CS - 1st Exam Flashcards
Questions regarding PAIN
Onset (what patient was doing)
Provocation (better/worse w/palpation or rest)
Quality (dull, tearing, intermittent, etc)
Region & Radiation (where & whether it radiates)
Severity (scale from 0 - 10)
Time (history - how long & if it has changed)
Questions for Body System - First questions
Energy?, Sleep?, Sweat?, Thirsty?, Appetite?
Run hot, cold or normal temp? Hot at night?
Questions for Body System - Digestion & Urination
Digestion (BM’s-shape, frequency, dry/moist, smell, undigested food) constipation, bloating, belching, associated noises?
Urination - frequency? amount? Up at night? Color? Odor? Clear or Turbid? Smooth flow or stops?
Questions for Body System - Menstruation
Mensus regular? When did mensus begin? Where are you in your cycle? Do you have cramps, cravings, back pain, etc. How long is your mensus? Do you have blood clots? How large? What color is the blood? How heavy is the blood flow?
Questions for Body System - Emotions
Do you get frustrated, irritable, impatient, or depressed?
Do you get anxious, panicky, jumpy?
Do you over-worry, over-analyze or obsess?
Do you get sad easily, or are weepy?
Do you have a lot of fears?
Questions for Body System - Eyes
Do you have dry eyes, hair or skin?
Do you have any problems with your ears? Pain or ringing? High pitched or low pitched?
Do your eyes get dry or burning?
Questions for Body System - Allergies
Do you have any allergies? Seasonal or dietary?
What are the symptoms of your allergies? Congestion, phlegm, clogged ears, sneezing, lacrimation, rhinitis, Post nasal drip, sore throat, cough, wheeze, shortness of breath, tightness in the chest?
Questions for Body System - Asthma & HT
Do you have asthma? SOB, tightness or pressure in the chest? Wheezing? Allergy induced? Exercise induced?
Do you have heart palpitations, chest pain or circulatory problems?
Examples of Objective Observations
Range of Motion Color of Complexion Tender points upon palpation Bruising visible Results from Xray or MRI
Objective - The Tongue Body
color of tongue body shape size toothmarks, if present landmark(midlinecrack,Yin cracks, papules, etc.) Dry, moist, or normal? Deviated? Quivering?
Objective - The Tongue Coating
Color
Distribution (Geographic, heavier on base)
Quality (Greasy, Dry)
Objective - Pulse
Rate of speed (i.e. rapid (>90), slow(<60), normal)
Qualities of the pulse: (i.e. Wiry, Slippery, Thready, Weak, Deep, Superficial, Floating-Empty, Intermittent, etc.)
Left hand: HT, LV, KD
Right hand: LU, SP, KD
Assessment (formula for writing)
Formula for writing a correct assessment:
[Name of ‘disease category’] due to [Pattern Differentiation]
Example: Low Back Pain due to trauma resulting in Qi Stagnation and Blood Stasis
Plan
Treatment Principles (Ex: Open the channels, Move Qi, Invigorate Blood, Relieve pain)
Acupuncture Tx Prescription (Rx) - Points
Herbal Tx Prescription (Rx)
Adjunctive Tx modalities (i.e. Tui na, moxibustion, cupping, gua sha, bleeding, auricular therapy)
Food Therapy, Chinese medicated dietor Western nutritional recommendations
Lifestyle recommendations
Course of Tx (i.e. 1 X week for 3 months)
Prognosis
Two Main Fx of the Channels
- Transporting qi and blood throughout the body and integrating/connecting the whole body (int/ext)
- Responding to dysfunction in the body, when the harmony is disrupted the channels respond in different ways
Three ways the channels respond to dysfunction in the body
- Disease of the channels themselves – giving rise to local tenderness, numbness, etc. (i.e. Stagnation or insufficiency of Qi and Blood)
- Disease of the zangfu are internal disharmonies that can show signs on the channel (i.e. LV Qi Stag causing pain in the path of the Liv/GB channel like flank, breast, genital pain.
