Localización de los Puntos Flashcards
13H
Anterior and inferior to the free end of the 11th rib, approximately 1 cun superior to the umbilicus.
How to find
Quick method: Ask the patient to press their flexed elbow (90°) against the lateral aspect of the thorax and the tip of the olecranon will be pointing to the free end of the 11th rib. LIV-13 can then be located on its anterior and inferior border. Or: Place the hand on the upper abdomen and, with gentle pressure, palpate along the lower border of the rib cage until you can feel the free end of the 11th rib just superior to the umbilicus. Locate LIV-13 on its anterior and inferior border.
Located on approximately the same level (1 cun superior to the umbilicus) are ➞Ren-9 (on the midline) and ➞ST-24 (2 cun lateral to the midline). ➞ G.B.-25 is located more laterally and inferiorly, at the free end of the 12th rib.
Needling
0.5–1 cun vertically or better obliquely in a lateral direction. Caution: Peritoneum, hypertrophied organs (right: liver, left: spleen).
Actions/Indications
● Harmonises the Liver and the Spleen, regulates Liver Qi (especially in the Middle and Lower Burner), strengthens the Spleen
● Opens the channel
Special features
Front-mu point of the Spleen, meeting point with the dai mai and the G.B. channel. Hui-meeting point of the zang-Organs.
9P
On the ventral aspect of the wrist, at the level of the wrist joint space (most distal wrist crease), on the radial aspect of the radial artery and ulnar to the tendon of the abductor pollicis longus muscle.
How to find
As the location of the wrist crease varies, the ventral joint space (➞ 3.3.3) between the proximal row of carpals and the radius/ulna is a more reliable landmark for orientation. By loosely moving the hand, the joint space is easily palpable. Palpate the radial artery (pulsation) on the radial side and locate LU-9 on its radial aspect. Located on the same level are ➞ P-7 (between two tendons) and ➞ HE-7 (radial to the insertion of the tendon of the flexor carpi ulnaris on the pisiform bone).
Needling
Vertically 0.2–0.5 cun. Caution: Avoid radial artery. If the needle is pulsating (desired effect), no additional stimulation!
Actions/Indications
● Strengthens the Lung, transforms Phlegm, descends the Lung Qi
● Regulates and harmonises the vessels (relationship between zong qi and Blood circulation)
● Opens the channel, alleviates pain
Special features
Yuan-source point, shu-stream point, Earth point, tonification point, hui-meeting point of the vessels. Important point for tonifying the Lung Qi and Yin, especially with chronic disorders.
12VC
Location
( Ren-12 Middle Cavity ZHONGWAN - Acupuncture Points ) On the anterior midline, 4 cun superior to the umbilicus or 4 cun inferior to the sternocostal angle.
How to find
The distance between the sternocostal angle (➞ 3.5) and the centre of the umbilicus can be divided into 8 cun, which can vary considerably from the patient’s finger cun. Therefore, only proportional cun measurements should be applied here (helpful device: elastic tape ➞ 2.3.1). From the centre of the umbilicus, measure either 4 cun in a superior direction or from the sternocostal angle 4 cun in an inferior direction. There, locate Ren-12 on the anterior midline. Or: Spreading hands technique (➞ 2.3.3): Place the little fingers on the sternocostal angle and the centre of the umbilicus respectively and determine the midpoint (Ren-12) of this distance by joining the index fingers.
Located on the same level are ➞ KID-19 (0.5 cun lateral to the midline) and ➞ ST-21 (2 cun lateral to the midline).
Needling
0.8–1.5 cun vertically or obliquely towards surrounding points (➞ ST-21, Ren-10, Ren-15). Caution: Peritoneum, pregnancy.
If indicated, moxa is recommended.
Actions/Indications
● Harmonises and tonifies the Middle Burner, descends counterflow Qi, regulates the Qi flow and alleviates pain, transforms Dampness
Special features
Front-mu point of the stomach, meeting point with the S.I., T.B.* and ST channels, hui-meeting point of the fu-Organs. Major point for (functional) stomach disorders.
17VC
Location
( Ren-17 Chest Centre DANZHONG - Acupuncture Points ) On the anterior midline, on the level of the 4th intercostal space.
How to find
Quick method, especially in men: Locate Ren-17 on the sternum, between the two nipples. For more detailed orientation on the intercostal region (➞ 3.5), first, locate the manubriosternal synchondrosis, which can be felt on the sternum as a welldefined horizontal bony structure on the level of the costal cartilage of the 2nd rib. The 2nd intercostal space is below it. From there, count in an inferior direction to the 4th intercostal space.
Locate Ren-17 on this level on the midline of the sternum. Located on the same level in the 4th intercostal space are ➞ KID-23/ST-17/P-1/SP-18/G.B.-22/G.B.-23 (2 cun lateral to the midline/on the nipple/1 cun lateral to the nipple/6 cun lateral to the midline/on the axillary line/1 cun anterior to ➞ G.B.-22).
