LIVER Flashcards

1
Q

LV blood stagnation

A

hypochondrial or abd. pain, vomiting blood, epistaxis, painful period, irregular period, menstrual blood dark and clotted, infertility

T n/a
P choppy or irregular

key
- sharp pain or masses along LV channel,
- plus blood stagnation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

LV fx

A

The two most important functions of the Liver include:
1. Ensure smooth flow of qi
● “Governs coursing and discharging”

  1. Storing Blood
    ● Storing blood, retaining blood, and regulating its circulatory volume

The Liver regulates emotional activities
2. Assists digestion and absorption
3. Promotes the smooth flow of qi, blood and
water
4. Helps in water metabolism
5. Regulates reproductive function

Stores blood, nourishes Liver,
controls Liver Yang, and
prevents bleeding
2. Regulates Blood volume:
according to the body’s
activities, the Liver increases
or decrease blood volume
inside the body to nourish
organs and tissues as needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

cold stagnation in LV channel

A

usually caused by being out in the cold

sagging distention and pain of pudendum
lower abdomen cold pain
cold limbs
vertex headache

T moist, white tc
P deep slow and tight

Tx warm liver decoction
clear liver points

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Yin Deficiency
Generating Wind

A

LV and KD yin xu

  • trembling,
  • LV sx and
  • yin xu heat sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Blood Deficiency Generating Wind

A

malnutrition of tendons meridians
- numbness in limbs
- stiff joints, muscle spasms,
- trembling hands and feet,
- itching
- & dizziness, tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Extreme Heat Generating Wind

A

extreme heat consumes body fluid, leads sinews/tendons to spasm. or extreme heat invade PC reversely during exogenous febrile disease.

sx:
- high fever
- irritability, fidgeting, coma, spasm, convulsion, stiff neck
- opistotonus, lockjaw, upward or straight staring eyes

t deep red, dry yellow tc
p wiry, rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Liver Yang Transforming into Wind

A

sx:
- dizziness, vertigo, tend to fall, shaking head, headache, neck stiffness, slurred speech, limb numbness, hand and feet trembling, staggering
- sudden loss consciousness, deviated mouth/eyes, hemiplegia, difficult speech, rattling sound in throat

t red, white or greasy tc
p wiry, thready forceful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 causes of LV wind stirring internally

A

Liver Wind Stirring Internally (also referred to as Liver Wind Agitating Within)
1. Liver Yang Transforming into Wind
2. Extreme Heat Generating Wind
3. Blood Deficiency Generating Wind
4. Yin Deficiency Generating Wind

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Liver Yang Rising Pattern
肝阳上亢証
gān yáng shàng yàng zhèng

A

Definition: hyperactivity of Liver yang with Liver and Kidney Yin deficiency

Clinical Manifestations: Dizziness, vertigo, tinnitus, distending pain in the head and eyes, flushed face, congested eyes, vexation, lassitude in the loins and legs, lumbar and knee soreness and weakness, feeling heaving in the head, ‘top heavy’, tendency to fall, insomnia and dream-disturbed sleep, poor memory.

Tongue: Red, scanty or no tc if there’s more yin xu
Pulse: Wiry and rapid

Key Points: Distending pain in the head and eyes, dizziness, vertigo, ‘top heavy’ feeling, lumbar and knee soreness and weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Liver Fire Blazing Pattern
肝火上炎証
gān huǒ shàng yán zhèng

A

Definition: flaring up of qi and fire in the Liver channel

Clinical Manifestations: Dizziness, vertigo, distending headache, flushed face, conjunctival congestion, bitter taste and dryness in the mouth, irritability, burning pain in the chest and hypochondrium, insomnia, dream-disturbed sleep, sudden tinnitus and deafness, dry stool and
yellow urine, nosebleed or hematemesis.

