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Nov 26, 2007
Study Questions – Exam 2
Do: • • • • • • Know Chinese names of all channels (i.e. Lung – Lung Channel of the Hand Taiyin) General path of each channel (i.e., lung begins at MJ, where it goes, etc.) Know location of all acu points Know categories of all points Know needle depths/angles of points Know cautions/contraindications of points (like LI 4 not for preggers, ST 17 not for cupping)
Don’t need to know for exams in this class: • Don’t need to know paths of divergents, luos, just the main paths • Don’t need to know chinese names of acupoints. • Don’t need to know energetics/indications of any point for this class. Know the following cun measurements: From: Axillary crease (anatomical neck of humerus) to cubital crease Lateral hairline to lateral hairline on forehead Distance between the mastoid proceses on the back of the head Front hairline to back hairline Yintang point to front hairline Yintang to Du 20 Front hairline to Du 20 Cubital crease to wrist crease Sternal notch to acromion process Sternal angle (where ribs angle in, ends just above xyphoid proc) to umbilicus (Males) nipple to nipple (Females) distance between mid clavicular lines Umbilicus to pubic symphysis Gluteal fold to popliteal crease Popliteal crease to medial malleolus Cun: 9 9 9 12 3 8 5 12 8 8 8 8 5 14 15 Popliteal crease to lateral malleolus Great trochanter (find this lying on side—highest point of hip) to anterior popliteal crease Du 20 to back hairline Back hairline to Du 14 Yintang to Du 14 Between medial borders of scapula Top to bottom of patella Index finger: proximal phalangeal joint to tip Thumb: width of proximal phalangeal joint Index+mid finger: width of proximal phalangeal joints Know these needling angles: Angle Oblique Perpendicular Perpendicular-oblique Transverse-oblique Transverse Degrees 45 90 70 20 0 16 19 7 3 18 6 2 2 1 1.5
See CAMS for the ones I am missing here.
Page 1 of 33 Catnotes – Study questions for Pt loc I - Exam 2
Page 2 of 33 Catnotes – Study questions for Pt loc I - Exam 2
Lung Taiyin Channel of the Hand
Highlights of the Lung Taiyin channel of the hand. 1. Originates in Middle Jiao 2. Two branches split at LU 7 a. Collateral channel: Back of hand to LI channel on index finger b. Part of Primary: Branch to thenar eminence of the thumb Point LU 1 Categories Front Mu of Lung Meeting pt of LU and SP Location Level with 1st intercostal space 6 cun lateral to midline and 1 cun inferior to LU 2 Methods to locate: 1. Find 1st intercostal space. Find midline, measure 6 cun lateral. 2. Have pt raise arm straight out and parallel to ground. Find hollow of delta/pec triangle. Measure down 1 cun. 1 cun superior and slightly medial to LU 1 in hollow of delta-pectoral triangle. Can palpate when pt raises arm straight out and parallel to the ground. LU 3 Window of Heaven/Sky 3 cun below tip of axillary fold, 6 cun superior to cubital crease on upper arm, groove between lateral border of biceps brachii and shaft of humerus. To locate: 1. Divide distance between tip of axillary fold and cubital crease Perpendicular. 0.5 – 1 cun Angle/Depth Transverse oblique, pointing laterally. 0.5 – 0.8 cun. Caution/Contra Possible pneumothorax with deep perpendicular needling.
Transverse oblique, pointing laterally. 0.5 – 0.8 cun.
Possible pneumothorax with deep perpendicular needling.
5 – 1 cun LU 5 He Sea point of LU Water point of LU Perpendicular 0. groove between lateral border of biceps brachii and shaft of humerus.8 – 1. 3.5 – 1 cun LU 7 Luo connecting pt of LU Command pt head/nape Pinch skin. (abt 1. Slightly flex the elbow for easiest find. Go down 1 cun in groove between lateral border of biceps brachii and shaft of humerus.. Divide the distance between LU 5 and LU 9 in ½ and go 1 cun proximal on this line. insert either with or against the channel. Find border between top 1/3 and bottom 2/3. 2. In upper arm.Point Categories LU 4 Location (9cun) into thirds. Point lies on this borderline in groove between lateral border of biceps brachii and shaft of humerus. Locate LU 5 and LU 9 2. Find border between top 1/3 and bottom 2/3. Radial forearm superior to styloid process of radius. Divide distance between tip of axillary fold and cubital crease (9cun) into thirds.5 cun prox to LI 5) Between tendons of brachioradialis and Angle/Depth Caution/Contra Perpendicular 0. Cubital crease of elbow in radial side depression next to the tendon of the biceps brachii.2 cun LU 6 Xi cleft point of LU Perpendicular 0. . Should be a palpable depression here. To locate: 1. To locate: 1. 2. On flexor aspect of forearm in a line between LU 5 and LU 9.
