Hand Taiyang 11-19 Flashcards
SI11 Tian Zhong
Heavenly Gathering
SI11 Location
On the scapula in a tender depression, 1/3 the distance from the midpoint of the inferior border of the scapular spine and the inferior angle of the scapula
SI11 Needling
Perpendicular or oblique insertion 0.5-1.5 cun
SI11 Associations
No hats.
Trigger Point
Homeostatic Point 8
SI11 Indications
Conditions / Symptoms:
Mastitis, Insufficient Lactation
Asthma
Shoulder Pain
TMJ/Facial Pain
Anxiety
Breast Cancer/Distention
Arm Pain
Breast problems, mastitis, insufficient lactation, breast pain.
Emotional issues, anxiety that presents with asthma, expands and relaxes the chest, asthma generally.
Local point for channel pain within the shoulder, scapula region, elbow, arm, face and jaw.
SI11 TCM Actions
Activates the channel and alleviates pain
Moves qi and unbinds the chest and lateral costal region
Benefits breasts
SI11 TCM Patterns
Lung Qi Deficiency
Liver Qi Stagnation
SI11 Neuroanatomy
Superficial Innervation: Suprascapular nerve, from posterior division of the superior trunk of the brachial plexus (C5 - C6)
Dermatome Segment: T2
SI11 Trigger Point
Muscle: Infraspinatus and lower trapezius
Myotome Innervation: Infraspinatus: suprascapular nerve (C5 - C6); trapezius: motor - accessory nerve (CN XI), sensory - cervical spinal nerves from C3 and C4
Location Notes: There are three other trigger points near here that may become sensitized on the infraspinatus muscle. One lies superior, one superior and slightly lateral and one slightly medial
Pain Referral Pattern:
Infraspinatus: To shoulder with some spillover down radial side of arm and maybe to neck below occiput, or to medial side of scapula if located slightly medially
Lower trapezius: To medial border of scapula
Indications: Shoulder and arm pain, especially with inability to reach arm behind ; Cardiac syndromes
SI11 Nearby Points
UB14 - 1.5 cun lateral to GV line level with T4
UB43 - 3 cun lateral to the GV line, level with T4
Huatuojaiji - T4
SI12 Bing Feng
Grasping the Wind
SI12 Location
In the centre of the suprascapular fossa, directly above SI11, in a depression formed when the arm is raised
SI12 Needling
Perpendicular or oblique medial insertion toward the spine 0.5-1 cun
SI12 Caution
Deep needling carries risk of pneumothorax
SI12 Associations
No hats.
Meeting Point of SI, LI, GB and TH Meridians
Trigger Point
SI12 Indications
Conditions / Symptoms:
Muscle Weakness
Arm Pain
Shoulder Pain
Local point for shoulder, scapula and/or arm pain, numbness, weakness along the course of the channel.
SI12 TCM Actions
Expels wind and benefits shoulder and scapula
SI12 TCM Patterns
N/A
SI12 Neuroanatomy
Superficial Innervation: Suprascapular nerve from C5 - C6
Dermatome Segment: C4
SI12 Trigger Point
Muscle: Supraspinatus
Myotome Innervation: Suprascapular nerve (C5 - C6)
Pain Referral Pattern: To lateral aspects of shoulder and elbow, with spillover across top of shoulder and all down lateral and radial aspects of the arm
Indications: Pain of shoulder, especially on abduction of arm
SI12 Notes
One of the 18 tender spots used in the diagnosis of fibromyalgia
SI12 Nearby Points
UB12 - 1.5 cun lateral to the GV line, level with T2
UB41 - 3 cun lateral to the GV line, level with T2, on the spinal border of the scapula
SI13 Qu Yuan
Crooked Wall
SI13 Location
On the medial extremity of the suprascapular fossa, midway between SI10 and the spinous process of T2
SI13 Needling
Perpendicular 0.3-0.5 cun, or oblique 0.5-1 cun
SI13 Caution
Too medial insertion, or deep medial oblique insertion may puncture the lung
SI13 Associations
No hats.
Trigger Point
SI13 Indications
Conditions / Symptoms:
Shoulder Pain
Local point for shoulder and/or scapular region pain, weakness and/or stiffness. Useful for chronic shoulder problems.
