Single Points Flashcards
-4 cun below umbilicus
-Clear D-H + Stagnation (Qi)
Local Stagnation: amenorrhea d/t Blood Stasis
Ren 3 (Central Pole)
- Ren, Du, Chong crossing point
- benefits essence
Ren 1 (Meeting of Yin)
-Tonify Deficiency
-Tonify Yin
(Blood Xu, Body Fluid Xu) {any aspect of body fluids in body}
Ren 4 (Origin Pass)
Ren 3 vs. Ren 4
Ren 3 = Sedate Excess (also UB Xu Cold)
Ren 4 = Tonify Deficiency
- Tonify Qi and Yang
- Raise Yang Qi
- Regulate Qi: GI Tract
Ren 6 (Sea of Qi)
Ren 6 vs. Ren 17
Ren 6 = Move Qi in MJ, LJ
= Tonify Qi (whole body)
Ren 17 = Move Qi in UJ
- Moxa only
- Rescue Yang
- Strengthen Spleen
Ren 8 (Spirit Gate)
- Promotes transformation of fluids
- Controls the Water passages
- indication: Damp, edema, Tai-Yin, ascites
Ren 9 (Water Divide)
Water Metabolism points?
K7, SJ4, UB22, UB39, Sp9, Ren9, St28
- Pylorus (lower opening of St)
- Descends Qi
Ren 10
- Body (in stomach itself)
- Regulate Qi
- nausea, vomiting
- Food Stagnation
- Influential Point of Fu
- Front Mu of Stomach
Ren 12 (Central Venter)
- Fundus (Upper opening of Stomach)
- Descends Qi
- nausea, vomiting
- Food Stagnation
Ren 13
-palpitation, mental symptoms
(mania, hysteria, manic disorders)
-Front Mu point of Heart
Ren 14 (Great Tower Gate)
-itching of the abdominal skin
-Luo Connecting point of the Ren
-Calm the Mind
(emotional upset)
Ren 15 (Turtledove Tail)
-Regulate Zong Qi (circulation, respiration)
-Influential point of Qi
-Front Mu of Pericardium
-Local point: chest breast
(mastitis, poor milk supply)
Ren 17 (Chest Center)
Ren 17 and _____ point to regulate respiration.
Lung 9
Name the points level with the 4th Intercostal Space
Ren-17, K-23, St-17, Sp-18, P-1, GB-22/23
- Benefit the throat (itchy throat, esp. chronic sore throat)
- Soothe asthma
- Stop cough
- Hoarse voice, loss of voice
Ren 22 (Celestial Chimney)
Needling Technique Ren 22
- 2 cun perpendicular then…
0. 5-1 cun going down
- aphasia, slurred speech,dysphsia
- local point for tongue
Ren 23 (Ridge Spring)
Aphasia point combo
Ren 23 + Du 15
Ren 23 + H 5
- paralysis, bell’s palsy’s, windstroke
- local point for facial problem
Ren 24 (Sauce Receptacle)
- Regulate Du channel
- supporting point for rectal prolapse
Du 1(Long Strong)
- Basic point for lower backache
- any type of low back pain
Du 3 (Lumbar Yang Pass)
- Tonify Kidney Yang
- Warm Mingmen
*back pain d/t Yang Xu only…otherwise use Du 3 for back pain
Du 4 (Life Gate)
Du 4 vs. Ren 4
Du 4= only treats Yang
Ren 4= treats Yin or Yang
-Jaundice
-Resolve Damp Heat in Liver/Gallbladder (=yang jaundice)
~Cold-Damp in Spleen (=yin jaundice)
Du 9 (Extremity of Yang)
*Empirical Point for Boils
Du 10 (Spirit Tower)
- Eliminate Internal Wind: spasm, convulsion, termor, epilepsy
- Tonify Chronic Disease
Du 12 (Body Pillar)
- Clear Heat (Exterior & ShaoYang)
- Release Exterior Wind-Heat
- Warm Four Limbs (moxa)
- Heart Yang Xu or Heart Qi Xu (moxa)
- 6 Yang channel crossing
- YangMing Disorders (ShanHanLun)
Du 14 (Great Hummer)
- Stimulate Speech
- aphasia (+H 5)
Du 15 (Mute’s Gate)
Needling Technique Du 15
Perpendicular 0.5-0.8 cun
C: medulla oblangata (causing brain damage)
- Both Exterior and Interior Wind
- mainly W-C
Du 16 (Wind Mansion)
- Clear the Mind
- Lift the Spirit
- Ascend Spleen Yang (Xu above, Excess below)
- Promote resuscitation (uncosciousness)
- Eliminate Interior Wind
Du 20 (Hundred Convergence)
What way do you needle Du 20 to:
- Clear the Mind - Lift the Spirit - Ascend Spleen Yang
needle WITH the channel
What way do you needle Du 20 to:
-Eliminate Interior Wind
needle AGAINST the channel
-Open the nose
Du 23 (Upper Star)
When needling Du 23, Du 22 (possibly Du 19 & 21) what do you have to caution?
