Study Notes - Exam 2

Course:

Course:Point Location 2Date:

Study Notes Exam 2

This test covers the PC, BL, and Kidney

Bladder ChannelHow many layers are there on the scalp and into what layer do you needle for scalp acupuncture5 layers. The top 3 are tightly bound and can be considered as one layer. You needle into the 4th layer, the subaponeurotic space.

At what angle do you insert for scalp acupuncture?

15-30 degrees

You use Du 20 as the reference point for many Bladder points on the scalp. Where is Du 20 located?

5 cun posterior to the anterior hairline on the midline of the body at the junction of the midline of the head and the long axis line from ear to ear. The long axis line of the ear is the line from the bottom of the lobe to the apex of the ear. How many points are there on the Bladder channel?

67

Where does the Bladder channel originate?

Inner canthus of the eyes

There are 3 main branches on the primary Bladder channel. What are these main branchings?

1. From Bladder 3 transverse to Du 20

2. From Du 20 oblique to the temple and around the ear

3. From Bladder 10 (at the occipital bone) into 2 branches one to Du 14 to meet with all other yangs then down the back 1.5 cun lateral to the midline of the spine and the other down the back 3 cun from the spine.

Where do the 2 parallel branches of the Bladder channel rejoin?

Bladder 40 in the popliteal area.

What Zangfu organs does the Bladder channel connect to? Kidney and BladderWhat non-Zangfu organ does the Bladder channel enter? BrainWhat is the Luo connecting point on the Bladder channel? Bladder 58, which connects to the Kidney channel

What are the key points for acupuncture around the eyes (i.e., BL 1 and 2)? Patient keeps eyes closed

Good communication between practitioner and patient

Communicate expectation of possible bruising, etc.

Short, thin needles

Strict CNT

Push eyeball away from insertion with clean, dry cotton ball

Insert angled slightly away from eyeball, then perpendicular

No more than 0.3-0.5 insertion depth

No needle manipulation

No needle retention

Immediately apply pressure upon withdrawl for a minimum of 3 minutes. The Bladder channel is abbreviated as BL in the Deadman book, but you might also see it as UB.

PointCategoriesLocationNeedlingCaution/Contra

BL 1Mtg of Bl, SI, ST, GB, SJ with Du, Yin Motility and Yang Motility0.1 cun medio-superior to the inner canthus of the eye. There is a depression slightly above the inner canthus here.

Use acu around the eye guidelines.Contra to Moxa

BL 2Directly above the inner canthus at the supraorbital notch which is on the orbital ridge superior to the eye, usually level with the medial edge of the eyebrow.

1. Pinch and insert transv toward laterally or toward the Yuyao (extra point) medially.0.3 1 cun

2. Prick to bleed for a bad headache in this area.

Contra to moxa

NOTE: Location of anterior hairline: The hairline is considered to be 3 cun superior to the Yintang extra point (the 3rd eye in some philosophies) which is between the eyebrows.

BL 3Directly superior to BL 2/inner canthus, 0.5 cun within anterior hairline.

(3.5 cun superior to Yintang point)

Transverse downward twd the eye or upward twd vertex/Du 20.All points in the hair are contraindicated to moxa.

BL 4On same level as BL 3 (0.5 into anterior hariline), 1.5 cun lateral from midline/Du 24. Can also be measured as 1/3 of the distance between Du 24 and ST 8.

Transverse 0.3-0.5 into the subaponeurotic space/4th layer of skin of the scalpDeadman does not specifically state that this point is contra to moxa.

BL 50.5 cun directly posterior to BL 4

Also measured as 1 cun into anterior hairline, 1.5 cun lateral to Du 24.

Transverse 0.3-0.5 cun into the subaponeurotica space. Contra to moxa according to classical sources.

BL 6Also measured as 2.5 cun within anterior hairline and 1.5 cun lateral to midline


BL 74 cun within the anterior hairline, 1.5 cun lateral to the midline.


BL 85.5 cun within the anterior hairline and 1.5 cun lateral to the midline.

Note: DU 20 is 5 cun within the anterior hairline at the midline of the body the vertex of the head. Use for reference if necessary.


BL 91. Slide your fingers upward between the groove of the trapezius muscles at the center line of the back of the neck.

2. Find the shelf edge at the back of the skull. Continue up just over the edge of this ridge.

3. Move fingers lateral 1.3 cun and find the depression. Needle here.

Transverse subcutaneously 0.3-0.5 cun or a bit deeperDeadman does not specifically say this is contra to moxa.

NOTE: Location of posterior hairline: Posteior hairline is 3 cun above the lower border of the spinous process of C7 (Du 14)

BL 10Window of Sky pointDepression on lateral aspect of the trapezius muscle at the insertion point.

Also measured as cun above the posterior hairline and 2 cun superior to BL 9 on the trapezius muscle.

Perpendicular 0.5-0.8 cun

NOTE: There are 2 BL lines The first BL line, 1.5 cun from the posterior midline of the body encompasses the Back Shu points.

Insert these trans/oblique toward the spine.