5 – 1 cun per Deadman 0.5 cun.3 – 0. Level with Heart (HE) 7 point.3 per CAMS LU 10 Perpendicular 0.5 per CAMS Caution/Contra LU 8 Jing River pt of LU Metal pt of LU Note: not on line with LU 5 and LU 9 1 cun proximal to LU 9 in a line connecting LU 5 and LU 9 Find the depression at the base of the styloid process radius and the radial artery.3 – 0. Point is locate on their intersection.5 cun per Deadman 0. To locate: Draw a line down the radial edge of the nail and along the base line of the nail. LU 9 Shu Stream pt of LU Yuan Source pt of LU Hui Mtg pt of Vessels Earth pt of LU channel. 0.1 cun from corner of nail. Locate the point on the border of the red and white skin (or where skin changes textures) Outer corner of thumbnail.2 cun Or prick to bleed .1 – 0.Point Categories Location abductor pollicus longus Convenient though not always accurate locator: hook thumbs together and find point where index finger tip falls.3 – 0. Perpendicular or Oblique (proximal) 0. On thenar emminence. Ying Spring pt of LU Fire pt of LU At wrist joint in depression between radial artery and tendon of abductor pollicus longus (thumb tendon) on border of pisiform bone. midway down the shaft of the 1st metacarpal (thumb).2 – 0. Perpendicular 0.5 – 1 cun LU 11 Jing Well pt of LU Wood pt of LU Ghost pt (sun simiao) Best to use acupressure or for bleeding techniques. Angle/Depth Transverse 0. Oblique (proximally) Perpendicular 0. Beware of the radial artery!! Takes about 5 minutes to stop bleeding should you hit it. Point is between these 2.
2 – 0. Find the depression here. ends on opposite side from start. Use left LI 4 to treat problems on right face/mouth 3. Easier to find if patient makes a loose fist. approx 0.Large Intestine Yangming Channel of the Hand Highlights of the LI channel 1.5 cun Perpendicular 0. Oblique (prox or dist) 0.1 cun from the corner of the nail. Located where the skin changes color and/or texture. Radial border of index finger in a depression just distal to the flare of the metacarpo-phalangeal joint. Point LI 1 Categories Jing Well pt of LI Metal pt of LI Location Radial edge of corner of index fingernail.8 cun Caution/Contra LI 2 Ying Spring pt of LI Water pt of LI . Channel crosses midpoint of body.1 – 0. 2. Twenty points going from lateral index finger nail to naso-labial groove at side of the wing of the nose. Junction of these lines is the point.3 cun Perpendicular-oblique towards palm 0. LI 3 Shu Stream pt of the LI Wood pt of the Li Easier to find if patient makes a loose fist Radial border of the 2nd metacarpal bone just proximal to the flare on the distal head of the bone. Angle/Depth Perpendicular or oblique 0. Prick to bleed.2 cun Alternatively. LI 4 is command pt for face/mouth a. Use right LI 4 to treat problems no left face/mouth b.5 – 0. Located where the skin changes color/texture. Bilateral channel 4. Draw a line down from radial border of the nail and the base of the nail.
. 3. Angle/Depth Perpendicular 0. find the middle point of the 2nd metacarpal bone 2. Point is in the hollow created between the thumb (extensor pollicus longus) and the brevis (tendon leading to the thumb on radial edge of wrist).8 cun Caution: avoid cephalic vein. 2.5 – 0. needle next to the nail. Cock thumb back 3.Point LI 4 Categories Yuan Source pt of LI Command pt face/mouth Note: LI 4 + LV 3 = 4 gates Location Most accurate: 1. LI 5 Jing River point of LI Fire point of LI In “anatomical snuffbox” just across from the transverse crease of the wrist (where LU 9 is) 1. 2. Don’t needle too proximally! Perpendicular 0. Cover it with fingertip. 3. place the mid line of the bend of your opposite thumb on the tight edge from step 1. stretch your thumb and forefinger out in an L shape to create a tight edge in the webbing between the two. Convenient but less accurate: 1. go in toward the 2nd metacarpal bone a bit. bend the thumb here to that the tip touches between the 1st and 2nd metacarpals. Stretch hand out like shaking hands. find the mid distance between the 2nd metacarpal and the 1st metacarpal (prethumb).5 – 1 cun Caution/Contra Contraindicated for pregnancy…unless you’re trying to induce labor.
3 cun proximal to LI 5. Perpendicular 0. Combine proportional and thumb 1 cun to find this. string. 2. Point is on a line between these two. 2. etc . 5 cun proximal to LI 5. Use a measure . edge of sheet. 1. (6 cun) 4. 1. (3 cun) This is LI 6. paper.to mark the distance (12 cun) 3. Find LI 5 and LI 11.5 – 0. Point is on a line between these two.Point LI 6 Categories Luo Connecting pt of LI (fx both LU and LI) Locate LI 5 and LI 11 first! Location Locate LI 5 and LI 11 first. (3 cun above crease. Measure 1 cun distal to this location. Mark the midpoint and divide the distal ½ into half again. 7 cun distal to LI 11.tape. This is LI 7. use a tape or string to find the ½ way point between the two. 9 cun distal to LI 11) Angle/Depth Perpendicular 0.8 Caution/Contra LI 7 Xi Cleft point of LI Locate LI 5 and LI 11 first. After locating LI 5 and 11. 9 cun distal to LI 11. Divide the distance in ½ to find midpoint.5 – 1 cun .
