pt loc 1 - study questions exam 2-1
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Course: Point Location 1 Date: Nov 26, 2007Document: Study Questions Exam 2 on Wk 10
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)
Dont need to know for exams in this class:
Dont need to know paths of divergents, luos, just the main paths
Dont need to know chinese names of acupoints.
Dont need to know energetics/indications of any point for this class.
Know the following cun measurements:
From: Cun:
Axillary crease (anatomical neck of
humerus) to cubital crease
9
Lateral hairline to lateral hairline on
forehead
9
Distance between the mastoid
proceses on the back of the head
9
Front hairline to back hairline 12
Popliteal crease to lateral malleolus 16
Great trochanter (find this lying on
sidehighest point of hip) to
anterior popliteal crease
19
Du 20 to back hairline 7Back hairline to Du 14 3
Yintang to Du 14 18
Between medial borders of scapula 6
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Front hairline to back hairline 12 Between medial borders of scapula 6
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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 7a. Collateral channel:
Back of hand to LI channel on index fingerb. Part of Primary:
Branch to thenar eminence of the thumb
Point Categories Location Angle/Depth Caution/Contra
LU 1 Front Mu of Lung
Meeting pt of LU and SP
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 andparallel to ground.
Find hollow of delta/pec triangle.Measure down 1 cun.
Transverse oblique,
pointing laterally.0.5 0.8 cun.
Possible pneumothorax
with deepperpendicular needling.
LU 2 1 cun superior and slightly medial to LU 1in hollow of delta-pectoral triangle.
Can palpate when pt raises arm straight outand parallel to the ground.
Transverse oblique,pointing laterally.
0.5 0.8 cun.
Possible pneumothoraxwith deep
perpendicular needling.
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
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Point Categories Location Angle/Depth Caution/Contra
(9cun) into thirds.2. Find border between top 1/3 and
bottom 2/3.Point lies on this borderline in
groove between lateral border ofbiceps brachii and shaft of humerus.
3.
LU 4 In upper arm, groove between lateral borderof biceps brachii and shaft of humerus.
To locate:
1. Divide distance between tip ofaxillary fold and cubital crease
(9cun) into thirds.
2. Find border between top 1/3 andbottom 2/3. Go down 1 cun in
groove between lateral border ofbiceps brachii and shaft of humerus..
Perpendicular0.5 1 cun
LU 5 He Sea point of LUWater point of LU
Cubital crease of elbow in radial sidedepression next to the tendon of the biceps
brachii.
Slightly flex the elbow for easiest find.
Perpendicular0.8 1.2 cun
LU 6 Xi cleft point of LU On flexor aspect of forearm in a linebetween LU 5 and LU 9.
To locate:
1. Locate LU 5 and LU 92. Divide the distance between LU 5
and LU 9 in and go 1 cun
proximal on this line.Should be a palpable depression here.
Perpendicular0.5 1 cun
LU 7 Luo connecting pt of LUCommand pt head/nape
Radial forearm superior to styloid processof radius. (abt 1.5 cun prox to LI5)
Between tendons of brachioradialis and
Pinch skin, insert eitherwith or against the channel.
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Point Categories Location Angle/Depth Caution/Contra
abductor pollicus longus
Convenient though not always accuratelocator: hook thumbs together and find
point where index finger tip falls.
Note: noton line with LU 5 and LU 9
Transverse0.5 1 cun per Deadman
0.3 0.5 per CAMS
LU 8 Jing River pt of LUMetal pt of LU
1 cun proximal to LU 9 in a line connectingLU 5 and LU 9
Find the depression at the base of the styloid
process radius and the radial artery. Point isbetween these 2.
Oblique (proximally)Perpendicular
0.3 0.5 cun.
Beware of the radialartery!!
Takes about 5 minutes
to stop bleeding shouldyou hit it.
LU 9 Shu Stream pt of LU
Yuan Source pt of LU
Hui Mtg pt of VesselsEarth pt of LU channel.
At wrist joint in depression between radial
artery and tendon of abductor pollicus
longus (thumb tendon) on border ofpisiform bone.
Level with Heart (HE) 7 point.
Perpendicular
0.3 0.5 cun per Deadman
0.2 0.3 per CAMS
LU 10 Ying Spring pt of LUFire pt of LU
On thenar emminence, midway down theshaft of the 1st metacarpal (thumb).
Locate the point on the border of the redand white skin (or where skin changes
textures)
Perpendicular0.5 1 cun
LU 11 Jing Well pt of LU
Wood pt of LUGhost pt (sun simiao)
Outer corner of thumbnail.
To locate:
Draw a line down the radial edge of the nailand along the base line of the nail. Point is
locate on their intersection.
0.1 cun from corner of nail.
Best to use acupressure or
for bleeding techniques.
