanatomy

Superiorly, the transverse cervical artery . superficially, the intermediate supraclavicular nerve, deeper the supraclavicular portion of brachial plexus.

HE-1

Supreme Spring (Entry point) - Put finger on anterior end of axillary crease where upper arm joins shoulder - Slide finger down under pectoralis major muscle and on axilla - Patient abducts arm so finger is on He 1 Insert needle perpendicular insertion in direction of GB 21 to avoid axillary artery

BL 22

Triple Energizer Shu. 1.5 Cun lateral to Governing Vessel, between the spinous processes of L1 and L2.

UB needle insertion depth

UB 1: perpendicular 0.2-0.3

HT 2

When the elbow is flexed, the point is 3 cun proximal to the medial end of the transverse cubital crease, in the groove medial to the biceps brachii. needling HE 2 may damage the brachial artery . needled with an oblique distal or proximal insertion

GB 36

Xi-cleft point of GB empirical point for jaundice

The Yin divergent channels intersect first with?

Yang divergent channel

SI 8

`has a caution that ulnar nerve lies deep to the point SI 8 SHOULD BE needled with an oblique distal or proximal insertion or with a perpendicular insertion

cephalic vein

a large vein of the arm that empties into the axillary vein

in needling ST 41, what should be avoided?

anterior tibial vessels and nerve

Carotid artery

artery on each side of the neck that supplies blood to the head

dorsalis pedis artery

artery supplying the foot, lateral to the large tendon of the big toe