Tongue: Red tongue with yellow tc
Pulse: Wiry and rapid

Key Points:
- Dizziness, vertigo,
- distending headache,
- tinnitus or deafness,
- plus interior excess heat signs and symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Liver Qi Stagnation Pattern 肝气郁証
gān qì yù zhèng

A

Definition: Liver’s failure to course and discharge, which inhibits the smooth flow of qi

Clinical manifestations: Distending pain in the hypochondria or lateral abdomen (shao fu), sensation of chest oppression, frequent sighing, depression, short temper, irregular
menstrual cycle, premenstrual syndrome, distending breast pain, dysmenorrhea. There may possibly be plum-pit syndrome (globus hystericus) or goiter

Tongue: n.a. doesn’t rly change
Pulse: Wiry

Key Points:
- Depression,
- distending hypochondrium/ lateral abdomen pain,
- irregular menstrual cycle,
- wiry pulse,
- plus qi stagnation

causes
- emotional stress
- Improper diet: overconsumption of alcohol, or greasy food
- Exopathogens: Wind-cold, wind-dampness, etc. These exterior pathogenic factors may cause phlegm, dampness or blood stasis
which obstructs the Liver channel, leading to Qi stagnation
- Chronic illness may lead to qi and blood deficiency, which deprives the Liver of proper nourishment, and impairs its function of coursing and discharging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Liver Yin Deficiency
肝阴虚証 gān yīn xū zhèng

A

Definition: insufficient yin fluid in the Liver

Clinical Manifestations: Dizziness, tinnitus, dry eyes, blurry vision, hypochondriac pain with burning sensation, hot flashes, low-grade fever in the afternoon or evening,
five-center heat (palms chest soles), night sweats, trembling hands and feet

Tongue: Red, with dry coating

Pulse: Thin, wiry and rapid

Key Points:
- Malnourishment of eyes, sinews, and nails,
- plus yin deficiency

Etiology
- Long-term and excessive emotional stress
- causes qi stagnation
- which generates heat,
- which in turn impairs Yin

Treatment Principle: Tonify the Liver, nourish Yin, clear Empty-Heat if necessary
Acupuncture Method: Reinforcing, except for LIV-2 which is sedated. No moxibustion.
Formula: 一贯煎 yī guàn jiān
Linking Decoction, a.k.a. All the way through Brew

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Liver Blood Deficiency
肝血虚証 gān xuè xū zhèng

A

TEN
* tendons
* eyes
* nails

Definition: Liver and other organs lacking nourishment due to insufficient blood.

Clinical Manifestations: Dizziness, tinnitus, blurry vision, dry eyes, night blindness, floaters, pale brittle or withered nails, numbness of the limbs, muscle twitching, joint stiffness, and trembling of hands and feet. Scanty menses with light-colored bleeding, dysmenorrhea or
amenorrhea, pale lips.

Tongue: Pale
Pulse: Thin wiry

Key Points:
- malnourishment of tendons, eyes, and nails,
- plus blood deficiency

Treatment Principle: Tonify the Liver, nourish the Liver Blood
Acupuncture: Reinforcing, moxibustion may be used
formula: 補肝湯bǔ gān tāng Tonify the Liver Decoction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

LV primary functions

A
  1. Ensuring the smooth flow of qi
    ● “Governs coursing and discharging”
  2. Storing Blood
    ● Storing blood, retaining blood, and regulating its
    circulatory volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

LV major clinical manifestations

A

SHWIM
stress
hypochondriac pain or distention
wind (internal)
menstrual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

LV patterns

A

Excess Patterns
* Liver Qi Stagnation
* Liver Fire Blazing
* Liver Wind Stirring Internally
* Cold Stagnation in the
* Liver Channel
* Liver Blood Stagnation

Excess/Deficiency Pattern
* Liver Yang Rising
* Liver Yin Deficiency
* Liver Blood Deficiency
* Extreme Heat Generating Wind
* Liver Yang Transformed into Wind

Deficiency Patterns
* Blood Deficiency Generating Wind
* Yin Deficiency Generating Wind

17
Q

Primary signs and symptoms of Liver
Wind include:

A

● Spasms
● Tremors
● Tics
● Convulsions
● Paralysis
● Tingling or numbness in the limbs
● Muscle twitching
● Seizures
● Hemiplegia

18
Q

two classifications of Wind Symptoms:

A

There are two classifications of Wind Symptoms:
1. Group 1: Dizziness, vertigo, headache with a pulling sensation and/or loss of consciousness (i.e., symptoms located in the head area)
● Caused by disturbance of sensory orifices of the head and brain, referred to as the clear orifices 清竅 qīng qiào
● The disturbance of the sensory orifices is caused by pathogenic factor or lack of nourishment

  1. Group 2: Tense and stiff neck, tics, tremors, convulsions, paralysis, tingling or numbness of the limbs, seizures, hemiplegia, deviated or stiff tongue, and wiry pulse
    ● Caused by spasms of the tendons, sinews and muscles
19
Q