Perpendicular orOblique (proximal)
0.1 0.2 cun
Or prick to bleed
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Large Intestine Yangming Channel of the Hand
Highlights of the LI channel
1. Channel crosses midpoint of body, ends on opposite side from start.
2. LI 4 is command pt for face/moutha. Use right LI 4 to treat problems no left face/mouth
b. Use left LI 4 to treat problems on right face/mouth3. Bilateral channel
4. Twenty points going from lateral index finger nail to naso-labial groove at side of the wing of the nose.
Point Categories Location Angle/Depth Caution/Contra
LI 1 Jing Well pt of LIMetal pt of LI
Radial edge of corner of index fingernail.
Draw a line down from radial border of thenail and the base of the nail. Junction ofthese lines is the point, approx 0.1 cun from
the corner of the nail.
Perpendicular or oblique0.1 0.2 cun
Alternatively,Prick to bleed.
LI 2 Ying Spring pt of LI
Water pt of LI
Radial border of index finger in a
depression just distal to the flare of themetacarpo-phalangeal joint.
Located where the skin changes color
and/or texture.
Easier to find if patient makes a loose fist
Oblique (prox or dist)
0.2 0.3 cun
Perpendicular-obliquetowards palm
0.5 cun
LI 3 Shu Stream pt of the LIWood pt of the Li
Radial border of the 2nd metacarpal bonejust proximal to the flare on the distal head
of the bone. Find the depression here.
Located where the skin changes
color/texture.
Easier to find if patient makes a loose fist.
Perpendicular0.5 0.8 cun
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Point Categories Location Angle/Depth Caution/Contra
LI 4 Yuan Source pt of LICommand pt face/mouth
Note:
LI 4 + LV 3 = 4 gates
Most accurate:1. find the middle point of the 2nd
metacarpal bone2. find the mid distance between the 2nd
metacarpal and the 1st metacarpal (pre-thumb).
3. go in toward the 2nd metacarpal bone a
bit.
Convenient but less accurate:1. stretch your thumb and forefinger out in
an L shape to create a tight edge in the
webbing between the two.2. place the mid line of the bend of your
opposite thumb on the tight edge from
step 1.3. bend the thumb here to that the tip
touches between the 1st and 2nd
metacarpals.
Perpendicular0.5 1 cun
Contraindicated forpregnancyunless
youre trying to inducelabor.
LI 5 Jing River point of LI
Fire point of LI
In anatomical snuffbox just across from
the transverse crease of the wrist (where LU9 is)
1. Stretch hand out like shaking hands.
2. Cock thumb back3. 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).
Dont needle too proximally!
Perpendicular
0.5 0.8 cun
Caution: avoid cephalic
vein. Cover it withfingertip, needle next to
the nail.
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Point Categories Location Angle/Depth Caution/Contra
LI 6 Luo Connecting pt of LI(fx both LU and LI)
Locate LI 5 and LI 11
first!
Locate LI 5 and LI 11 first. Point is on aline between these two, 3 cun proximal to
LI 5, 9 cun distal to LI 11.
1. Find LI 5 and LI 11.2. Use a measure - tape, string, paper, edge
of sheet, etc - to mark the distance (12
cun)3. Divide the distance in to find
midpoint. (6 cun)4. Mark the midpoint and divide the distal
into half again. (3 cun)
This is LI 6.
(3 cun above crease, 9 cun distal to LI 11)
Perpendicular0.5 0.8
LI 7 Xi Cleft point of LI Locate LI 5 and LI 11 first. Point is on a
line between these two, 5 cun proximal to
LI 5, 7 cun distal to LI 11.
Combine proportional and thumb 1 cun tofind this.
1. After locating LI 5 and 11, use a
tape or string to find the waypoint between the two.
2. Measure 1 cun distal to this location.
This is LI 7.
Perpendicular 0.5 1 cun
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Point Categories Location Angle/Depth Caution/Contra
LI 8
Note: LI 8-10 are all 1
cun apart!!!
Measure from middle ofdot, not edges!
Locate LI 5 and LI 11 first. Point is on aline between these two, 4 cun distal to LI 11
(8 cun proximal to LI 5)
1. Use a tape measure or string to find the mark between LI 5 and 11.
2. Half this again to find the mark.
3. Measure distal from LI 11 and then add1 more cun distal
Should be 2 cun away from LI 9
Perpendicular0.5 1 cun
LI 9
Note: LI 8-10 are all 1cun apart!!!
Locate LI 5 and LI 11 first. Point is on a
line between these two, 3 cun distal to LI 11
(9 cun proximal to LI 5)
1. Use a tape measure or string to find the mark between LI 5 and 11.
2. Half this again to find the point.
Should be 1 cun away from LI 8
Perpendicular
0.5 1 cun
LI 10
Note: LI 8-10 are all 1
cun apart!!!
Locate LI 5 and LI 11 first. Point is on a
line between these two, 2 cun distal from LI11 (10 cun proximal to LI 5)
Method 1: find LI 8 and divide distance in
half.
Method 2: Find LI 9, measure proximally
by 1 cun.