BL 11

T11. Mtg of BL, SI, SJ, GB and Du channel

2. Hui Meeting of Bones

Level with lower border of T1 spinous process, 1.5 cun lateral to midline.

Oblique toward spine

0.5 1 cun.Perpendicular insertion carries substantial risk of pneumothorax.

BL 12

T2

Meeting of BL w/ DuLevel with lower border of T2 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 13

T3Back Shu of LungLevel with lower border of T3 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 14T4Back Shu of PericardiumLevel with lower border of T4 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 15

T5

Back Shu of HeartLevel with lower border of T5 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 16

T6

Level with lower border of T6 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 17

T7

Hui Meeting point of Blood

Informally known as the Bk Shu of Diaphragm

Level with lower border of T7 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 18T9

Back Shu of LiverLevel with lower border of T9 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 19

T10

Back Shu of GallbladderLevel with lower border of T10 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 20T11

Back Shu of SpleenLevel with lower border of T11 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 21T12

Back Shu of StomachLevel with lower border of T12 spinous process, 1.5 cun lateral to midlineOblique toward spine


BL 22

L1Back Shu of SanjiaoLevel with lower border of L1 spinous process, 1.5 cun lateral to midlineOblique toward spine or perpendicular

1 1.5 cun.Perpendicular insertion carries substantial risk of kidney puncture of perhaps pneumothorax.

BL 23

L2

Back Shu of KidneysLevel with lower border of L2 spinous process, 1.5 cun lateral to midlineOblique toward spine or perpendicular

1 1.5 cun.Perpendicular insertion carries risk of injuring kidney.

BL 24

L3

Level with lower border of L3 spinous process, 1.5 cun lateral to midlinePerpendicular 1 1.5 cun.

BL 25L4

Back Shu of Lg IntestineLevel with lower border of L4 spinous process, 1.5 cun lateral to midlinePerpendicular 1 1.5 cun.

BL 26L5

Level with lower border of L4 spinous process, 1.5 cun lateral to midline

Perpendicular 1 1.5 cun.

BL 27

S1Back Shu of Sm IntestineLevel with 1st sacral foramen, 1.5 cun lateral to midline

Perpendicular 0.5 1 cun

BL 28S2Back Shu of BladderLevel with 2nd sacral foramen, 1.5 cun lateral to midline


BL 29S3Level with 3rd sacral foramen, 1.5 cun lateral to midline


BL 30S4Level with 4th sacral foramen, 1.5 cun lateral to midline


BL 31

S1Mtg of BL and GB channelsIn the 1st sacral foramenPerpendicular 0.5 1.5 cun

Needle slightly oblique medial and inferior to get the needle in.1. Contra to moxa per some classical texts.

2. Not too deep nerves

BL 32S2Mtg of BL and GB channelsIn the 2nd sacral foramenPerpendicular 0.5 1.5 cun

Needle slightly oblique medial and inferior to get the needle in.

BL 33S3Mtg of BL and GB channels

In the 3rd sacral foramenPerpendicular 0.5 1.5 cun

BL 34

S4Mtg of BL and GB channelsIn the 4th sacral foramenPerpendicuylar 0.5 1.5 cun

BL 350.5 lateral to the tip of the coccyxPerpendicular 1 1.5 cun

This is a very personal spot. Be sure your patient knows what youre doing and why. Might wanna have a witness pressent.

BL 36Midpoint of the gluteal crease directly superior to BL 40 in the depression between the hamstring muscles. Perpendicular 1-2 cunUse a long needle to get through the fatty tissue here.

BL 37Inline with BL 36 and BL 40, 6 cun inferior to BL 36 in a depression. Distance between BL 36 and BL 40 is 14 cun. Use a measure to find the midpoint between these 2 (7 cun) and then move proximally by 1 cun.

There is a depression here.

Perpendicular 1 2 cun

Note: Locating BL 40BL 40 is located on the popliteal crease at the midpoint of the 2 tendons on the lateral and medial side of the crease.

The lateral tendon is the biceps femoris.

The medial tendon is actually 2 tendons, the semitendinosus and the semimembranosus.

BL 381 cun superior to popliteal crease on the medial edge of the biceps femoris tendon (the tendon on the lateral side of the popliteal crease). Locate with knee slightly flexed

Perpendicular 1 1.5 cun

BL 39Lower He Sea of SJOn the popliteal crease in a depression medial to the biceps femoris tendon. Locate with knee slightly flexed.


BL 401. He Sea and Lower He Sea of BL

2. Cmd of back/lumbar

On popliteal crease in a depression midway between tendons of biceps femoris and semitendinosus. Locate with knee slightly flexed.

Perpendicular 1 1.5 cun or prick to bleed the superficial veins.Caution: tibial nerve and popliteal artery and vein are deep to here.

Notes: Numbers for 2nd bladder line:

Locating the 2nd bladder line level:

Relation to Bk Shu

1st BL line no. + 29 = 2nd BL line no.When shoulders are relaxed the medial border of the scapula is 3 cun from the midline.

