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Course: Point Location 2 Study Notes – Exam 1 Date: Jan 17, 2008 Heart Channel What is Mu Xi and how does it relate to the Heart Channel? Mu Xi is translated as 1) the eye system or 2) the tissues connecting the eyes to the brain. Heart Channel ascends to the face and connects to Mu Xi. (Condition of Heart is expressed in the inner and outer canthus of the eyes.) What other channel is related to eyes? Liver. Liver and Heart have yang aspects and are the only two yin channels traveling to the face. What are the yang-like aspects of the Heart Channel? 1) Heart has fire 2) Goes to the face – eyes and tongue. Where does the Heart channel begin? Heart organ. What are the branches of the primary channel? Branches: 1) Descends from Heart through diaphragm to Small Intestine organ 2) From Heart, ascends next to esophagus, to face/cheek/eye. 3) Heart to Lung to axilla… Some books say heart to lung, descends, then goes to axilla... down medial aspect of arm to terminate at the radial corner of the nail on the pinkie. Where on the tongue can you find Heart expressed? Heart travels to root of tongue, upper surface of tongue (not lower surface! That’s spleen.) Page 1 of 8 Point HT 1 HT 2 Categories Location Depression at center of axilla. Needling Perpendicular 0.5 – 1 cun To locate: Method 1 Find deepest point of armpit (hollow of axilla) Method 2 (more accurate) Find anterior and posterior ends of the axillary fold. Use a measure to get the distance between the 2 and divide it in half. Avoid the axillary artery. 3 cun proximal to the medial end of the transverse cubital crease, in the groove between the medial side of the biceps brachii and the humeral shaft. Perpendicular 0.5 – 1 cun Beware the axillary artery! Great point for blurry To locate: vision due to the cnx between heart and eyes. Locate with elbow flexed Find the medial end of the transverse cubital crease. Measure proximally 3 cun using hand measure (or measuring tool, dividing axillary crease end to med cub crease end into 3rds). Locate the point at this line in the groove between the humeral shaft and the medial border of the biceps brachii. Note: LU 3-4 and LI 13 are on the lateral border of the biceps brachii. Also, this is generally in line between HT 3 and HT 1, Page 2 of 8 Caution/Contra Medial insertion towards chest may = pneumothorax. Point Categories Location but more important to locate the point in the groove between humerus and biceps. Needling HT 3 He Sea point Medial end of the transverse cubital crease when the elbow is fully flexed. Perpendicular 0.5 – 1 cun To locate: Elbow slightly flexed: Midway between end of cubital crease and the bump of the humeral epicondyle. Elbow fully flexed: Medial edge of the transverse cubital crease. HT 4 Jing River point Radial side of the flexor carpi ulnaris, 1.5 cun proximal to HT 7. Perpendicular 0.3 – 0.5 cun To locate, first find HT 7, measure proximally 1.5 cun. Note: Ht 4-7 are all located inline. 1.5 cun total between Ht 4 and Ht 7. HT 5 Luo Connecting point Radial side of the flexor carpi ulnaris, 1 cun proximal to HT 7. To locate, find HT 7 first, measure proximally by 1 cun. Note: Ht 4-7 are all located inline. 1.5 cun total between Ht 4 and Ht 7. Page 3 of 8 Perpendicular 0.3 – 0.5 cun Caution/Contra Point HT 6 Categories Xi Cleft point Location Radial side of the flexor carpi ulnaris, 0.5 cun proximal to HT 7. Needling Perpendicular 0.3 – 0.5 cun Caution/Contra Caution: ulnar nerve and artery lie adjacent to this point. To locate, find HT 7 first, measure proximally by 0.5 cun. Note: Ht 4-7 are all located inline. 1.5 cun total between Ht 4 and Ht 7. HT 7 Shu-Stream and YuanSource point At the wrist joint on the transverse crease that runs through the pisiform bone. On the radial side of the flexor carpi ulnaris in the depression at the proximal border of the pisiform bone. Perpendicular 0.3 – 0.5 cun HT 8 Ying Spring point Between the 4th and 5th metacarpal bones where the tip of the pinkie rests when you make a fist. Perpendicular 0.3 – 0.5 cun Usually located between the two transverse palmar creases. HT 9 Jing-Well point Dorsal aspect of pinkie on the radial corner of the fingernail. Small Intestine Where does the Small Intestine channel begin? Ulnar side of little finger on corner of fingernail. What is the path of the SI primary channel? Page 4 of 8 Perpendicular 0.1 – 0.2 cun Ascends along the ulnar (yang) side of the arm, to medial side of elbow (but still on the yang aspect), to shoulder then to Du 14. Goes over shoulder to anterior side of body, up neck to cheek below eye, around and into ear. One branch descends to the lower he-sea point at ST 39. To what organs does the SI channel connect? Heart, Stomach, Small intestine. Point SI 1 Categories Jing-Well point Location Ulnar corner of pinkie