Point is on a line between these two. 3. 3 cun distal to LI 11 (9 cun proximal to LI 5) Note: LI 8-10 are all 1 cun apart!!! 1. Point is on a line between these two. Use a tape measure or string to find the ½ mark between LI 5 and 11. Point is on a line between these two. Should be 1 cun away from LI 8 Perpendicular 0. Half this again to find the ¼ mark. Half this again to find the point. 2. not edges! LI 9 Locate LI 5 and LI 11 first. measure proximally by 1 cun. pushing up to pain threshold.5 – 1 cun (good for acute lumbar pain – insert then do mild activity in the area of the pain. Should be 1 cun away from LI 8 Perpendicular 0. 4 cun distal to LI 11 (8 cun proximal to LI 5) 1.5 – 1 cun LI 10 Note: LI 8-10 are all 1 cun apart!!! Locate LI 5 and LI 11 first. Measure distal from LI 11 and then add 1 more cun distal Should be 2 cun away from LI 9 Angle/Depth Perpendicular 0. 2 cun distal from LI 11 (10 cun proximal to LI 5) Method 1: find LI 8 and divide distance in half. Use a tape measure or string to find the ½ mark between LI 5 and 11. but not injuring) . 2. Method 2: Find LI 9.Point LI 8 Categories Location Locate LI 5 and LI 11 first.5 – 1 cun Caution/Contra Note: LI 8-10 are all 1 cun apart!!! Measure from middle of dot.
not by cun measures.Point LI 11 Categories He Sea pt of LI Earth point of LI Ghost point (sun sim) Location At elbow mid way between LUNG 5 and lateral epicondyle of humerus Location: 1. 2. Point is located on border between distal 1/3 and prox 2/3 in the depression between the lateral border of the biceps brachii and the shaft of the humerus. This point lies inline Perpendicular between them.5 – 1 cun LI 13 Find LI 11 and 15 first Not in line with LI 11and LI 14. run finger down until you feel the curve begin.5 – 1 cun distal to the axillary fold. Point is located at the radial end of the cubital transverse crease. Fully flex elbow. (Also is inline with LU 3 and 4) 1. 3. Find LI 11 and LI 15. Perp 0. Divide this into 1/3’s. If can’t flex elbow: find LU 5 and lateral epicondyle of humerus. Angle/Depth Perpendicular 1 – 1. Backward a bit. Find the humeral shaft. . 2. Point is radial to the tendon of the biceps brachii.5 cun Caution/Contra LI 12 Locate by landmarks. Palpate lateral epicondyle of humerus. 6 cun 0. Use a measure to find distance between LI 11 and axillary fold. Locate with elbow flexed to 90 degrees. 3 cun prox to LI 11.
But you can use 1 hand breadth above LI 11 on line between LI 11 and 15. Tense the arm to feel/see more easily. Trans/Oblique 0. but proportions are more accurate. Move your angle of vision to see it better.8 – 1. I found this by finding the delt tip. Lateral side upper arm. Inline with LI 11-15 Note: some ppl have bigger delts from working out and such. Hold the arm out (airplane) to see the depression here.5 cun .5 cun LI 15 Locate by landmark only!! In depression anterior and inferior to the acromion at the origin of the delt.Point Categories Location Finger cun and proportional measurements are about the same here. up by ~ 1 cun… Angle/Depth Caution/Contra LI 14 Find LI 11 and 15 first Oblique 1 – 1. Women and overweight ppl will have softer definiton here. in visible depression formed by the distal insertion of the deltoid and brachialis. SJ 14 is the depression on the back side of the acromion. so may not be so reliable.
5 cun Perpendicular 0. but on posterior border of SCL muscle Perpendicular 0.3 – 0. LI 17 Locate LI 18 first. bruises when you do. is under high pressure here – hard to stop bleeding. depression medial to the acromion process. (supraspinatus is here?) Angle/Depth Perpendicular 0.3 – 0. Between the sternal head (cnx to sternal notch) and the clavicular head (wider and flat. Go lateral 0. Find the junction between the upper 1/3 and lower 2/3 (Du 26) 3. LI 19 Perpendicular or oblique Transverse up to 1 cun. Contraindicated for moxabustion (classical texts) .5 cun LI 18 Window of Heaven LI 17-18 hardest to find on practicum. Make sure you are finding the tip! 2. Have patient turn head to emphasize SCL muscle.5 – 1 cun Caution/Contra Risk of pneumothorax with deep needling – medial insertion. Divide the philtrum into thirds vertically. 1. Find the laryngeal prominence (adam’s apple).5 cun Carotid artery and jugular vein are both very close here! Palpate for the artery. Locate point level with adam’s apple between sternal head and clavicular head of SCL muscle. more lateral) 1. Point is 1 cun inferior to LI 18. Between lateral extremity of clavicle and scapular spine. This channel crosses the midline of the body! Located on opposite side from where the channel started! Located just lateral to philtrum of the nose. Carotid A.Point LI 16 Categories Location Locate by landmark only! Upper aspect of shoulder. 2.
0.2 – 0. 8. 6. oblique across foot to meet SP 1at medial aspect of great toe. Split at ST 42. terminates at lateral aspect of 3rd toe. 3. Three branches of ST channel a. what to expect. 5. c. High risk of infection. Use a clean dry cotton ball to push the closed eye up and away from the insertion site. what the risks are. No manipulation. 7. down lateral aspect of lower leg. 5. then push in no more than 0. thin needles.5 cun perpendicular. CNT techniques should be strictly applied. 4. . b.3 – 0. Lower anterior aspect of midline on top of foot. 4. use points on legs for ST.5 cun Contraindicated for moxa.Point Categories Location Again. ST 8 doesn’t connect to ST 9. Split at ST 36. terminates at ST 45 . Originates at LI 20 in naso-labial groove lateral to the wing of the nose. then switch to heat to speed healing of bruises. Select short. 2. ST channel goes to upper gums. this is on the opposite side of the midline from where you started! Located in naso-labial groove level with the midpoint of the lateral edge of the wing of the nose (ala nasi) Angle/Depth Caution/Contra LI 20 Terminus of the LI channel Transverse insertion directed medio-superiorly. but to ST 5 Split in ST channel around ST 5. 3. For numbness/pain/swelling in upper gums. Opposite side of the body across the midline from where the channel started! Stomach Yangming Channel of the Foot Highlights of the Stomach Yangming Channel of the Foot 1. have pt hold another 2-3 minutes. no retention. Insert slightly downward. 2. Need good communication with your patient – they need to know what you’re going to do.lateral aspect of 2nd toe nail lower corner. In the event of hematoma. ice 24-48 hours. What do you need to do/know about needling around the eyes? (esp ST 1) 1. Bruising is a real possibility. Press 1 minute after withdrawl.