Liver Fire Blazing
vs.
Heart Fire Blazing

A

Pathogenesis
* LV FIRE: Qi stagnation transforms into fire and flares up along the Liver channel
* HT FIRE: Internal excess heat disrupts the Heart

Common
* Insomnia, irritability, dream-disturbe sleep, bitter taste in the mouth, red face, thirst and preference for cold
water, yellow urine, dry stool, red tongue with yellow coating, rapid pulse, or nosebleed, hematemesis

Different
* Dizziness, distending headache, conjunctival congestion, burning pain in hypochondrium, sudden tinnitus and deafness
* Vexation, hot sensation in the chest, palpitations, tongue ulcers, rapid and forceful pulse, manic behavior, delirium, burning painful urination

Tongue & Pulse
* Red tongue with yellow coating, rapid pulse

Treatment strategy Clear Liver fire Clear Heart Fire
Herbal Formulas Jia Wei Xiao Yao San, Chai Hu Qing Gan Wan Xie Xin Tang, Dao Chi San Symptoms

20
Q

pattern that causes wind stroke?

A

LV fire
LV yang rising

21
Q

LV fire blazing
vs
LV yang rising

A

LV fire blazing
- more acute
- excess heat
- Red tongue with yellow coating,
- Pulse Wiry and rapid

LYR
- gradual onset and chronic
- LYR is excess + deficiency. excess above with deficiency below
- thin yellow tc, dry coating,
- wiry thready pulse

22
Q

distinguish
lv extreme heat
liver yang
lv blood xu
lv yin xu

A

lv extreme heat
- excess heat
- convulsion, stiff neck, lockjaw, opistotonus, upward/straight staring eye
- high fever, fidget, coma
- t red/deep red
- p rapid, wiry, forceful

liver yang
- KD LV yin xu, LV yang hyperactive
- heat, excess above, deficiency below
- severe vertigo, tremor, difficult speech, sudden coma, hemiplegia
- HA, stiff tongue, staggering
- t red
- p wiry, may be thready, forceful

lv blood xu
- xu heat
- numbness, trembling, twitching, stiff joints
- paleness, dizziness
- t pale
- p thready, weak

lv yin xu
- xu heat
- tidal fever, night sweat
- t red, cracked with little tc
- p thready, rapid, weak

23
Q

Liver Relationships

A

Spirit Ethereal Soul 魂 hún
Internal-external connection Gallbladder
Open orifice Eyes
Controls Tendons and Sinews
External manifestation Nails
Fluid Tears
Fire Ministerial fire
Emotion Anger
Season Spring
Five Phase Wood
Six Climate Factor Wind

24
Q

Physiological characteristics of the Liver

A

In relation to Qi, the most important pattern is Liver Qi stagnation
● The Liver only very rarely suffers from deficiency of Qi

Deficiency
- Liver Qi deficiency does occur, manifesting primarily on a psychological level, with symptoms such as depression, shyness and lack of initiative
- The Liver does encounter patterns of deficiency of Blood and Yin
- Blood may easily be depleted, giving rise to Blood deficiency and scanty
periods
○ Blood may also become stagnant, often due to stagnation of Liver Qi
○ ‘Qi is the commander of Blood’ and when Qi stagnates, Blood congeals

Liver and the Sinews
● The relationship between the Liver and the Sinews very often manifests in pathology of the muscles and fatigue
● Physical tiredness with weakness or contraction of the tendons may be seen

Liver pathology also involves pathological changes that
develop very rapidly (just like Wind) such as:
● Sudden tinnitus
● Skin rashes appearing out of the blue
● Sudden outbursts of anger
● If severe, sudden collapse and coma

25
Q

LV 6 channel pairing
internal/external pair

A

In the Six-Channel pairing the
Liver Foot Jueyin
Pericardium Hand Jueyin

Internal/external
LV GB

26
Q

Liver Disease Patterns (12)

A

Excess Patterns (5)
* Liver Qi Stagnation
* Liver Fire Blazing
* Liver Wind Stirring Internally
* Cold Stagnation in the Liver Channel
* Liver Blood Stagnation

Excess/Deficiency Pattern (5)
* Liver Yang Rising
* Extreme Heat Generating Wind
* Liver Yang Transformed into Wind
* Blood Deficiency Generating Wind
* Yin Deficiency Generating Wind

Deficiency Patterns (2)
* Liver Yin Deficiency
* Liver Blood Deficiency