Needling
Depending on the indication, 0.5–1 cun transversely (subcutaneously) in a superior or inferior direction or towards the nipples (for mamillary disorders). Caution: Intracardiac needling, pneumothorax. The sternum can be very thin in this area owing to embryonic ossification disorders! Moxibustion is recommended in order to tonify the Qi, but caution with asthmatic patients.
Actions/Indications
● Regulates and benefits the Qi, unbinds the chest, descends counterflow Lung and Stomach Qi
● Benefits the breasts
Special features
Front-mu point of the Pericardium, meeting point with the SP, KID, S.I. and T.B. channels. Hui-meeting point of the Qi. Sea of Qi. Important point for respiratory disorders.
11V
Location
[(BL-11) Great Shuttle DAZHU - Acupuncture Points] 1.5 cun lateral to the posterior midline, on the level of the lower border of the spinous process of the 1st thoracic vertebra (T1,with hanging shoulders on the level of the acromion).
How to find
First, locate the spinous process of C7 (➞ 3.4.1). The next spinous process inferior to this belongs to the T1. Locate BL-11 1.5 cun lateral to the lower border of T1, at the highest point of the paraspinal musculature. Located on the same level are ➞Du-13 (on the midline), a point of ➞ Ex-B-2 (0.5 cun lateral to the midline) and ➞ S.I.-14 (3 cun lateral to the midline).
- *Needling**
0. 5–1 cun obliquely towards the spine or transversely (subcutaneously).
Caution: Pneumothorax.
Actions/Indications
● Expels pathogenic factors (Wind-Heat)
● Regulates the Lung Qi
● Opens the channel, benefits the bones and joints
Special features
Hui-meeting point with the bones; meeting point with the S.I. channel, according to some authors also with the T.B., G.B. channels and the du mai; Sea of Blood point.
17V
Location
[(BL-17) Diaphragm Shu GESHU - Acupuncture Points] 1.5 cun lateral to the posterior midline, on the level of the lower border of the spinous process of the 7th thoracic vertebra (T7).
How to find
The spinous process of the T7 is approximately on the level of the inferior angle of the scapula (➞ 3.4.2). BL-17 is located on the level of the lower border of its spinous process and 1.5 cun lateral to the midline at the highest point of the paraspinal musculature. Or: Use the spinous process of the T3 for reference (generally on the level of the medial end of the scapular spine) (➞ 3.4.2). Or: Use C7 as a reference point (➞ 3.4.1). Located on the same level are ➞ Du-9 (on the midline), a point of ➞ Ex-B-2 (0.5 cun lateral to the midline) and ➞ BL-46 (3 cun lateral to the midline).
- *Needling**
0. 5–1 cun obliquely towards the spine. In clinical practice, this point is often needled transversely (subcutaneously) towards the spine. This allows the patient to lie in a supine position during needle retention (the needles can be secured with tape).
Caution: Pneumothorax.
Actions/Indications
● Cools Blood-Heat, stops bleeding, removes Blood stasis, nourishes and harmonises Blood (and Yin)
● Regulates the diaphragm, descends counterflow Qi
● Moves Qi locally and along the channel pathway
Special features
Back-shu point of the Diaphragm, hui-meeting point of the Blood.
16IG
Location
( L.I.-16 Great Bone JUGU - Acupuncture Points ) In a depression between the acromial extremity of the clavicle and the junction of the scapular spine and the acromion.
How to find
This point is located on the shoulder, at the angle between the acromio-clavicular joint and the junction of the scapular spine and the acromion (➞3.3.1), above the most lateral portion of the trapezius and supraspinatus muscles. At this point, the tendon of the supraspinatus delves below the acromion, where it often causes problems owing to the cramped anatomical structure (for example, impingement syndrome).
Needling
Vertically 0.5–1 cun
Actions/Indications
● Opens the channel, supports the shoulder joint.
Special features
Meeting point with the yang qiao mai.
36E
Location
( ST-36 Leg Three Miles ZUSANLI - Acupuncture Points ) 3 cun distal to ➞ ST-35 (‘lateral eye of the knee’) and 1 fingerbreadth lateral to the anterior crest of the tibia, on the tibialis anterior muscle.
How to find
First, locate ➞ST-35 (‘lateral eye of the knee’, at the level of the knee joint space). From ➞ST-35, palpate 3 cun (1 handbreadth) down and 1 fingerbreadth towards lateral by placing the middle finger adjacent to the tibial crest. There, ST-36 is located in a depression, which can be palpated ‘dynamically’ (choose the point according to pressure sensitivity). Or: Palpate the lower border of the tibial tuberosity and ‘dynamically’ locate ST-36 1 fingerbreadth lateral to it.
Needling
Vertically 1–1.5 cun. Moxibustion is often used on this point.
Actions/Indications
● Regulates the Stomach, strengthens the Spleen, transforms Dampness
● Tonifies Qi and Yang, nourishes the Blood and Yin
● Calms the shen
● Opens the channel
Special features
He-sea point, Earth point, ben point (Five Phases point), lower he-sea point of the Stomach, Gao Wu command point for disorders of the abdomen, Ma Dan Yang point, Sea of Water and Grain point. Main point to tonify Qi and Blood for general weakness. Very important point.