Should be 1 cun away from LI 8
Perpendicular
0.5 1 cun
(good for acute lumbar
pain insert then do mildactivity in the area of the
pain, pushing up to painthreshold, but not injuring)
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Point Categories Location Angle/Depth Caution/Contra
LI 11 He Sea pt of LIEarth point of LI
Ghost point (sun sim)
At elbow mid way betweenLUNG 5 andlateral epicondyle of humerus
Location:
1. Fully flex elbow. Point is located atthe radial end of the cubital
transverse crease.
2. If cant flex elbow: find LU 5 andlateral epicondyle of humerus. Point
is radial to the tendon of the bicepsbrachii.
Perpendicular1 1.5 cun
LI 12 Locate by landmarks, not by cun measures.
Locate with elbow flexed to 90 degrees.
Palpate lateral epicondyle of humerus.Find the humeral shaft, run finger downuntil you feel the curve begin.
Not in line with LI 11and LI 14. Backward abit.
Perp 0.5 1 cun
LI 13
Find LI 11 and 15 first
Find LI 11 and LI 15. This point lies inlinebetween them, 3 cun prox to LI 11, 6 cun
distal to the axillary fold.(Also is inline withLU3 and 4)
1. Use a measure to find distance
between LI 11 and axillary fold.
2. Divide this into 1/3s.3. Point is located on border between
distal 1/3 and prox 2/3 in thedepression between the lateral
border of the biceps brachii and the
shaft of the humerus.
Perpendicular0.5 1 cun
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Point Categories Location Angle/Depth Caution/Contra
Finger cun and proportional measurementsare about the same here, but proportions are
more accurate. But you can use 1 handbreadth above LI 11 on line between LI 11
and 15.
LI 14
Find LI 11 and 15 first
Lateral side upper arm, in visible depression
formed by the distal insertion of the deltoidand brachialis. Tense the arm to feel/see
more easily.
Inline with LI 11-15
Note: some ppl have bigger delts from
working out and such, so may not be so
reliable.
I found this by finding the delt tip, up by ~ 1
cun
Oblique 1 1.5 cun
LI 15 Locate by landmark only!!
In depression anterior and inferior to the
acromion at the origin of the delt.
Hold the arm out (airplane) to see thedepression here. Women and overweight
ppl will have softer definiton here.
SJ 14 is the depression on the back side of
the acromion.
Move your angle of vision to see it better.
Trans/Oblique
0.8 1.5 cun
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Point Categories Location Angle/Depth Caution/Contra
Again, this is on the opposite side of themidline from where you started!
LI 20
Terminus of the LI
channel
Located in naso-labial groove level with the
midpoint of the lateral edge of the wing ofthe nose (ala nasi)
Opposite side of the body across the midlinefrom where the channel started!
Transverse insertion
directed medio-superiorly.0.3 0.5 cun
Contraindicated for
moxa.
Stomach Yangming Channel of the Foot
Highlights of the Stomach Yangming Channel of the Foot
1. Originates at LI 20 in naso-labial groove lateral to the wing of the nose.2. ST 8 doesnt connect to ST 9, but to ST 5
3. Split in ST channel around ST 5.
4. ST channel goes to upper gums. For numbness/pain/swelling in upper gums, use points on legs for ST.5. Three branches of ST channel
a. Lower anterior aspect of midline on top of foot, terminates at ST 45 - lateral aspect of 2nd toe nail lower corner.b. Split at ST 36, down lateral aspect of lower leg, terminates at lateral aspect of 3rd toe.
c. Split at ST 42, oblique across foot to meet SP 1at medial aspect of great toe.
What do you need to do/know about needling around the eyes? (esp ST 1)
1. Need good communication with your patient they need to know what youre going to do, what the risks are, what to expect. Bruisingis a real possibility.
2. CNT techniques should be strictly applied. High risk of infection.3. Select short, thin needles.
4. Use a clean dry cotton ball to push the closed eye up and away from the insertion site.
5. Insert slightly downward, then push in no more than 0.2 0.5 cun perpendicular.6. No manipulation, no retention.
7. Press 1 minute after withdrawl, have pt hold another 2-3 minutes.8. In the event of hematoma, ice 24-48 hours, then switch to heat to speed healing of bruises.
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9. No moxa!!!
Point Categories Location Angle/Depth Caution/Contra
ST 1 Locd mid between inner and outer canthus
between pupil of eyeball and infraorbital
ridge.
Method 1:Have patient look straight ahead, go down
between infraorbital ridge and eyeball
Method 2:
Find the midline between the inner andouter canthus. Find infraorbital
ridge/eyeball space.
Have pt look upward
w/eyes closed. Use a dry
cotton ball to push eyeballupwards and away from
insertion point.
0.2 0.5 cun
Moxa contraindicd
(smoke and burns)
CNT practices
Communicate w/pt
Risk of hematoma
use short/thin
needles
Dont manip/retain.
Press 1 min when
w/draw, have ptpress addit 2-3
minutes.
ST 2 Located by landmark only.
Located directly below midline of eye
(below pupils when looking straight ahead)in the depression of the infraorbital foramen
depression on the infraorbital ridge.
Location: Inline with ST 1 and ST 3
Perpendicular (very
superficial)0.2 0.4 cun
Moxa
contraindicated.