SI13 TCM Actions
Benefist the shoulder and scapula
SI13 TCM Patterns
N/A
SI13 Neuroanatomy
Superficial Innervation: Suprascapular nerve from C5 - C6
Dermatome Segment: T1
SI13 Trigger Point
Muscle: Serratus posterior
Myotome Innervation: 2nd through 5th intercostal nerves
Location Notes: This point is located beneath the scapula and accessible only when the scapula is abducted. When needling Travell & Simons (1998) suggest putting fingers on the underlying rib to fix its location and needling at a tangent to the skin, keeping the needle directed towards the rib at all times. Melzack (1977) correlates this point to the infraspinatus trigger point but his diagrams clearly point beneath the scapular spine making Tianzhong SI-11 a better alternative.
Pain Referral Pattern: To the entire scapula and through to the anterior chest wall. Also down the posterior aspect of the arm, the dorsal aspect of the forearm and to the little finger
Indications: Deep ache at rest exacerbated by lifting objects with outstretched hands, but unaffected by unloaded movements
SI13 Nearby Points
UB12 - 1.5 cun lateral to GV line, level with T2
UB41 - 3 cun lateral to GV line, level with T2
TH15 - Midway between GB21 and SI13 on the superior angle of the scapula
SI14 Jian Wai Shu
Outer Shoulder Shu
SI14 Location
3 cun lateral to the lower border of T1 (GV 13)
SI14 Needling
Oblique medial insertion 0.5-1 cun (0.5-0.8)
SI14 Caution
Perpendicular insertion carries risk of pneumothorax
SI14 Associations
No hats.
Trigger Point
SI14 Indications
Conditions / Symptoms:
Pleurisy
Occipital Neuralgia
Neck Pain (rigidity, hard to turn)
Shoulder Pain (cold sensation
(Pons in brainstem close to neck, this is mainly for neck issues)
SI14 TCM Actions
Activates channel and alleviates pain
Expels wind and cold, benefits shoulder and neck
SI14 TCM Patterns
N/A
SI14 Neuroanatomy
Superficial Innervation: Dorsal scapular from ventral ramus of C5
Dermatome Segment: C6
SI14 Trigger Point
Muscle: Middle trapezius and middle levator scapulae (deep)
Myotome Innervation: Trapezius: Motor - accessory nerve (CN XI), Sensation - dorsal rami of C2 - C3; Levator scapulae: Cervical nerve (C3 - C4) and dorsal scapular nerve (C5)
Location Notes: A second levator scapulae trigger point may be located directly above this point, between Jianjing GB-21 and bailao
Pain Referral Pattern:
Middle trapezius: to midline around spine at levels of neck and scapula
Levator scapulae: directly superior to this point to the posterior neck and medial portion of the trapezius with some spillover to the medial border of the scapula and the posterior lateral joint of the scapula (around Naoshu SI-10)
Indications: Myalgia in shoulder region ; Shoulder and neck pain
SI14 Nearby Points
GV13 - Lower border of T1
TH15 - Midway between GB21 and SI13 on the superior angle of the scapula
GB21 - Directly above the nipple at the midpoint of a line connecting GV14 and the acromion at the highest point of the shoulder
SI15 Jian Zhong Shu
MIddle Shoulder Shu
SI15 Location
2 cun lateral to the lower border of C7
SI15 Needling
Oblique medial insertion towards the spine 0.5-1 cun (0.5-0.8 in thin)
SI15 Caution
Risk of pneumothorax on deep needling
SI15 Associations
No hats.
SI15 Indications
Conditions / Symptoms:
Shoulder Pain
Cough (coughing blood) hemoptysis
Asthma
Neck Pain
SI15 TCM Actions
Activates channel and alleviates pain
Descends lung qi
SI15 TCM Patterns
N/A
SI15 Neuroanatomy
Superficial Innervation: Dorsal rami of spinal nerves C3 - C5
Dermatome Segment: C5
SI15 Nearby Points
GV14 - Lower border of spinous process of C7
GB21 - Midway between GV14 and acromion
TH15 - Midway between GB21 and SI13 (spoon of superior angle of scapula)
SI16 Tian Chuang
Heavenly Window
SI16 Location
On the posterior border of the sternocleidomastoid muscle level with the laryngeal prominence, posterior to LI18
http://www.steve-woodley.co.uk/?content=pointsearch&point=SI-16
SI16 Needling
Perpendicular insertion 0.5-0.8 cun
SI16 Indications
Conditions / Symptoms:
Goiter
Alzheimers
Uritcaria
Neck pain
Thyroiditis
Multiple Sclerosis (MS)
Anxiety, bipolar, hallucinations
Parkinson’s Disease
Loss of voice/hoarseness
Ear - tinnitus
Sore Throat
Shoulder Pain - radiating to neck
SI16 Associations
Window of Sky
SI16 Notes
Both SI 16 & SI 17 are Window of the Sky Points and are useful for throat distention, swelling, goiters, lumps in neck a/or throat, voice issues.