- Disease transmitting via the channels, from one zangfu to another through the channels or from one channel to another channel.
Two Functions of the Channels
- Protecting the body (Minute then Lou then Primary), preventing disease from going deeper.
- The channels serve to transmit qi to the disease area, by stimulation of the acupuncture point.
Channels - From most Superficial to Deepest
Cutaneous regions Minute collateral Sinew/Muscle channels Lou-connecting channels Primary channels Divergent channels Extraordinary channels Deep pathway of the primary and divergent channels
Why do we need to know the interior pathways of the channels?
Because this explains why certain points or meridians treat certain conditions. i.e. PC 6 (interior pathway descends through the middle jiao) explains why it is used to treat nausea.
The Fx of the Eight (8) Extraordinary Vessels
- Act as reservoirs- able to absorb excessive qi and blood from primary channels.
- Protect the body.
- All derive their energy from the Ki so they all contain the Essence which is stored in the Ki.
- Link the 12 primary channels.
Names of the 8 Extraordinary Vessels
- Sea of Yang: Governing Vessel: (DU)
- Sea of Yin: Conception Vessel: (Ren)
- Sea of Blood or Sea of 12 Primary: (Chong)
- Girdling Vessel: (Dai)
- Yin Motility: (Yin Qiao)
- Yang Motility: (Yang Qiao)
- Yin Linking: (Yin Wei)
- Yang Linking: (Yang Wei)
How do you needle the Extraordinary Vessels
- Opening Point First
2. If Unilateral, needle R side on Women first and reverse for Men with coupled point on the Opposite side
Which Extraordinary Vessels are the source of all other Extraordinary vessels?
Directing, Governing, and Penetrating vessels are the source of all other Extra-Ordinary vessels since they originate directly from the Ki and are therefore connected to the Essence. They affect the patient’s energy at a constitutional level.
Which Extraordinary Vessel is the Sea of Blood, Sea of 12 Channels?
Penetrating Vessel/Chong Mai:
The Penetrating Vessel (Chong Mai) functions
Influence abdomen, uterus, chest, heart.
Pathological symptoms: counter flow of qi, abdominal urgency, gynecological disorders, atrophy of the leg
Together with Directing vessel, regulates the uterus, menstruation and nourish blood
Penetrating Vessel (Chong Mai)
Provides link between Pre-Heaven and Post-Heaven Qi so it can be used in all cases of weak constitution.
Penetrating Vessel (Chong Mai)
Master & Coupling Points for Chong Mai
Inner Gates
Master Pt.: SP-4
Couple Pt.: PC-6
Physiology of Chong Mai
- Stores and regulates blood
- Channel curves around the lips, and is related to the pubic region and perineum.
- Strongly regulates the 12 regular channels.
- Most effective channel for regulating circulation of qi & blood in the entire body.
- Powerful for opening blockages & stagnations.
Pathological Sx of Chong Mai
Blood disorders of either excess or deficiency.
Sense of fullness and distention of the body.
Blood circulation is accelerated and stagnated. Flushed face due to qi and blood rushing to head. With Bld Def - general weakness, coldness of body. Sensation as if the body is reduced in size.
Irregular menses, dysmenorrhea, miscarriage. Infertility, difficult delivery, impotence
Sensations of Qi rushing upward to the chest, throat and head.
Cramping pain in the abdomen.
Severe, acute Onset of all types of bleeding, asthma, dizziness, headache and vomiting.
Girdling Vessel/Dai Mai
Vertical path of 12 primary channels
Influence the genitals, waist, and hips.
Pathological symptoms of Dai Mai
Abdominal fullness, sensation at the waist as though sitting in water, waist and lumbar spine, leucorrhea, damp heat in the lower burner, irregular menstruation, infertility, insufficient sperm, weakness of the legs/atrophy.