No
lift/thrust manip.Damage to
infraorbital nerve in
foramen
Deep
insertion could injureeyeball, but hard to
do.
ST 3 Below ST 1 and 2 (usually in a line with
them, not always), level with the lowerborder of the wing of the nose (ala nasi) on
the lateral side of the naso-labial groove.
Might need to have pt smile to find groove
Perpendicular
0.5 0.8 cun
ST 4 0.4 cun lateral to corner of mouth. Perpendicular
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Point Categories Location Angle/Depth Caution/Contra
Generally in line with ST 1-3, but not
always.
Should be in the naso-labial groove.
0.2 0.3 cun
Transverse/oblique towardanother feature (usually
ST 6)
0.5 0.8 cunST 5 Dont get this one too high!!
1. Clench teeth.
2. Feel for the masseter muscle at theangle of the jaw.
3. Find the anterior border of thismuscle.
4. Go 0.5 cun above lower border of
the mandible bone at this location.
Oblique
0.3 0.5 cun
Theres an artery here
to avoid.
ST 6 Ghost point (sunsim) Dont get this one too high either!!
Located on the prominence (highest point)
of the masseter (chewing) muscle, 1fingerbreadth anterior/superior to angle of
the jaw about 45 degree angle from corner
of jaw.
Have pt clench teeth to find it, relax toneedle it.
Perpendicular0.3 0.5 cun
Transverse toward anotherpoint.
ST 7 Located in the zygomatic arch, usually just
anterior to the ear hole.1. Find the depression just in front of
the ear in the zygomatic arch (ridge
of cheekbone as it approaches theear.
2. Have pt open mouth, should feel abone pop into this depression.
Perpendicular and slightly
inferior0.5 1 cun
ST 8 Corner of the forehead, 4.5 cun lateral to Du Oblique or transverse Contraindicated to
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Point Categories Location Angle/Depth Caution/Contra
24, 0.5 cun within anterior hairline. Smalldepression here.
Three methods for locating.
Method 1:
1. Find the corner of the hairline2. Go back 0.5 cun within anterior
hairline.
Method 2:1. Double the distance from GB 15
(0.5 cun into hairline and above
midline eye) to Du 24 (0,.5 cun intohairline and above midline of body)
2. Go lateral from midline of body at
Du 24 this distance.
Method 3:
1. 4.5 cun (5 fingers) from midline of
hairline (remember its 3 cun fromYintang up to hairline)
2. 0.5 cun posterior into hairline.
0.5 1 cunInto the 4th layer of the
scalp in loose cnx tissue
moxabustion
Not perpendicular!
ST 9 Window of heaven More closely related to ST 5 than to ST 8!!!
1. Find the tip of the adams apple
(laryngeal prominence)2. Have pt turn head to side3. Go lateral, level with adams apple
tip, to the anterior border of thesternal head of the SCL. Point is just
anterior to this border.
Carotid artery is here palpate for it then
use pressing to hold it aside for puncture
Perpendicular
0.5 1 cun
1. Contraindication:
Moxa contrad.Burns infect,
carotid arterymoves it thru thebody.
2. Caution: Carotidartery located here
ST 10 On neck, anterior border of SCL sternal Perpendicular 1. Contraindication:
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Point Categories Location Angle/Depth Caution/Contra
Find ST 11 first!!
head, midway between ST 9 and ST 11but not inline with them.
The 3 of them make a shallow triangle.
Have patient turn their head to the sidewhile you apply resistance to the chin to
make this area more prominent.
0.3 0.5 cun Moxa contrad.Burns infect,
carotid arterymoves it thru the
body.
2. Caution: Carotidartery located here
ST 11 Located at root of neck in the depressionlocated just above the collar bone in the
triangle formed by the sternal and clavicularheads of the SCL muscle.
Have pt turn their head to the side to see this
triangular depression.
Perpendicular0.3 0.5 cun
1. Small artery here2. Deep insertion =
risk ofpneumothorax
ST 12 Meeting pt of ST, LI, SI,SJ, GB!!
Know this! Can stim
many areas w/o adding
more points.
1. Find midpoint of clavicle2. Go up into supraclavicular fossa.
Point is located at the upper border of the
clavicular bone in the fossa.
Safer:
Transverse posterior
toward trapezius muscle0.5 1 cun
Not so safe:
Perpendicular
0.3 0.5 cun
Contraindicated inpreggers.
ST 13-18: on mamillary line 4 cun lateral to the midline of the body. Two methods to locate mamillary line:1. Use finger cun 4 cun from midline
2. Find midpoint of clavicle then go downward. More accurate than the finger cun method.
Point Categories Location Angle/Depth Contraindic/Cautions
ST 13 On mamillary line. Directly below ST 12just below the inferior border of the
clavicle.
Transverse, aiming towardmanifestation
0.3 0.5 cun
Deep or perpendicularinsert carries risk of
pneumothorax and/orinjuring subclavian
vessel
ST 14 Middle of the 1st intercostal space on the Transverse, aiming toward Deep or perpendicular
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Point Categories Location Angle/Depth Contraindic/Cautions
mamillary line
Note that the intercostal spaces curveupward as they go lateral
manifestation0.3 0.5 cun
insert carries risk ofpneumothorax
ST 15 Middle of the 2nd intercostal space onmamillary line.