Tong Ren/Tam Healing System: Used to effect the circulation within the vertebral artery and the occipital artery. Useful for occipital headache, alzheimer’s, brain tumors, dyslexia, MS, and many brain issues related to circulation. Often used with Tian Dong as a starting point.
SI16 TCM Actions
Benefits the ears, throat, voice
Regulates qi and calms spirit
Activates channel, alleviates pain and clears heat
SI16 TCM Patterns
N/A
SI16 Neuroanatomy
Superficial Innervation: Transverse cervical nerve (C2 - C3)
Dermatome Segment: C3
SI16 Trigger Point
Muscle: Cleidomastoid
Myotome Innervation: Motor functions supplied by ipsilateral accessory nerve (CN XI); Sensation provided by dorsal rami of C2 - C3
Location Notes: Trigger point location would be on the belly of the cleidomastoid
Pain Referral Pattern: To the ear and behind the ear and to the forehead above the eye.
Indications: Frontal headaches and dizziness
SI16 Nearby Points
LI18 - Level with the tip of the Adam’s apple, between the sternal and clavicular heads of the SCM
Yi MIng - 1 cun posterior to TH17
Tian Dong -Center point between GV 14 and CV 22, below SI 16, behind LI 17 at the corner of the neck and shoulder, angling 45 degrees downward towards C7.
ST9 - Level with the tip of the laryngeal promincence on the anterior border of the SCM (where the pulse of the common carotid artery is felt)
SI17 Tian Rong
Heavenly Appearance (Celestial Countenance)
SI17 Location
In the depression between the angle of the mandible and the anterior border of the SCM
SI17 Needling
Directed toward the root of the tongue, anterior to the carotid vessels, 0.5-1 cun
SI17 Caution
Carotid artery
SI17 Associations
Window of Heaven
(Trigger Point)
SI17 Indications
Conditions / Symptoms:
Headache
Obstruction of throat/Goiter/Thyroiditis
TMJ
Hypertension (High BP)
Ear - tinnitis, hard of hearing
Asthma
Dizziness
Sore Throat/Cough
Both SI 16 & SI 17 are Window of the Sky Points and are useful for throat distention, swelling, goiters, lumps in neck a/or throat.
Chest oppression, wheezing, cough, asthma.
Ear issues - tinnitus, deafness.
Tong Ren/Tam Healing System: Used to effect the circulation to the brain, and the facial nerves. Useful for facial issues such as TMJ, gum problems, etc. Also used with headaches, hearing issues, dizziness and/or high blood pressure.
SI17 TCM Actions
Benefits the neck and throat and disperses swelling
Descends rebellious qi
Benefits the ears
SI17 TCM Patterns
N/A ?
SI17 Neuroanatomy
Superficial Innervation: Transverse cervical nerve (C2 - C3)
Dermatome Segment: C3
SI17 Trigger Point
Muscle: Medial pterygoid and posterior diagastric
Myotome Innervation: Mandibular branch of trigerminal nerve (CN V3)
Pain Referral Pattern: Medial pterygoid (pressure upwards to jaw): To condyloid process and posterior of mandible
Posterior diagastric (into muscles of neck): To mastoid process and occipital region
Indications: Pain in jaw, sore throat and difficulty swallowing, lump in the throat
SI17 Notes
Ling Shu Ch. 75, On Piercing to Regulate True and Evil Qi, recommends this point as part of the “Shaking Off Dust” treatment for when Yang Qi rebels upwards to fill the chest making the patient agitated, breathing with his shoulders, averse to dust or smoke, panting noisily and sitting forward. The throat seems closed. The piercing must not exceed 1 Cun in depth.
SI17 Nearby Points
http://steve-woodley.co.uk/?content=pointsearch&point=SI-17
TH16 - Directly below the mastoid process, level with the mandibular angle and on the posterior border of the SCM (in line with SI17 and GV15)
ST5 - Anterior to the angle of the mandible on the anterior border of the masseter muscle in a groove-like depression (facial artery groove) with cheeks bulged (jaw clenched)
GB12 - in a depression inferior and posterior to the mastoid process
SI18 Quan Liao
Cheek Bone Crevice
SI18 Location
Directly below the outer canthus of the eye, in a depression at the lower border of the zygomatic bone
SI18 Needling
Perpendicular 0.3-0.5
Oblique or SubQ 0.5-1 cun
Transverse to ST4, ST6, ST7, LI20
No Moxa
SI18 Caution
Contraindicated to moxibustion
SI18 Associations
No hats?