not always). ST 2 Located by landmark only. Find infraorbital ridge/eyeball space. Location: Inline with ST 1 and ST 3 Perpendicular (very superficial) 0. have pt press addit 2-3 minutes. • Press 1 min when w/draw. but hard to do.9. • Moxa contraindicated. ST 3 Below ST 1 and 2 (usually in a line with them. 0. No moxa!!! Point ST 1 Categories Location Loc’d mid between inner and outer canthus between pupil of eyeball and infraorbital ridge.4 cun Angle/Depth Have pt look upward w/eyes closed. Damage to infraorbital nerve in foramen • Deep insertion could injure eyeball.5 – 0.8 cun ST 4 Perpendicular .4 cun lateral to corner of mouth. level with the lower border of the wing of the nose (ala nasi) on the lateral side of the naso-labial groove. go down between infraorbital ridge and eyeball Method 2: Find the midline between the inner and outer canthus. Method 1: Have patient look straight ahead. Use a dry cotton ball to push eyeball upwards and away from insertion point.5 cun Caution/Contra • Moxa contraindic’d (smoke and burns) • CNT practices • Communicate w/pt • Risk of hematoma – use short/thin needles • Don’t manip/retain. Located directly below midline of eye (below pupils when looking straight ahead) in the depression of the infraorbital foramen depression on the infraorbital ridge. Might need to have pt smile to find groove 0.2 – 0.2 – 0. • No lift/thrust manip. Perpendicular 0.
Go 0.3 cun Transverse/oblique toward another feature (usually ST 6) 0. There’s an artery here to avoid. Feel for the masseter muscle at the angle of the jaw. 4. 2. Have pt clench teeth to find it.5 cun lateral to Du Perpendicular and slightly inferior 0.Point Categories Location Generally in line with ST 1-3.3 – 0.2 – 0. 1 fingerbreadth anterior/superior to angle of the jaw – about 45 degree angle from corner of jaw. but not always. Don’t get this one too high either!! Located on the prominence (highest point) of the masseter (chewing) muscle. 2. 1. usually just anterior to the ear hole.5 – 1 cun Oblique or transverse Contraindicated to . 4. 3.5 cun Caution/Contra ST 5 Don’t get this one too high!! 1.5 cun above lower border of the mandible bone at this location.5 – 0. Clench teeth.8 cun Oblique 0. Find the anterior border of this muscle. should feel a bone pop into this depression. ST 7 ST 8 Located in the zygomatic arch. Find the depression just in front of the ear in the zygomatic arch (ridge of cheekbone as it approaches the ear. Have pt open mouth. relax to needle it.5 cun Transverse toward another point.3 – 0. Corner of the forehead. Should be in the naso-labial groove. Angle/Depth 0. ST 6 Ghost point (sunsim) Perpendicular 0.
Burns infect.5 cun posterior into hairline.5 cun into hairline and above midline of body) 2.Point Categories Location 24. Point is just anterior to this border.5 cun within anterior hairline. level with adam’s apple tip.. More closely related to ST 5 than to ST 8!!! 1. anterior border of SCL sternal Angle/Depth 0.5 cun (5 fingers) from midline of hairline (remember it’s 3 cun from Yintang up to hairline) 2. 0. Contraindication: . Go lateral. Method 3: 1.5 – 1 cun Into the 4th layer of the scalp in loose cnx tissue Caution/Contra moxabustion Not perpendicular! ST 9 Window of heaven Perpendicular 0. Have pt turn head to side 3. 0. 4. Find the tip of the adam’s apple (laryngeal prominence) 2. Double the distance from GB 15 (0. carotid artery moves it thru the body. Caution: Carotid artery located here ST 10 Perpendicular 1. Method 2: 1. Small depression here.5 cun into hairline and above midline eye) to Du 24 (0.5 cun within anterior hairline. Method 1: 1. to the anterior border of the sternal head of the SCL. Go back 0. Three methods for locating. Contraindication: Moxa contra’d. 2. Find the corner of the hairline 2. Go lateral from midline of body at Du 24 this distance. Carotid artery is here – palpate for it then use pressing to hold it aside for puncture On neck.5 – 1 cun 1.