Transverse, aiming towardmanifestation
0.3 0.5 cun
Deep or perpendicularinsert carries risk of
pneumothorax
ST 16 Middle of the 3rd intercostal space on themamillary line
Transverse, aiming towardmanifestation
0.3 0.5 cun
Deep or perpendicularinsert carries risk of
pneumothorax
ST 17
UniqueLandmark point
Technically in the middle of the 4thintercostal space, but always located in the
center of the nipple regardless of where thatfalls.
Dont!!! Contraindicated for everything this is a
landmark only.
ST 18 Middle of the 5th intercostal space, onmamillary line. Might need to push breast
up to find this intercostal.
Some books say is in 5th intercostal just
below nippleaint necessarily so.
Transverse, aiming towardmanifestation
0.3 0.5 cun
Deep or perpendicularinsert carries risk of
pneumothorax
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Stomach 19-25 are all upper abdominal points. Lie on a different line than 13-18 located 2 cun from the midline.
To find 2 cun you can do any of these:1. Measure with finger cun least reliable.
2. Measure way between mamillary line and the midline. Probably the best.
3. On a muscular patient with 6-pack abs look for the ridge.
Location for these points works like this:1. Find the center of the umbilicus and the sternal costal angle. Distance between these = 8 cun.
2. Divide the distance in half. 4 cun. This is ST 21.
3. Divide the upper half again 2 cun. This is ST 194. Divide the lower half into halves this is ST 23.
5. ST 25 is on either side of the umbilicus.Other points (even points) lie exactly inbetween.
Point Categories Location Angle/Depth Contraindic/Cautions
ST 19 2 cun lateral to midline. Locate as described
above, locate ST 21 first, then ST 19
Perpendicular
0.5 1 cun
Deep insertion may
injure heart (left), liver(right) if either organenlarged.
ST 20 See location notes above and locateaccordingly
Perpendicular0.5 1 cun
In thin subjects deepneedle can puncture
peritoneal cavity.
On right side if liver isenlarged can penetrate.
ST 21 See location notes above and locateaccordingly
Perpendicular0.5 1 cun
In thin subjects deepneedle can puncture
peritoneal cavity.
On right side if liver is
enlarged can penetrate.
ST 22 See location notes above and locate
accordingly
Perpendicular
0.5 1 cun
In thin subjects deep
needling can punctureperitoneal cavity.
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Point Categories Location Angle/Depth Contraindic/Cautions
ST 23 See location notes above and locateaccordingly
Perpendicular0.5 1 cun
In thin subjects deepneedling can puncture
peritoneal cavity.
ST 24 See location notes above and locate
accordingly
Perpendicular
0.5 1 cun
In thin subjects deep
needling can puncture
peritoneal cavity.ST 25 Front Mu point of LI 2 cun lateral to umbilicus Perpendicular
1 1.5 cunIn thin subjects deepneedling can puncture
peritoneal cavity.
ST 26 30 are lower abdomen points. Cun measures here are larger than the thumb width, so use proportional measures.
1. Palpate for top margin of the pubic bone.Be sure you communicate well with your patient, telling them what youre palpating for, what these points will do for them, etc. They
may be more comfortable finding this for you. More on that in a minute.2. 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.
3. Find the location by dividing the distancea. Divide the distance between the umbilicus mark and the top margin of the pubic bone in half. This is a reference point
b. ST 27: Go cun above the middle mark in 3a.c. ST 26: Go way between ST 27 and ST 25.
d. ST 28: Go cun below the middle mark in 3a.
e. ST 30: Top margin of the pubic bone, 2 cun lateral from the midline.f. ST 29: Go way between ST 30 and ST 28.
Point Categories Location Angle/Depth Contraindic/Cautions
ST 26 See location notes above Perpendicular
1 1.5 cun
In thin subjects deep
needling can punctureperitoneal cavity.
ST 27 See location notes above Perpendicular
1 1.5 cun
In thin subjects deep
needling can punctureperitoneal cavity.
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Point Categories Location Angle/Depth Contraindic/Cautions
ST 28 See location notes above
KNOW: for Abdominal Edema
Perpendicular1 1.5 cun
In thin subjects deepneedling can puncture
peritoneal cavity.
ST 29 See location notes above
KNOW: for irregular menstruation
Perpendicular
1 1.5 cun
In thin subjects deep
needling can punctureperitoneal cavity.
ST 30 Level with superior border of pubic
symphysis, 2 cun off of midline
Perpendicular
0.5 1 cun
Contraindication: No
Moxa!Cautions:
Deep insert superiordirection can =
penetration peritonealcav or full bladder. On
men, can penetratespermatic cord.
ST 31 Located on upper thigh.To find:
1. Find ASIS and lower border ofpubic symphysis
2. Draw a line down from ASIS andover from pubic symphysis.
Intersection is ST 31.
