Hand Flashcards
List the 2 taught hand points and describe their location
- LI4
At the level of the midpoint of the second metacarpal, between the first and second metacarpal on the dorsum of the hand. Feel for a depression and a tender spot.
- HT7
On the wrist crease (palmar aspect) located between the ulnar styloid process and the pisiform bone, lateral to (on the radial side) of the flexor carpi ulnaris tendon.
LI4 location and needling technique
- Location
- Insertion
- Depth
LI4 Needling technique
Location: At the level of the midpoint of the second metacarpal, between the first and second metacarpal on the dorsum of the hand. Feel for a depression and a tender spot
Insertion: perpendicular
Depth: 0.5 cun
LI4 anatomy
- Muscles
- Nerves (superficial, intermediate, deep) + influences
- Vessels
Muscles:
- adductor pollicis
- first dorsal interosseus
- thenar muscles
a. opponens pollicis
b. flexor pollicis brevis
c. abductor pollicis brevis
Nerves:
superficial level: superficial branch of the radial nerve (innervating the skin)
intermediate level: ulnar nerve
deep: median nerve
influences C5-T1 nerve roots
Vessels:
- radial arterydeep
- palmar arch
List 4 neuroanatomical indications for LI4
LI4 indications
- Osteoarthritis hand and wrist
- De Quervain’s tenosynovitis
- Headache, neck pain, pain in the upper extremity
- Carpal tunnel syndrome
Nb. Sympathetic switch
HT7 needling technique
- Location
- Insertion
- Depth
HT7 needling technique
Location
On the wrist crease (palmar aspect) located between the ulnar styloid process and the pisiform bone, lateral to (on the radial side) of the flexor carpi ulnaris tendon.
Insertion
Perpindicular
Depth
0.25-0.5 cun
Describe relevant HT7 anatomy
- Nerves (2)
- Muscles (1)
- Vessels (2)
HT7 anatomy
Nerves:
- medial cutaneous nerve of the forearm in the skin
- deeper - ulnar (C5 –T1)
Muscles:
- flexor carpi ulnaris
Vessels
- ulnar artery
- ulnar vein
List 4 neuroanatomical indications for HT7
HT7 indications
- Heart dysfunction (parasympathetic switch)
- wrist joint osteoarthritis or rheumatoid arthritis
- ulnar collateral ligament sprain
- flexor carpi ulnaris sprain/strain
Nb. parasympathetic switch