Knee Flashcards
List the 3 taught knee points and describe their location
Knee points
- GB34
On the lateral aspect of the leg, inferior to the head of the fibula and anterior to the neck 2 cun below the lateral knee joint line.
- SP9
On the medial aspect of the leg, 2 cun below the medial knee joint line, posterior to the tibia and anterior to the soleus and gastrocnemius, at the apex of the curve between the shaft and the tibial condyle.
- BL40
At the midpoint of the Popliteal crease between the tendons of biceps femoris and semitendinosus.
GB34 location and needling technique
- Location
- Insertion
- Depth
GB34 location and needling technique
Location
On the lateral aspect of the leg, inferior to the head of the fibula and anterior to the neck 2 cun below the lateral knee joint line.
Insertion
lateral to medial, towards the interosseous space
Depth
1-1.5 cun
List relevant GB34 anatomy
- Muscles (2)
- Nerves (1; deeper - 3)
- Vessels (2)
GB34 anatomy
Muscles
- peroneus longus
- peroneus brevis
Nerves
- lateral sural nerve L4-S1 in the skin
* Deeper*
common peroneal (anterior division of sciatic nerve) L4-S2 Three branches:
- deep peroneal nerve (anterior compartment) L4-S2
- superficial peroneal nerve (lateral compartment) L5-S2
- recurrent articular nerve (lateral aspect of knee joint)
Vessels
- & 2. inferior lateral genicular artery and vein
List 5 neuroanatomical indications for GB34
GB34 indications
Nb Sympathetic Switch, special point for musculoskeletal disorders
- Often used in conjunction with SP 9 to treat the entire knee joint (peripheral nerve stimulation dealing with all the soft tissues in the knee)
- Pain and inflammation of the lateral aspect of the knee joint,
- Ligament strain/sprain
- chondromalacia
- patellofemoral syndrome.
SP9 location and needling technique
- Location
- Insertion
- Depth
SP9 location and needling technique
Location
On the medial aspect of the leg, 2 cun below the medial knee joint line, posterior to the tibia and anterior to the soleus and gastrocnemius, at the apex of the curve between the shaft and the tibial condyle.
Insertion
perpendicular, medial to lateral
Depth
1-1.5 cun
List relevant SP9 anatomy
- Muscles (5)
- Nerves (1; deeper - 1)
- Vessels (6)
SP9 anatomy
Muscles
- sartorius insertion
- gracilis insertion
- semitendinosus insertion
- plantaris
- popliteus
Nerves
- saphenous nerve L3-4 in the skin
* Deeper* - tibial nerve L4-S3
Vessels
- & 2. posterior tibial artery and vein
- & 4. medial inferior genicular artery and vein
- great saphenous vein
- genu suprema artery
List 3 neuroanatomical indications for SP9
SP9 indications
- Pain in the muscles of the leg
- Sprain/strain/arthritis of the medial aspect of the knee joint
- Tendonitis of popliteal and plantaris
BL40 location and needling technique
- Location
- Insertion
- Depth
BL40 location and needling technique
Location
At the midpoint of the Popliteal crease between the tendons of biceps femoris and semitendinosus.
Insertion
posterior to anterior, perpendicular to the skin, (possible to insert intra- articularly if using a long enough insertion). Flex the knee slightly to take tension off the posterior neural and vascular structures.
Depth
1 - 1.5 cun
List relevant BL40 anatomy
- Muscles (3)
- Nerves (2)
- Vessels (3)
BL40 anatomy
Muscles
- biceps femoris
- semitendinosus
- gastrocnemius
Nerves
- posterior femoral cutaneous nerve S1-3 in the skin
- tibial nerve L3-S4 (continuation of the line of the sciatic nerve)
Vessels
- femoropopliteal vein
- & 3. popliteal vein and artery
List 5 neuroanatomical indications for BL40
BL40 indications
Nb. Parasympathetic Switch
- Increases ROM of the knee
- Hamstring tendonitis
- Baker’s cyst
- Low back pain (with or without sciatica)
- Achilles’ tendonitis