Perpendicular
1-2 cun
ST 32 Locate 32-24 with knee flexed
1. Draw a line from ST 31 lateralsuperior corner of patella.
2. Locate point 6 cun above superiorborder of patella on this line.
Alternately, you can draw a line from the
ASIS to the superior lateral corner of the
patella and locate the point on this line.
Perpendicular
1-2 cun
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Point Categories Location Angle/Depth Contraindic/Cautions
ST 33
Easy to locate, but oftenmistaken on exams
Locate 32-24 with knee flexed
On same line as ST 31 and 32, 3 cun abovesuperior border of patella or 1 cun above ST
34.
Perpendicular1 1.5 cun
ST 34 Xi Cleft point of ST Locate 32-24 with knee flexed
Three methods to locate this:1. Three fingers to 2 cun measure
2. Best: Measure length of knee cap (2cun) with fingers. Go up above superior
border this distance then rotate fingers45 degrees laterally.
3. Locate point in bulge of vastus lateralis
Perpendicular1 1.5 cun
ST 35 Locate with knee flexed
Level with lower border of patella andlateral to the ligament, yet lower than where
the patella is.
This ligament looks like an oxs nose where
youd put the ring through. Use the topdepression here, not the lower one.
Note: Extrapoint called Xiyan is in the same
place, but both lateral and medial, so ST 35overlaps.
Oblique towards
middle/back of poplitealcrease UB 401 1.5 cun
Insertion into joint
capsule carries risk ofinfection of capsule.
ST 36 He Sea of ST & Earth ptLower He-Sea of ST
Command pt (ab diss)
Ways to find this:
1. Proportional method is better than 3 cun
hand method, but hand method is close.Three cun below ST 35
2. Body landmarks:Where tibia flares and 1 finger wid off
bone crest.
Perpendicular1 1.5 cun
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Point Categories Location Angle/Depth Contraindic/Cautions
Highlights to know
1. Makes sure ST 35 iscorrect.
2. One fingerwidth
lateral to crest of tibia.3. Know locating
methods
Level with lower border of tuberosity oftibia, 1 fingerwid lateral to bone crest.
3. Find ST 38/40 (in middle 8 cun between prominence of lateral malleolus
and tibiofemoral joint/popliteal crease).
Divide distance from here to poplitealcrease to get 4 cun. Go proximal by 1
cun.
ST 37 Lower He Sea pt of LI Lower leg, 3 cun inferior to ST 36, 2 cun
above ST 38.
1. Find ST 38. This is the midmarkbetween prominence of lateral
malleolus and the tibio-femoral joint
crease (level with poplit.crease). It is
8 cun to both extremes.2. Divide the distance between ST 38
and the popliteal crease level into
and into again to get 2 cun above
ST 38.3. Use middle or index finger to
measure 1 finger breadth lateral toanterior crest of tibia. This is ST 37.
4.
Perpendicular
1 1.5 cun
ST 38 1. Use a measure (tape, string, etc) to
find the distance between the tibio-femoral joint line (even with the
popliteal crease) and the lateral
malleolus.2. Divide this in half, measuring up
from the lateral malleolus.3. Mark a spot at this level, one
fingers breadth lateral to the
anterior crest of the tibia. This is ST38.
Perpendicular
1 2 cun
You can also thread from
here to UB 57 (at the backof the calf near the base of
the calf muscles)
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Point Categories Location Angle/Depth Contraindic/Cautions
ST 39 Lower He Sea pt of SI Located 1 cun below ST 38. See measuretechniques for ST 38 above.
Be sure to go one fingers breadth lateral to
anterior crest of the tibia.
Perpendicular1 1.5 cun
ST 40 Luo connecting pt of ST Level with ST 38. See location notes above.
2 fingers breadth lateral to the anteriorcrest of the tibia.
Perpendicular1 1.5 cun
ST 41 Jing River point of STFire point of ST
On the ankle, level with the prominence ofthe lateral malleolus.
1. Slight dorsal-flex the foot to see the
depression here. There are 3 majortendons here: tibialis anterior (most
medial), extensor hallicus longus(going to the big toe), and extensordigitorum longus (most lateral - goes
to remaining 4 toes).2. Find the depression between
extensor hallicus longus and
digitorum longus at the bend of theankle. This is ST 41
Perpendicular0.5 1 cun
Caution: anterior tibialvessels/nerve lie deep
to this point.
ST 42 Yuan Source for ST
Hard to find
Located on dorsum of foot in a depressionformed where the 2nd and 3rd metatarsals
meet the cuneiform bones.1. Find the depression between the 2nd
and 3rd metatarsals.2. Slide your finger proximally and
find the end of the depression.
3. Keep going proximal and feel for adepression on the other side of the
flare of the metatarsals.
Good luck with that.
Perpendicular0.3 0.5 cun
Caution: dorsalis pedisartery here. Feel for it,
use pressing tech ifpossible.
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Point Categories Location Angle/Depth Contraindic/Cautions
ST 43 Shu Stream pt of STWood pt of ST
Located between 2nd and 3rd metatarsalbones.