fingernail, opposite side from HT 9. Needling Perpendicular 0.1 – 0.2 cun SI 2 Ying-Spring point Ulnar border (where skin changes Perpendicular 0.2 – 0.3 cun color/txture) of little finger in a depression just distal to the metacarpo-phalangeal joint. Make a loose fist and palpate for the depression – it’s usually right at the end of the crease. (You locate LI 2 this same basic way.) SI 3 SI 4 Shu-Stream point Ulnar border of hand where skin changes Confluent pt of Du vessel color in a big depression proximal to the head of the 5th metacarpal bone. Du = Governing Make a loose fist and it’s easier to find. Perpendicular 0.3 – 0.8 cun Yuan-Source point Perpendicular 0.3 – 0.5 cun. Ulnar border of the hand where the skin changes colors in a depression between the base of the 5th metacarpal bone and the triquetral bone. Just distal to triquetral bone. Page 5 of 8 Needle it with hand in a loose fist also. Caution/Contra Point SI 5 Categories Jing-River point Location On the transverse crease of the wrist in the depression between the head of the ulna and the triquetral bone. Needling Perpendicular 0.3 – 0.5 cun SI 6 Xi Cleft point Dorsal aspect of the head of the ulna in a cleft level with and to the radial side of the high point of the styloid process of the ulna. Perpendicular 0.5 – 0.8 cun KNOW: Indicated for— 1) eye degeneration due to aging. 2) Headaches 3) Acute lower back pain 4) Shoulder joint pain such as bursitis or tendonitis. SI 7 Luo-connecting point Caution/Contra To locate: 1) lie hand flat on table. 2) Place point of finger on the styloid high point of the ulna. 3) Have patient rotate the wrist toward their own body and the finger will fall into a depression. 4) Be sure to locate the point on the distal side of this depression, not the proximal side. Inline with SI-5 and SI-8, 5 cun proximal to SI-5. Perpendicular 0.5 – 1 cun (5 to 5…just like LI 7 is 5 to 7. Both are 5 cun proximal to transverse crease of wrist.) SI 8 He-Sea point Funny bone point… In depression between the tip of the olecranon process of the ulna and the tip of the medial epicondyle of the humerus. Page 6 of 8 Perpendicular 0.3 – 0.5 cun Ulnar nerve lies deep to the point. “Zap” isn’t Qi here! It’s the ulnar nerve! Pull out a bit, change direction and no damage if you do it quick. Point SI 9 Categories Location 1 cun superior to the posterior tip of the axillary crease when the shoulders are dropped and the arms are at the sides normally. Needling Perpendicular 1-1.5cun SI 10 Meeting of SI and BL with Yin Linking and Yang Motility Depression directly below the acromion on the lateral side of the scapular spine. This point should be directly above the posterior tip of the axillary crease. Perpendicular 1-1.5cun SI 11 SI 12 Caution/Contra In a depression on the infrascapular angle Perpendicular or oblique line. To find this point: toward manifestation .51. Locate the mid point of the lower 1.5 cun border of the scapular spine 2. Locate the posterior border of the scapula. 3. Draw a line between these two points and divide into thirds. SI 11 is located at the meeting point of the upper 1/3 and the lower 1/3. Meeting of SI, LI, SJ, GB In the suprascapular fossa at the mid point of the upper border of the scapular spine. Locate the point just above the bone. Perpendicular 0.5-1cun Risk of pneumothorax with deep puncture! SI 13 Depression at the medial end of and superior to the scapular spine. To locate, find the medial border of the scapula. Should be about midway between SI 10 and the spinous process of T2. Perpendicular or oblique toward the scapula 0.5-0.8 cun Risk of pneumothorax if point is angled to medially. SI 14 3 cun lateral to the lower border of the spinous process of T1 (Du 13) on or near the medial border of the scapula. Oblique scapula 0.5-1 cun Risk of pneumothorax Page 7 of 8 Point SI 15 Categories Location 2 cun lateral to Du 14 (lower border of C7 spin process Needling Oblique scapula 0.5-1 cun SI 16 Window of Sky On lateral aspect of neck level with laryngeal prominence. Locate the point on this level on posterior border of SCM. (in horizontal line with ST 9 on anterior border and LI 18 between the two heads of the SCM) Perp 0.3-0.8 cun SI 17 Window of Sky In a depression between the angle of the jaw Perp 0.3-0.8 and the anterior border of the SCM. Point is level with the angle of the jaw/mandible SI 18 Meeting of SI and SJ Directly below the outer canthus of the eye and on the inferior border of the zygomatic bone. Perp 0.3-0.5 cun SI 19 Meeting of SI, SJ, GB Just anterior to the tragus of the ear (or the lower tragus if the pt has 2 of them) and posterior to the condyloid process of the mandible/jaw. Perp 0.5-1cun Note: with the mouth open there’s a depression. Locate and needle with the mouth open, then pt can close jaw. Page 8 of 8 Caution/Contra Risk of pneumothorax Contra: moxa