5 cun Contraindicated in preggers. Directly below ST 12 Transverse.5 cun ST 12 Meeting pt of ST. Transverse posterior toward trapezius muscle Point is located at the upper border of the 0. Have patient turn their head to the side while you apply resistance to the chin to make this area more prominent. Find midpoint of clavicle then go downward. The 3 of them make a shallow triangle. Angle/Depth 0. Burns infect. Deep insertion = risk of pneumothorax ST 11 Located at root of neck in the depression located just above the collar bone in the triangle formed by the sternal and clavicular heads of the SCL muscle. Not so safe: Perpendicular 0. ST 13-18: on mamillary line – 4 cun lateral to the midline of the body. 2. GB!! Know this! Can stim many areas w/o adding more points.3 – 0. Have pt turn their head to the side to see this triangular depression. Point Categories Location Angle/Depth ST 13 On mamillary line. midway between ST 9 and ST 11… but not inline with them. More accurate than the finger cun method. aiming toward Contraindic/Cautions Deep or perpendicular insert carries risk of pneumothorax and/or injuring subclavian vessel Deep or perpendicular . Perpendicular 0. LI.3 – 0.3 – 0. Find midpoint of clavicle Safer: 2.5 – 1 cun clavicular bone in the fossa.Point Categories Find ST 11 first!! Location head. Go up into supraclavicular fossa. aiming toward just below the inferior border of the manifestation clavicle. Use finger cun – 4 cun from midline 2.3 – 0. 1. 0. Two methods to locate mamillary line: 1. Small artery here 2. SJ. SI.5 cun Caution/Contra Moxa contra’d. carotid artery moves it thru the body. Caution: Carotid artery located here 1.5 cun ST 14 Middle of the 1st intercostal space on the Transverse.
aiming toward manifestation 0. on mamillary line.5 cun Don’t!!! Deep or perpendicular insert carries risk of pneumothorax Deep or perpendicular insert carries risk of pneumothorax Contraindicated for everything – this is a landmark only. Might need to push breast up to find this intercostal. Some books say is in 5th intercostal just below nipple…ain’t necessarily so.5 cun . Middle of the 5th intercostal space. aiming toward manifestation 0. Middle of the 3rd intercostal space on the mamillary line Technically in the middle of the 4th intercostal space. Transverse. Deep or perpendicular insert carries risk of pneumothorax ST 16 ST 17 Unique… Landmark point ST 18 Transverse.3 – 0.3 – 0.5 cun Transverse.5 cun Contraindic/Cautions insert carries risk of pneumothorax ST 15 Middle of the 2nd intercostal space on mamillary line. but always located in the center of the nipple regardless of where that falls. aiming toward manifestation 0.3 – 0.Point Categories Location mamillary line Note that the intercostal spaces curve upward as they go lateral Angle/Depth manifestation 0.3 – 0.
liver (right) if either organ enlarged.Stomach 19-25 are all upper abdominal points.5 – 1 cun Contraindic/Cautions Deep insertion may injure heart (left). Divide the lower half into halves – this is ST 23.5 – 1 cun . 3. Divide the distance in half. On right side if liver is enlarged can penetrate.5 – 1 cun ST 21 See location notes above and locate accordingly Perpendicular 0. 3. This is ST 21. Distance between these = 8 cun. In thin subjects deep needle can puncture peritoneal cavity. Location for these points works like this: 1. Measure ½ way between mamillary line and the midline. locate ST 21 first. Lie on a different line than 13-18 – located 2 cun from the midline. In thin subjects deep needling can puncture peritoneal cavity. 4 cun. Point ST 19 Categories Location 2 cun lateral to midline. then ST 19 Angle/Depth Perpendicular 0. Other points (even points) lie exactly inbetween. 5. Locate as described above. To find 2 cun you can do any of these: 1. 2. On right side if liver is enlarged can penetrate. ST 25 is on either side of the umbilicus. ST 20 See location notes above and locate accordingly Perpendicular 0. On a muscular patient with 6-pack abs look for the ridge.5 – 1 cun ST 22 See location notes above and locate accordingly Perpendicular 0. Find the center of the umbilicus and the sternal costal angle. Measure with finger cun – least reliable. 2. Probably the best. Divide the upper half again – 2 cun. This is ST 19 4. In thin subjects deep needle can puncture peritoneal cavity.
ST 27 See location notes above . Be sure you communicate well with your patient.5 cun Perpendicular 1 – 1. telling them what you’re palpating for. Cun measures here are larger than the thumb width. d. They may be more comfortable finding this for you.Point ST 23 ST 24 ST 25 Categories Location See location notes above and locate accordingly See location notes above and locate accordingly Angle/Depth Perpendicular 0. This is a reference point b. More on that in a minute. 2. what these points will do for them. In thin subjects deep needling can puncture peritoneal cavity. Find the center of the umbilicus ST 26 through ST 30 are located 2 cun lateral to this line on both sides of the body.5 cun Front Mu point of LI 2 cun lateral to umbilicus Contraindic/Cautions In thin subjects deep needling can puncture peritoneal cavity. so use proportional measures. 3. ST 29: Go ½ way between ST 30 and ST 28. f.5 cun Contraindic/Cautions In thin subjects deep needling can puncture peritoneal cavity. Palpate for top margin of the pubic bone. 2 cun lateral from the midline.5 – 1 cun Perpendicular 0. ST 26 – 30 are lower abdomen points. In thin subjects deep needling can puncture peritoneal cavity. Find the location by dividing the distance a. ST 28: Go ½ cun below the middle mark in 3a. etc. ST 27: Go ½ cun above the middle mark in 3a.5 – 1 cun Perpendicular 1 – 1. In thin subjects deep needling can puncture peritoneal cavity. 1. ST 26: Go ½ way between ST 27 and ST 25. Divide the distance between the umbilicus mark and the top margin of the pubic bone in half. Point ST 26 Categories Location See location notes above Angle/Depth Perpendicular 1 – 1. e. c. ST 30: Top margin of the pubic bone.