The Master and Coupled Points of the Dai Mai
Master Pt: GB-41
Coupled Pt: SJ-5
Physiology of Dai Mai
Controls and binds all the channels which travel longitudinally.
Regulates Leukorrhea
Regulates the Gall Bladder Channel
Yang Motility Vessel (Yang Qiao)
Dominates activity.
Influence lateral aspect of leg, back, neck, head, and eyes.
Pathological Sx of Yang Motility Vessel (Yang Qiao)
Daytime epilepsy, insomnia, tightness of muscles on side of leg/flaccidity of muscles on inside of leg, eversion of foot.
Master & Coupled Points for (Yang Qiao)
Master Pt: UB-62
Coupled Pt: SI-3
Yin Motility Vessel (Yin Qiao)
Dominates quietness.
Influence inner side of legs, abdomen, and eyes.
Pathological Sx of Yin Motility Vessel (Yin Qiao)
Night time epilepsy, pain in the genitals, contracted sinews, great desire to sleep, inversion of foot, flaccidity of the muscles of the lateral side of leg and tightness of the muscles of the medial leg.
Master & Coupled Points for Yin Qiao
Master Pt: KI-6
Coupled Pt: LU-7
Balance the Yin/Yang Qi of the lower extremities
If the medial muscles are spasmed and the lateral muscles are flaccid, this is a disorder of the
Yin Qiao
Physiology of Yin & Yang Qiao Mai
Regulate the function of the brain
Yang Qi excess in Yang Qiao-over-excitement, hyperactivity, restlessness and uneasiness
Yin Qi excess in Yin Qiao- spiritlessness, hypoactivity, apathy, and lassitude
Yang Qiao is a branch of the UB channel and can treat symptoms of the UB channel.
Yin Qiao is a branch of the KD channel and can treat symptoms of the KD channel.
The Yin Qiao passes through the throat and is useful for disorders of the throat and vocal cords.
When the Yang Qiao channel is disordered, there may be
Insomnia, epilepsy, muscle spasms on the lateral aspect of the lower extremities while those on the medial aspect may be flaccid or atrophied
When the Yin Qiao Channel is disordered, there may be
Somnolence, epilepsy, muscle spasm on the medial aspect of the lower extremities while those on the lateral aspect may be flaccid or atrophied
Yang Linking Vessel/Yang Wei Mai
Dominates the exterior of the body.
Influence lateral aspect of leg, sides of body, lateral aspects of neck, head, and ears.
Master & Couple Points for Yang Linking Vessel (Yang Wei Mai)
Master Pt: SJ-5
Couple Pt: GB-35
Pathological Sx of Yang Wei Mai
Visual dizziness, chills and fever
Physiology of Yang Wei Mai
Dominates the exterior -Tai Yang and Shao Yang
Balances the Yang qi
When the Yang Wei is disordered there may be
Exterior syndromes, vertigo, chills, and fever alternatingly, muscular stiffness and pain, fatigue, and distention in the waist
The points of the Yang Wei Channel are mainly used to treat
Exterior syndromes, Shao Yang syndrome, and symptoms related to the GB channel
When the Yang Qiao channel is disordered, there may ALSO be
Eversion of the foot, and pain and stiffness of the lumbar region, hip, scapula, shoulder, and headache
If the lateral muscles are spasmed and the medial muscles are flaccid this is a disorder of the
Yang Qiao
If yang qi is excess in the Yang Qiao it will result in
Insomnia
If yin qi is excess in the Yin Qiao it will result in
Somnolence
When Yang Qi is deficient there may be symptoms of
General lassitude and listlessness
When qi in the Yang channels are disturbed, there may be
Bi-polar, obesessive/compulsive behavior, excessive anger
When Yang Qi is excess there may be symptoms of
Dizziness, vertigo, blurred vision, asthmatic breathing
Yin Linking Vessel/Yin Wei Mai
Dominates the interior of the body
Influences chest, and heart
Pathological Sx of Yin Wei Mai
HT pain, pain in the chest
Master & Coupling Points for Yin Wei Mai
Master Pt: PC-6
Coupled Pt: SP-4
Physiology of Yin Wei Mai
Dominates the Interior: It dominates the Qi in the Yin channels and their associated organs, especially the heart, lung, stomach and spleen
Pathological Sx of Yin Wei Mai
Chest pain, cardiac and epigastric pain, pain of the abdomen and external genitalia, fullness and distention in the hypochondriac region, abdominal masses, bofborygmus, diarrhea, or lumbar pain
When the Qi in the Yin channels are disturbed, there may be
Mental instability, uneasiness, low self esteem, lack of will power, and discouragement
When the Yin Wei channel is disordered, there may be
Interior syndromes, cardiac pain, pain in the stomach, chest or abdomen
The points of the Yin Wei channel are mainly used to treat interior syndromes and disorders of the
Heart, chest and stomach
Governing Vessel/ Du Mai Fx
Sea of all Yang channels
Helps regulate the qi of all yang channels.