Meeting point for all Leg Yang Sinew meridians
Crossing Point of SI and SJ meridians
SI18 Indications
Conditions / Symptoms:
Bells Palsy
Eye deviation, eyelid twitching
Abscess of lip
Trigeminal Neuralgia/Toothache
Inability to chew
Facial Pain/Twitching
Yellow sclera
SI18 TCM Actions
Eliminates wind and alleviates pain
Clears heat and reduces swelling
SI18 TCM Patterns
Lung Wind Invasion - Wind Heat
Lung Wind Invasion - Wind Cold
?
SI18 Neuroanatomy
Superficial Innervation: Infraorbital nerve, from maxillary branch of trigeminal nerve (V2)
Dermatome Segment: CN V2 maxillary branch of trigeminal
SI18 Notes
Although this seems an odd point for pain of the back and legs indicated by it being the confluence of the Yang leg sinews, it could be due to strain or pain in the sinews producing a grimace and tension at this point which will become an ahshi over time.
In Tung acupuncture the point Ma Jin Shui Horse Gold Water, is located at this point with another Ma Kuai Shui, Horse Fast Water, located 0.4 cun below it. They are indicated for pain originating in the kidney, bladder, lower back and legs, including stones and UTIs, nephritis and frequent urination. They also have indications for sinusitis and chest pain. (Chu, 2015).
SI18 Nearby Points
http://steve-woodley.co.uk/?content=pointsearch&point=SI-18
LI20 - In the nasolabial groove, level with the midpoint of the lateral border of the ala nasi
ST3 - Directly below the pupil, level with the lower border of the ala nasi
Bitong - At the highest point of the nasolabial groove
SI19 Ting Gong
Hearing Palace
SI19 Location
Anterior to the tragus and posterior to the condyloid of the mandible in a depression formed when the mouth is opened
SI19 Needling
Needle with mouth open. Perpendicular 0.5-1 cun. The patient can close their mouth after needling.
SI19 Associations
Exit Point to BL1
(Intersection point of SI, TH, GB)
SI19 Indications
Conditions / Symptoms:
Manic Depression
Abdominal/Heart/Chest Fullness
Tinnitus
Ear Problems any kind
Laryngitis
Otitis/Otorrhea
Temporomandibular Joint Disorder (TMJ)
Toothache
Epilepsy (Seizure)
(Matelotte is a fish stew with wine. Ear bones (ossicles) were formed from bones in the jaws of reptiles. Reptile jaws homologous to fish gills.)
Ear problems of any etiology, inflammation, deafness, tinnitus, hearing loss. TMJ, toothache.
Calms the spirit - manic behavior, epilepsy, sensation of pressure below the heart.
SI19 TCM Actions
Benefits the ears (Empirical ear point)
Calms the spirit
SI19 TCM Patterns
Shen Disturbance
Phlegm Misting Heart
SI19 Neuroanatomy
Superficial Innervation: Auriculo-temporal nerve from posterior division of mandibular branch of trigeminal nerve (CN V3)
Dermatome Segment: CN V3 mandibular branch of trigeminal
SI19 Notes
Ling Shu Ch. 5 places this point, described as the “centre of the ear”, as the end of of Shaoyang with Qiao Yin GB-44 as the root. In cases of where the joints become weak and the patient sways the whole channel is to be examined for surplus and deficiency and the pathology removed. Ting gui GB-2 might seem a more obvious location, being at the other end of the foot Shaoyang meridian but both arm and leg Shaoyang meridians meet at this location.
Ling Shu Ch. 52, On the Wei Qi, considers this to be the tip of the foot Shaoyang meridian with the root being at Zuqiaoyin GB-44.
SI19 Nearby Points
http://steve-woodley.co.uk/?content=pointsearch&point=SI-19
TH21 - Anterior to the supratragic notch and behind the posterior border of the condyloid process of the mandible with mouth open
GB2 - Anterior to the intratragic notch at the posterior border of the condyloid process of the mandible with the mouth open
ST7 - On the face, anterior to the ear, in a depression between the zygomatic arch and the mandibular notch, with mouth closed
TH17 - Posterior to the lobule of the ear, in between the mandible and the mastoid process
GB3 - In a depression directly above ST7 on the upper border of the zygomatic arch, in front of the ear