1. Curl toes so you can see the
knuckles.
2. Locate the depression between the2nd and 3rd metatarsals. Point is in a
depression just proximal to theknuckles, just below the flare at the
distal end of the metatarsals.
Perpendicular0.3 0.5 cun
ST 44 Ying Spring pt of STWater pt of ST
Located between 2nd and 3rd metatarsalbones.
1. Curl toes so you can see the knuckles.
2. Locate the depression between the 2ndand 3rd metatarsals. Point is in adepression just distal to the knuckles.
Perpendicular0.5 1 cun
ST 45 Jing Well pt of STMetal pt of ST
Located on 2nd toenail, lateral side, bottomcorner.
1. Intuit a line drawn along the lateralborder of the nail and the base of the
nail.2. Point lies on this junction at the
lateral aspect of the 2nd toenail.
Perpendicular0.1 0.2 cun
Alternatively, prick tobleed.
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Spleen Channel of the Foot Taiyin
What channel does the Spleen Channel change positions with, which is anterior and posterior, and where do they change positions?
The SP channel changes positions with the LV channel 8 cun above the medial malleolus. Up to this point the Liver channel is anterior. Afterthis measurement the Spleen channel is anterior and the Liver channel is posterior.
Does the Spleen channel go above the neck? If so, where does it go?
Yes, it does. 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.
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/textureLower leg: Follows the posterior border of the tibia on the medial aspect.
Upper leg: ascends along antero-medial aspect of the thigh.Trunk: intersects Conception vessel, enters Spleen, cnx with Stomach. Runs 6 cun lateral to midline
Point Category Location Needling Caution/Contra
SP 1 Jing Well
Ghost point (SSM)
Medial/dorsal aspect of big toe 0.1 cun from
the corner of the nail.
Draw a line down the medial aspect of the
nail and another across the lower border ofthe nail. The intersection is the point.
Perp or oblique 0.1 cun
Moxa
SP 2 Ying Spring Medial side of the big toe in a depression
distal/inferior to the first metatarso-phalangeal joint, almost on the bottom of
the bone.
1. Curl the toes to see the knuckle, uncurlto locate.
Perp 0.3-0.5 cun
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Point Category Location Needling Caution/Contra
2. Slide fingertip distally over the side ofthe ball of the foot to find the
depression.3. Locate the point on the border where
skin changes color/texture.
SP 3 Shu Stream
Yuan Source
Medial inferior side of the foot in the
depression proximal to the head of the firstmetatarsal bone (almost under the foot).
1. Find the ball of the foot by curling the
toes.2. Slide your fingertip proximally over the
side of the ball of the foot to find the
depression.
3. Locate the point on the border whereskin changes color/texture.
Perp 0.5 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.
1. Palpate along the shaft under the foot tofeel.
Beware of the deeper depression and seeif it goes all the way up to the top of the
footif so, youre too proximal and
youre on the MT joint.2. Locate the point on the border where the
skin changes texture/color
Perp 0.5 1 cun
SP 5 Jing River Anterior and inferior to the medial Perp 0.3 0.5 cun
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Point Category Location Needling Caution/Contra
malleolus.
1. Observe first look for the bulge andthe depression here.
2. Draw a line along the anterior border of
the prominence of the medial malleolusand the inferior border of the medial
malleolus.3. Locate the point on the intersection of
these lines in the depression that youwill find here.
SP 6 Meeting point of the SP,
LIV, and KI channels
On medial aspect of lower legjustposterior
to the medial crest of the tibia, 3 cun
superior to the prominence of the medial
malleolus.
While proportional measure is more
accurate, its 15cun from medial mal to the
popliteal creaseif you can do 20% of this,bully for you, if not, use hand cun measure.
Perp 1-1.5cun Contra: preggers
SP 7 On medial aspect of the lower leg, 6 cun
proximal to the tip of the medial malleolus.Locate the point just posterior to the medial
crest of the tibia.
Locate this point in relation to SP 6.
Measure 1 hand-breadth above SP 6.
Perp 1-1.5
SP 8 Xi Cleft of SP channel Medial leg 3 cun inferior to SP 9 in adepressionjustposterior to the medial crest
of the tibia. Might be slightly more anteriorthan SP 9 due to the curvature of the bone.
Perp 1-1.5cun
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Point Category Location Needling Caution/Contra
To locate:1. Locate SP 9 first, then distal by 1
handbreadth.2. Alternately, divide 15cun between pop
crease and the medial mal into 1/3s and
locate this point at the border betweenthe top 1/3 and bottom 2/3s.
SP 9 He Sea Point of SP Medial side of lower leg in a depression at
the angle formed by the medial condyle ofthe tibia and the posterior border of the
tibia.
Run finger in the groove posterior to tibias
medial border until you find the point where
the bone curves back. Point is located in thedepression here. (FYI, located at same levelas GB 34)
Perp 1 1.5 cun
SP 10
#1 point for Blood
tonify and move blood,skin problems. To treat
wind, treat the blood.