2 cun off of midline ST 31 ST 32 Located on upper thigh. can penetrate spermatic cord. Find ASIS and lower border of pubic symphysis 2. In thin subjects deep needling can puncture peritoneal cavity. Perpendicular 1-2 cun Perpendicular 1-2 cun .5 – 1 cun Contraindic/Cautions In thin subjects deep needling can puncture peritoneal cavity.To find: 1. Intersection is ST 31. Alternately.5 cun Perpendicular 1 – 1. ST 29 See location notes above KNOW: for irregular menstruation ST 30 Level with superior border of pubic symphysis. 2. Locate 32-24 with knee flexed 1. Draw a line from ST 31 – lateral superior corner of patella.5 cun Perpendicular 0.Point ST 28 Categories Location See location notes above KNOW: for Abdominal Edema Angle/Depth Perpendicular 1 – 1. Locate point 6 cun above superior border of patella on this line. On men. Contraindication: No Moxa! Cautions: Deep insert superior direction can = penetration peritoneal cav or full bladder. Draw a line down from ASIS and over from pubic symphysis. you can draw a line from the ASIS to the superior lateral corner of the patella and locate the point on this line.
but hand method is close. not the lower one.5 cun ST 35 Oblique towards middle/back of popliteal crease – UB 40 1 – 1. Note: Extrapoint called Xiyan is in the same place. but both lateral and medial. Best: Measure length of knee cap (2 cun) with fingers. Locate point in bulge of vastus lateralis Locate with knee flexed Level with lower border of patella and lateral to the ligament. Body landmarks: Where tibia flares and 1 finger wid off bone crest. Three cun below ST 35 2. Go up above superior border this distance then rotate fingers 45 degrees laterally. yet lower than where the patella is. This ligament looks like an ox’s nose where you’d put the ring through. Three fingers to 2 cun measure 2. Angle/Depth Perpendicular 1 – 1.5 cun Contraindic/Cautions ST 34 Xi Cleft point of ST Perpendicular 1 – 1. Locate 32-24 with knee flexed Three methods to locate this: 1. ST 36 He Sea of ST & Earth pt Lower He-Sea of ST Command pt (ab dis’s) Perpendicular 1 – 1. but often mistaken on exams Location Locate 32-24 with knee flexed On same line as ST 31 and 32. Ways to find this: 1. so ST 35 overlaps. Proportional method is better than 3 cun hand method. 3.5 cun Insertion into joint capsule carries risk of infection of capsule. 3 cun above superior border of patella or 1 cun above ST 34.Point ST 33 Categories Easy to locate. Use the top depression here.5 cun .
3. It is 8 cun to both extremes. This is ST 37. 3. 4. Divide distance from here to popliteal crease to get 4 cun. 2 cun Perpendicular above ST 38. Contraindic/Cautions ST 38 Perpendicular 1 – 2 cun You can also thread from here to UB 57 (at the back of the calf near the base of the calf muscles) . Lower leg. 3. 2. string.Point Categories Highlights to know 1. measuring up from the lateral malleolus. This is ST 38. Find ST 38/40 (in middle – 8 cun – between prominence of lateral malleolus and tibiofemoral joint/popliteal crease). 3 cun inferior to ST 36. Makes sure ST 35 is correct. 2. Use middle or index finger to measure 1 finger breadth lateral to anterior crest of tibia. Find ST 38. 1 – 1. Use a measure (tape. 2. One fingerwidth lateral to crest of tibia. This is the midmark between prominence of lateral malleolus and the tibio-femoral joint crease (level with poplit. etc) to find the distance between the tibiofemoral joint line (even with the popliteal crease) and the lateral malleolus.crease). Mark a spot at this level. Know locating methods Lower He Sea pt of LI ST 37 Location Angle/Depth Level with lower border of tuberosity of tibia. Divide this in half.5 cun 1. Go proximal by 1 cun. one finger’s breadth lateral to the anterior crest of the tibia. 1. Divide the distance between ST 38 and the popliteal crease level into ½ and into ½ again to get 2 cun above ST 38. 3. 1 fingerwid lateral to bone crest.
Keep going proximal and feel for a depression on the other side of the flare of the metatarsals. This is ST 41 Located on dorsum of foot in a depression Perpendicular nd rd formed where the 2 and 3 metatarsals 0. Level with ST 38. Slide your finger proximally and find the end of the depression.5 cun Perpendicular 0. Slight dorsal-flex the foot to see the depression here. See measure techniques for ST 38 above. Good luck with that. extensor hallicus longus (going to the big toe). ST 41 Jing River point of ST Fire point of ST ST 42 Yuan Source for ST Hard to find 1. Feel for it.5 cun meet the cuneiform bones. . Caution: dorsalis pedis artery here. use pressing tech if possible. On the ankle.5 cun Contraindic/Cautions ST 40 Luo connecting pt of ST Perpendicular 1 – 1. level with the prominence of the lateral malleolus. and extensor digitorum longus (most lateral . 2. Be sure to go one finger’s breadth lateral to anterior crest of the tibia. 2.3 – 0. 1. Angle/Depth Perpendicular 1 – 1. Find the depression between the 2nd and 3rd metatarsals.5 – 1 cun Caution: anterior tibial vessels/nerve lie deep to this point.goes to remaining 4 toes). There are 3 major tendons here: tibialis anterior (most medial). 2 finger’s breadth lateral to the anterior crest of the tibia. 3.Point ST 39 Categories Lower He Sea pt of SI Location Located 1 cun below ST 38. Find the depression between extensor hallicus longus and digitorum longus at the bend of the ankle. See location notes above.