37E
Location
( ST-37 Upper Great Emptiness SHANGJUXU - Acupuncture Points ) 6 cun distal to ➞ST-35 (at the knee joint space) or 3 cun distal to ➞ST-36 and 1 fingerbreadth lateral to the anterior crest of the tibia.
How to find
First, find ➞ ST-35 (‘lateral eye of the knee’, level with the knee joint space). From ➞ST-35, measure 6 cun (2 handbreadths) in a distal direction and, at that level, 1 fingerbreadth towards lateral (place the middle finger onto the anterior crest of the tibia). There, ST-37 is located in a depression, which can be ‘dynamically’ palpated (choose the point according to pressure sensitivity). Or: Find the midpoint of the line joining ➞ ST-35 and ➞ ST-41 (in the depression between the tendons of the extensor digitorum longus and the hallucis longus, level with the highest prominence of the lateral malleolus) by using the spreading hands technique (➞ 2.3.3). ST-37 is located 2 cun proximal and 1 fingerbreadth lateral to this point.
Needling
Vertically or obliquely 1–1.5 cun
Actions/Indications
● Regulates the Spleen, Stomach and Intestines, eliminates stagnation, clears Damp-Heat
● Opens the channel, alleviates pain
Special features
Lower he-sea point of the Large Intestine, Sea of Blood point.
39E
Location
( ST-39 Lower Great Void XIAJUXU - Acupuncture Points ) 1 cun distal to ➞ ST-38 (midpoint of the line joining ➞ ST-35 and ➞ ST-41) and 1 fingerbreadth lateral to the anterior crest of the tibia.
How to find
Quick method: Spreading-hands technique (➞ 2.3.3): Place the little fingers on ➞ ST-35 (‘lateral eye of the knee’, level with the knee joint space) and ➞ST-41 (in the depression between the tendons of the extensor digitorum longus and the hallucis longus, level with the highest prominence of the lateral malleolus) and determine the midpoint of this line (level with ➞ ST-38), using the thumbs. ST-39 is located in a depression 1 cun distal and 1 fingerbreadth (middle fingerbreadth, measured from the anterior crest of the tibia) lateral to this point. ST-39 may be palpated ‘dynamically’ (according to pressure sensitivity).
Located on the same level (7 cun proximal to the lateral malleolus) are ➞ G.B.-35 (on the posterior border of the fibula), ➞G.B.-36 (on the anterior border of the fibula) and ➞BL-58 (on the lateral border of the gastrocnemius muscle).
Needling
Vertically or obliquely 1–1.5 cun
Actions/Indications
● Moves the Small Intestine Qi, eliminates stagnation, clears Damp-Heat
● Opens the channel, alleviates pain
Special features
Lower he-sea point of the Small Intestine, Sea of Blood point.
34VB
Location
( G.B.-34 Yang Mound Spring YANGLINGQUAN - Acupuncture Points ) In the depression anterior and inferior to the head of the fibula, between the peroneus longus and extensor digitorum longus muscles.
How to find
This point is best located with the patient’s knee flexed (use knee support). Palpate for the head of the fibula on the lateral aspect of the leg and hold it with the index and middle fingers in a tweezer-like way. Gliding distally with both fingers, the more medial finger will drop into a depression directly anterior and inferior to the head of the fibula, the location of G.B.-34. Located on the same level but on the medial aspect of the lower leg is ➞SP-9 (at the junction of the shaft and the medial condyle of the tibia).
Needling
1–1.5 cun vertical insertion between the tibia and fibula towards the interosseous membrane. Caution: Deep peroneal nerve with deep needling, in some cases also common peroneal nerve. The needle may reach the interosseous membrane as well as the epineural tissue of the peroneal nerve.
Actions/Indications
● Benefits the tendons and joints
● Opens the channel, alleviates pain, benefits the lateral costal region
● Clears Damp-Heat from the Liver and Gall Bladder
● Spreads Liver Qi
Special features
He-sea point, Earth point, hui-meeting point of the tendons (coordination/movement), lower he-sea point of the Gall Bladder, Ma Dan Yang Heavenly Star point. Major point for disorders of the tendons and musculature.
39V
Location
[(BL-39) Outside of the Crook WEIYANG - Acupuncture Points] At the lateral end of the popliteal crease, on the medial side of the tendon of the long head of the biceps femoris muscle, 1 cun lateral to ➞ BL-40 (in the centre of the popliteal crease).
How to find
This point is best located with the patient’s knee slightly flexed. Find the midpoint of the popliteal crease (➞ BL-40) and locate BL-39 approximately 1 cun lateral in a depression medial to the tendon of the long head of the biceps femoris muscle. Located on the same level is ➞BL-40 at the centre of the popliteal crease.
Needling
Vertically 0.5–1.5 cun. Caution: N. fibularis communis.
Actions/Indications
● Harmonises the Triple Burner and regulates the water passages
● Opens the channel and the luo vessels, alleviates pain
Special features
Lower he-sea point of the Triple Burner.