Two cun proximal to the superior border of
the patella on the medial side on the bulge
of the vastus medialis.
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,rotate medially by 45 degrees.
Perp 1 1.5 cun
SP 11 Medial side of thigh, 6 cun proximal to SP
10 inline with SP 10 and SP 12.
To locate, find SP 10, go 6 cun proximal.
Alternately, find the way distancebetween SP 12 and the tibiofemoral joint
(pop crease).
Perp 0.5 1 cun Caution: deep needling
can puncture the
femoral artery
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Point Category Location Needling Caution/Contra
SP 12 Meeting point of SP &
LV with Yin Linking
Not commonly usedNot strong function
Three point five (3.5) cun lateral to Ren 2
(top margin of the pubic symphysis level
with ST 30, but on the anterior midpoint) or1.5 cun lateral to ST 30 on the lateral side of
the femoral artery.
1. Locate upper border of pubic symphysisat the level of the anterior midline of the
body. Go lateral 3.5 cun from here.2. Locate the pulse of the femoral artery on
this line.
3. Locate SP 12 immediately lateral in the
depression
Perp 0.5 1 cun Caution: deep needle
medially may puncture
the femoral artery whiledeep needling laterally
can puncture thefemoral nerve!
SP 13 Meeting pt of SP & LIV
with Yin Linking
Lower ab, .7 cun superior, .5 lateral to SP
12, 4 cun lateral to the midline of the body.
To locate, find SP 12. Measure 1 cun
diagonally (lateral and superior). Thisshould be about right. Verify that you are 4
cun lateral to the midline (on the samevertical level as the mamillary line)
Perp 1-1.5 cun Caution:
Possible peritonealpuncture with deep
needling in thin
patients.
SP 14 (NOT part of SP/LIV
meeting with YinLinkingwill be on test!)
Lower ab, 1.3 cun inferior to SP 15 (level
with umbilicus), 4 cun from midline.
Shen says measure to 1.25 cun and that
should be fine. On same vertical as themamillary line.
Perp 1-1.5 cun Caution:
Can punc peritonealcav in thin patients if
deep needle.
SP 15 Meeting pt of SP & LIV
with Yin Linking
Four (4) cun lateral to the center of the
umbilicus. (In the depression at the lateral
Perp 0.5 1 cun Cautions:
1. Possible peritoneal
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Point Category Location Needling Caution/Contra
border of the rectus abdominis muscle ) cav punc in thins.2. Enlarged liver or
spleen at this level.
SP 16 Meeting pt of SP with
Yin Linking
On ab 3 cun superior to SP 15 and 4 cun
lateral to the midline on lateral border of
rectus abdominis muscle.
Perp 0.5 1 cun Cautions:
1. Possible peritoneal
cav punc in thins.2. Enlarged liver or
spleen at this level
SP 17 20 are 6 cun lateral to anterior midline, inline with LU 1 and 2. Needle all of them transverse with intercostal spaces 0.5 0.8 cun
deep. Guide needle towards manifestations that need help.
Point Category Location Needling Caution/Contra
SP 17 Lateral side of chest, 5th intercostal space, 6
cun to midline.
1. Find the 6 cun mark from midline.a. Same line as LU 1 and 2
b. 8 fingers from anterior mid
c. Mamillary line + 2 cun2. Count to the 5th intercostal space (bout
level with the bra-line)
Trans-obl, 0.5 0.8 cun
either lateral or medial
Caution: perp insert =
risk of pneumothorax.
SP 18 Lateral side of chest, 4th intercostal space, 6
cun to midline.
1. Find the 6 cun mark from midline. 3ways:
a. Same line as LU 1 and 2b. 8 fingers from anterior mid
c. Mamillary line + 2 cun.2. Count to 4th intercostal (almost always =
nip level on dudes)
Trans-obl, 0.5 0.8 cun
either lateral or medial
Caution: perp insert =
risk of pneumothorax.
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Point Category Location Needling Caution/Contra
SP 19 Lateral side of chest, 3rd intercostal space, 6
cun to midline.
1. Find the 6 cun mark from midline. 3
ways:a. Same line as LU 1 and 2
b. 8 fingers from anterior midc. Mamillary line + 2 cun.
2. Count to 3rd intercostal space.
Trans-obl, 0.5 0.8 cun
either lateral or medial
Caution: perp insert =
risk of pneumothorax.
SP 20 Lateral side of chest, 2nd intercostal space, 6cun to midline.
1. Find the 6 cun mark from midline. 3ways:
a. Same line as LU 1 and 2b. 8 fingers from anterior mid
c. Mamillary line + 2 cun.
2. Count to 2nd intercostal space.
Trans-obl, 0.5 0.8 cuneither lateral or medial
Caution: perp insert =risk of pneumothorax.
SP 21 Great Luo Connecting ofthe Spleen
Located on the mid-axillary line (from frontedge of armpit crease to back edge), level
with the 6th or 7th intercostal space
Trans-obl along intercostalspace 0.5 1 cun
Caution: perp insert =risk of pneumothorax.