5 – 1 cun ST 45 Jing Well pt of ST Metal pt of ST Perpendicular 0. 2. just below the flare at the distal end of the metatarsals.2 cun Alternatively. 1. Intuit a line drawn along the lateral border of the nail and the base of the nail.Point ST 43 Categories Shu Stream pt of ST Wood pt of ST Location Located between 2nd and 3rd metatarsal bones. Angle/Depth Perpendicular 0. Curl toes so you can see the knuckles. Located on 2nd toenail. Point lies on this junction at the lateral aspect of the 2nd toenail. Locate the depression between the 2nd and 3rd metatarsals. Curl toes so you can see the knuckles. Point is in a depression just distal to the knuckles. 2. Locate the depression between the 2nd and 3rd metatarsals.5 cun Contraindic/Cautions ST 44 Ying Spring pt of ST Water pt of ST Located between 2nd and 3rd metatarsal bones. lateral side. Point is in a depression just proximal to the knuckles.3 – 0. 1.1 – 0. 2. bottom corner. prick to bleed. Perpendicular 0. 1. .
Upper leg: ascends along antero-medial aspect of the thigh. After this measurement the Spleen channel is anterior and the Liver channel is posterior. Trunk: intersects Conception vessel. cnx with Stomach. Begins at the medial corner of the nail of the big toe (SP 1) Runs along the medial aspect of the foot on the border where the skin changes color/texture Lower leg: Follows the posterior border of the tibia on the medial aspect. enters Spleen.1 cun the corner of the nail. where does it go? Yes. uncurl to locate. Up to this point the Liver channel is anterior. It travels under the lower surface of the tongue to the root of the tongue (Heart channel is on the upper surface) Briefly describe the path of the Spleen channel.1 cun from Perp or oblique 0. Curl the toes to see the knuckle.Spleen Channel of the Foot Taiyin What channel does the Spleen Channel change positions with. almost on the bottom of the bone.5 cun . 1. it does. Caution/Contra SP 2 Ying Spring Medial side of the big toe in a depression distal/inferior to the first metatarsophalangeal joint. Perp 0. Runs 6 cun lateral to midline Point SP 1 Category Jing Well Ghost point (SSM) Location Needling Medial/dorsal aspect of big toe 0. which is anterior and posterior. Moxa Draw a line down the medial aspect of the nail and another across the lower border of the nail. and where do they change positions? The SP channel changes positions with the LV channel 8 cun above the medial malleolus.3-0. Does the Spleen channel go above the neck? If so. The intersection is the point.
2. Slide fingertip distally over the side of the ball of the foot to find the depression.5 – 1 cun SP 5 Jing River Anterior and inferior to the medial Perp 0. 3. Locate the point on the border where skin changes color/texture.Point Category Location 2. Beware of the deeper depression and see if it goes all the way up to the top of the foot—if so. Medial inferior side of the foot in the depression proximal to the head of the first metatarsal bone (almost under the foot). Palpate along the shaft under the foot to feel. 2. Locate the point on the border where the skin changes texture/color Perp 0. you’re too proximal and you’re on the MT joint. 1.5 cun .5 – 1 cun SP 4 Luo Connecting Confluent Pt of the Penetrating Vessel Medial side of foot in depression distal/inferior to the base of the first metatarsal. 3. Slide your fingertip proximally over the side of the ball of the foot to find the depression. Needling Caution/Contra SP 3 Shu Stream Yuan Source Perp 0. Locate the point on the border where skin changes color/texture.3 – 0. 1. Find the ball of the foot by curling the toes.
6 cun proximal to the tip of the medial malleolus. if not. it’s 15cun from medial mal to the popliteal crease…if you can do 20% of this. Locate this point in relation to SP 6. LIV. Measure 1 hand-breadth above SP 6. Perp 1-1.5cun Contra: preggers SP 7 On medial aspect of the lower leg. Draw a line along the anterior border of the prominence of the medial malleolus and the inferior border of the medial malleolus.5cun . Perp 1-1. use hand cun measure.5 SP 8 Xi Cleft of SP channel Medial leg 3 cun inferior to SP 9 in a depression just posterior to the medial crest of the tibia. While proportional measure is more accurate. 1. 3. and KI channels On medial aspect of lower leg just posterior to the medial crest of the tibia. Locate the point on the intersection of these lines in the depression that you will find here. Might be slightly more anterior than SP 9 due to the curvature of the bone. 2. Locate the point just posterior to the medial crest of the tibia. Observe first – look for the bulge and the depression here.Point Category Location malleolus. Needling Caution/Contra SP 6 Meeting point of the SP. 3 cun superior to the prominence of the medial malleolus. Perp 1-1. bully for you.