Metopism (fontanels on infants not closed)
- Promote resuscitation
- used for ACUTE lower backache
- used only if trauma, surgery, etc.
- Facial Edema: Yang Edema (like wind-water)
Du 26 (Water Through Mansion)
What Yangming channels pass through Du 26?
Large Intestine & Stomach
->Yangming channels has the most Qi & Blood
Lu 1 vs. UB 13
Lung 1= Excess
UB 13= Better for deficiency
- Cough d/t yin xu
- better for sedation
Lu 1
- Phlegm in the Lungs
- Phlegm Heat or Phlegm
- Visible Phlegm
Lu 5 (Cubit March)
Lu 10 vs. Lu 5
Lu 5= Phlegm Heat
Lu 10= Heat
(NO phlegm)
Lu 5 vs. St 40
Lu 5= Phlegm in the Lungs (visible)
St 40= Phlegm anywhere (invisible or visible phlegm)
- Stop Hemoptysis (+UB17)
- Treat Bleeding hemorrhoid (moxa)
Lu 6 (Collection Hole)
- Ren Confluent Point (+K6)
- Disperse W-C (+LI4, UB12)
- Open water passages for yang edema
- command point for head and neck
Lu 7 (Broken Sequence)
- Tonify Lung, Benefit the Heart
- Yuan source of Lung
- Vessel influential point
- strengthens Zong Qi
Lu 9 (Great Abyss)
Lu 7 vs. Lu 9
Lu 7= exterior, interior / excess, deficiency / water (yang edema)
Lu 9= interior / deficiency / phlegm
- Clear Lung Heat
- Ying spring point
Lu 10 (Fish Border)
Whats the difference fro Lu 5 and Lu 10
Lu 5= Phlegm Heat
Lu 10= Lung Heat
-Mental problem: manic disorder
-Bleeding point for sore throat
(excess heat to clear excess heat)
Lu 11 (Lesser Metal)
LI 4 vs. Liv 3
LI 4= located at Yin to Yang transition
Liv 3= located at Yang to Yin transition
- Promote delivery during labor
- Disperse Exterior Wind (eplipsey, w-d, wind d/t blood xu, yang xu)
- Treat Internal Wind
- Stop Pain
- Command point of Face (Bell Palsy, Trigeminial Neurigal)
LI 4 (Union Valley)
- open the Lu Water passage
- Yang edema (+ Lu 7)
LI 6 (Slanting Passage)
Yang Edema vs. Yin Edema?