Tonify yang.
Influence the back, spine, back of head and neck.
Nourish spine and brain.
Master & Coupling Points of Du Mai
Master Pt: SI-3
Couple Pt: BL-62
Physiology of the Du Mai
Governs all the Yang Channels
Provides heat (yang qi) to warm all the organs and channels
Influences the fx of the brain, head & sense organs
Strengthens body constitution & enhance immunity
Regulate the fx of its associated organs (uterus, kidney, heart and brain) and channels
Because pathway connects w/UB channel, it is first line which connects all 12 channels through the Back Shu points
Du Mai
It influences all the channels due to it’s connection to the Ren and Chong
Du Mai
When the Qi of the Du Channel is disordered, there may be
Stiffness and pain along the spinal column, opoisthotonos, bi-polar, disorders due to wind such as Wind Stroke, epilepsy, infantile convulsions, shaking, tremors, heavy sensation in the head, dizziness, vertigo, fever, Qi rushing upward, hemorrhoids, enuresis, retention of urine, and pain along the channel distribution
Conception Vessel/Ren Mai/Directing Vessel
Sea of all Yin Channels
Helps regulate qi of all yin channels.
Influence abdomen, thorax, lungs, throat, and face.
Moves qi in lower burner, women: lumps, fibroids, and cancer in uterus; men: hernia.
Master & Coupling Points for Ren Mai
Master Pt.: LU-7
Couple Pt.: KD-6
Very important in reproductive system, especially women (regulates menstruation, fertility, conception, pregnancy, childbirth and menopause)
Ren Mai
Physiology of Ren Mai
Regulates all the Yin Channels
Circulate Yin Qi, including the blood, essence, and body fluids to nourish and lubricate all the organs and channels.
Regulate reproductive function
Regulate the function of the internal organs.
Dist the Yin Qi upward to the face, lips and eyes.
Treats the 7 hernias
When the qi of the Ren Channel is disordered there may be
Irregular menstruation, dysmenorrhea, leukorrhea, seven types of hernia, infertility, vaginal pain, nocturnal emission, enuresis, difficult urination, and pain along the channel distribution.
Branch out from the 12 primary and have no specific points of their own
12 Divergent Channels
12 Divergent Channels are divided into
6 Yin and 6 Yang pairs. The pair circulates together either parallel or joining together.
They emphasize circulation of Qi and blood in the interior of the body reinforcing Zang/Fu and Yin/Yang pairs
12 Divergent Channels
They all run from the extremities to the trunk, face and head benefiting sense organs (except SJ starts at the vertex)
12 Divergent Channels
They have no points of their own and share points on the regular channel and share the same pathology as the regular channel
12 Divergent Channels
Channels that correspond to the zang organs are yin. Inner surface of the legs, arms, abdomen, and chest.
12 Primary Channels