Shen uses 2nd BL line to treat emo imbal based on pattern i.d. Often corresponds with the back shu points with which the points of the 2nd BL line are level. Function can be similar and complementary to the back shus.

BL 41T2Mtg of BL and SILevel with BL 12/ T2, 3 cun lateral to midlineNote: on same vertical level as SI 14

Transverse/oblique toward lateral, 0.3 0.5 cun

Perp of deep oblique medially = risk of pneumothorax.

BL 42T3Level with BL 13/ T3, 3 cun lateral to midline

Level with Bk Shu of LU

Transverse/oblique medial or lateral, 0.3 0.5 cun

Deep perp or medial oblique = risk of pneumothorax

Bl 43T4Level with BL 14/ T4, 3 cun lateral to midline

Level with Bk Shu of PC

Transverse/oblique medial or lateral, 0.3 0.5 cunDeep perp or medial oblique = risk of pneumothorax

BL 44T5Level with BL 15/T5, 3 cun lateral to midline

Level with Bk Shu of Heart

Transverse/oblique medial or lateral, 0.3 0.5 cunDeep perp or medial oblique = risk of pneumothorax


Transverse/oblique lateral, 0.3 0.5Deep perp or medial oblique = risk of pneumothorax


Level with Bk Shu of Diaphragm


BL 47

T9Level with BL 18/T9, 3 cun lateral to midline

Level with Bk Shu of Liver


BL 48

T10Level with BL 19/T10, 3 cun lateral to midline

Level with Bk Shu of GB



Level with Bk Shu of SP


BL 50T12Level with BL 21/T12, 3 cun lateral to midline.

Level with Bk Shu of ST


BL 51L1Level with BL 22/L1, 3 cun lateral to midline

Level with Bk Shu of SJ

Oblique 0.5 1 cunDeep perp = risk of injury to kidney

BL 52L2Level with BL 23/L2, 3 cun lateral to midline

Level with Bk Shu of KD

Oblique 0.5 1 cunDeep perp = risk of injury to kidney

BL 53S2Level with 2nd sacral foramen, 3 cun lateral to midline.

Level with Bk Shu of BL


BL 54

S4Level with 4th sacral foramen, 3 cun lateralPerpendicular 2 3 cun or angled toward genitals

BL 55Lower leg, 2 cun inferior to BL 40, inline with BL 40 + BL 57, in a depression on the upper border of the junction of the 2 heads of the gastrocnemius


BL 565 cun distal from BL 40 or 3 cun distal from BL 55. Located on the highest point of the gastrocnemius. Inline with BL 40 and 57.

Perpendicular 1 1.5 cunClassical texts say contra to moxa.

BL 57Mispoint between BL 40 and lateral tip of the malleolus in a depression between the 2 gastrocnemius muscles. Perpendicular 1 1.5 cun

BL 58Luo Connecting point of the Bladder channelAbout 45 degrees lateral and distal to BL 57 (and abt 7 cun proximal from prominence of lateral malleolus.


BL 59XiCleft of the Yang Motility vessel3 cun directly superior to BL 60, midway between the Achilles tendon and the peroneal tendon or mid point between the posterior edge of the leg and the bone when viewed from the side.


BL 60Jing River of Bladder chPosterior to the ankle joint in the depression between the prominence of the lateral malleolus and the Achilles tendon.

Perpendicular 0.5 0.8 cunContra for preggs.

Used to induce labor

BL 61Mtg of BL and Yang Motility vesselOn lateral side of foot in a depression on the calcaneus bone formed by the junction of the Achilles tendon with the bone. Must be at the junction of the red/white skin. Usually abt 1.5 cun inferior to BL 60, but not always.

Perpendicular 0.3 0.5 cun

BL 62Confluent pt of Yang Motility vesselLateral foot in a depression directly inferior to the lateral malleolus (usually abt 0.5 cun) and posterior to 2 tendons found here.

Must satisfy both conditions.

Oblique inferiorly, 0.3 0.5 cun

BL 63Xi Cleft of BL

Mtg of BL and Yang Linking

Lateral foot in depression posterior to tuberosity of MT 5 on the line where red/white skin meet.

To find:

1. Below anterior brdr of malleolus

2. Lower border of cubiod bone

3. Posterior to tuberosity ot MT 5 where skin chgs color/txture.


BL 64Yuan Source of BLLateral foot, depression anterior + inferior to MT 5 tuberosity on the border where red/white skin meet.

Perpendicular 0.3 0.5 cun.

BL 65Shu Stream of BLLateral foot, proximal to knuckle of MT 5 and phalanges on border where red/white skin meets. Curl toes to see better.


BL 66Ying Spring of BLLateral foot, distal to knuckle of MT 5 and phalanges on border where red/white skin meets.

Curl toes to see better.

Perpendicular/obl 0.2 0.3 cun.

BL 67Jing Well of BLLateral corner of little toe nail.

Perpendicular 0.1 0.2 or prick to bleed.

Contra to pregs,

But most imp point to turn the baby with fetal malposition.

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Study Notes - Exam 2