Medial side of lower leg in a depression at the angle formed by the medial condyle of the tibia and the posterior border of the tibia. 2. To locate. (FYI. divide 15cun between pop crease and the medial mal into 1/3’s and locate this point at the border between the top 1/3 and bottom 2/3’s. Locate this point like ST 34 – flex the knee. then use the kneecap as a measure. go above the superior border of the patella this much. Run finger in the groove posterior to tibia’s medial border until you find the point where the bone curves back. Alternately. Locate SP 9 first. Perp 1 – 1.” SP 11 Two cun proximal to the superior border of the patella on the medial side on the bulge of the vastus medialis. “To treat wind. Point is located in the depression here. located at same level as GB 34) Needling Caution/Contra SP 9 He Sea Point of SP Perp 1 – 1. find SP 10. then distal by 1 handbreadth. find the ½ way distance between SP 12 and the tibiofemoral joint (pop crease). rotate medially by 45 degrees. 6 cun proximal to SP 10 inline with SP 10 and SP 12. Alternately. skin problems.5 cun Perp 0. treat the blood.5 cun SP 10 #1 point for Blood… tonify and move blood. Medial side of thigh. go 6 cun proximal.5 – 1 cun Caution: deep needling can puncture the femoral artery .Point Category Location To locate: 1.
Locate SP 12 immediately lateral in the depression Caution: deep needle medially may puncture the femoral artery while deep needling laterally can puncture the femoral nerve! SP 13 Meeting pt of SP & LIV with Yin Linking Lower ab.5 cun lateral to ST 30 on the lateral side of the femoral artery. Locate upper border of pubic symphysis at the level of the anterior midline of the body.5 cun Caution: Possible peritoneal puncture with deep needling in thin patients.25 cun and that should be fine. SP 15 Meeting pt of SP & LIV with Yin Linking Four (4) cun lateral to the center of the umbilicus. This should be about right. . On same vertical as the mamillary line.7 cun superior. Locate the pulse of the femoral artery on this line.5 cun from here. 1. 2.5 cun Caution: Can punc peritoneal cav in thin patients if deep needle. 4 cun from midline.5 – 1 cun Cautions: 1. Go lateral 3. Shen says measure to 1. Measure 1 cun diagonally (lateral and superior). but on the anterior midpoint) or 1. Possible peritoneal .5) cun lateral to Ren 2 Perp 0. . SP 14 (NOT part of SP/LIV meeting with Yin Linking…will be on test!) Lower ab. 1. (In the depression at the lateral Perp 0. find SP 12. Verify that you are 4 cun lateral to the midline (on the same vertical level as the mamillary line) Perp 1-1.3 cun inferior to SP 15 (level with umbilicus). To locate.5 – 1 cun (top margin of the pubic symphysis level with ST 30. 4 cun lateral to the midline of the body.Point Category Location Needling Caution/Contra SP 12 Meeting point of SP & LV with Yin Linking Not commonly used Not strong function Three point five (3.5 lateral to SP 12. Perp 1-1. 3.
6 cun to midline. 2. 3 ways: a. 1. 1. 0. Guide needle towards manifestations that need help. Possible peritoneal cav punc in thins. 5th intercostal space. inline with LU 1 and 2.5 – 1 cun Caution/Contra cav punc in thins.5 – 0. Same line as LU 1 and 2 b.8 cun either lateral or medial Caution/Contra Caution: perp insert = risk of pneumothorax. Cautions: 1. Mamillary line + 2 cun 2.8 cun deep. Find the 6 cun mark from midline.5 – 0. Count to the 5th intercostal space (‘bout level with the bra-line) SP 18 Lateral side of chest. Mamillary line + 2 cun. Same line as LU 1 and 2 b. Needling SP 16 Meeting pt of SP with Yin Linking Perp 0. Enlarged liver or spleen at this level. Find the 6 cun mark from midline. Point SP 17 Category Location Lateral side of chest. Count to 4th intercostal (almost always = nip level on dudes) Trans-obl. 4th intercostal space. a. 8 fingers from anterior mid c. 6 cun to midline.5 – 0.Point Category Location border of the rectus abdominis muscle …) On ab 3 cun superior to SP 15 and 4 cun lateral to the midline on lateral border of rectus abdominis muscle. 2. Needling Trans-obl. Enlarged liver or spleen at this level SP 17 – 20 are 6 cun lateral to anterior midline. 0.8 cun either lateral or medial Caution: perp insert = risk of pneumothorax. 2. Needle all of them transverse with intercostal spaces 0. 8 fingers from anterior mid c. .
Same line as LU 1 and 2 b. 2. SP 20 Lateral side of chest. 2. SP 21 Great Luo Connecting of the Spleen Located on the mid-axillary line (from front edge of armpit crease to back edge). 6 cun to midline. level with the 6th or 7th intercostal space Trans-obl along intercostal space 0. Trans-obl. Find the 6 cun mark from midline.8 cun either lateral or medial Caution: perp insert = risk of pneumothorax. Count to 2nd intercostal space.5 – 1 cun Caution: perp insert = risk of pneumothorax. Count to 3rd intercostal space. 2nd intercostal space. 0. Trans-obl. 3 ways: a. 8 fingers from anterior mid c. 8 fingers from anterior mid c.5 – 0. 0. 1. 6 cun to midline.5 – 0.8 cun either lateral or medial Caution: perp insert = risk of pneumothorax. 3 ways: a. Find the 6 cun mark from midline. 1.Point Category Location Needling Caution/Contra SP 19 Lateral side of chest. . Mamillary line + 2 cun. Same line as LU 1 and 2 b. Mamillary line + 2 cun. 3rd intercostal space.
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