Yang Edema= Acute, on face, wind-water invasion
Yin Edema= Lower Body, Abdomen, d/t yang xu of spleen & Kidney
- Powerful Qi + Blood Tonic
- Boost Wei Qi (prevent cough & colds)
St 36 + LI 10
- both are yangming - both are located at elbow/knee
*Clear Heat
-organ level
-Wind Heat, Blood Heat, Toxic Heat, Damp Heat
!!Tongue: Red
!!Pulse: Rapid
{must have this tongue and pulse to use this point}
-Fire Engine Point
LI 11 (Crooked Pond)
- Benefits sinews
- Promotes circulation of Qi in the Channels
- Stop Pain
- Expel Wind
LI 15 (Shoulder Transporting Point)
-Open nasal orifice (+Lu 7 +LI4 +Du23)
LI 20
-Facial Paralysis: Bell’s Palsy, Trigeminal Neuraliga, Stroke (+ LI4)
St 4 (Earth Granary)
Needling Technique ST 4
thread subcuntaneously ST 4 -> ST 6
- major local point: Dizziness d/t Damp/Phlegm
- Yangming Headache (+LI 4 +ST4)
ST 8 (Head Support)
Label the points in order that are level with St-8
Du-24, UB-3, UB-4, GB-15, GB-13
-cupping point for chronic cough
-Local point for breast problems
(mastistis, pre-menstrual swelling, lump)
-regulate lactation
ST 18 (Breast Root)
- supports Ren 12
- excess and deficiency conditions for Stomach issues
- St prolapse local point (CAM)
St 21 (Beam Door)
- Acute/Chronic constipation
- Acute diarrhea
- Abdominal Distension
St 25 (Heavenly Pillar)
Point combination for Constipation
SJ-6 + K-6
Basic point for Diarrhea: St 36
- Acute: \_\_\_\_\_ - Chronic: \_\_\_\_\_
Diarrhea= ST-36
- Acute: +ST 25 - Chronic: +UB20
- Qi Stagnation
- LI Abscess
- Intense stuck Qi in LJ
St 27
ST-27, ST-28, ST-29
ST-27: QI
ST-28: Water
ST-29: Blood
- open the water passage
- water metabolism point
St 28 (Water Passage)
- Excess case of gynecological disease (blood stasis)
- remove blood stasis & regulate menses
- amenorrhea d/t blood stasis
St 29 (Returns)
-xi cleft: Stop Pain
(pain d/t heat, cold, food stagnation)
St 34 (Beam Mound)
- organ prolapse
- slightly warming
- treats cold in LJ
- regulate abdomen (command point)
- major point to tonify Qi and Blood
- Any etiology: excess/deficiency, heat/cold
St 36 (Foot 3 Mile)
ST 36 + Ren-12
Abdomen
ST-36 + Ren-12 + P6
Epigastrium
ST-36 + SP-3
Tonify Middle Jiao
ST-36 + LI-10
Boost up immune system
ST-36 + GB-39(moxa)
Prevent stroke (internal wind)
ST-36 + UB-12(moxa)
Prevent Cold (external wind)
-Regulate LI (Damp-Heat, Heat)
Lower He Sea: Stomach 37
-Regulate SI (SI Qi Pain, SI Qi Tied, SI Xu Cold)
St 39 Lower He Sea
-Regulate SJ (water metabolism)
UB 39 Lower He Sea
-Empirical distal point for shoulder pain
St 38 (Narrow Opening)
- Any phlegm (visible/invisible/channel)
- drains excess from Stomach
- calms mind
St 40 (Abundant Buldge)
-St heat: bleeding gums, bad breath, intense thirst, etc. (+LI 11)
-Distal point:
facial paralysis, trigeminal neuralgia, yangming headache (+LI 4)
St 44 (Inner Courtyard)
- located on opposite side of ST 44
- food stagnation
Inner-Neiting
Moxa for Uterine bleeding d/t Cold, Heat, phlegm, etc.
Gui Pi Tang (spleen not holding blood)
Gu Jing Wan
Wen Jin Tang
Gui Zhi Fu Ling Wan
Sp 1 (Hidden Whites)
Remove Stagnation of Blood, Cold, Food, Damp
(does NOT clear Heart from middle Jiao)
Luo Connecting
Chong Confluent
Sp 4 (Ancestor and Descendent)
Local point for Foot Edema (+GB41)
-yin/yang edema local point
Sp 5 (Metal Mound)
Nourish Kidney Yin
Soothe Liver Qi Stagnation
Remove Spleen Damp
*nourish whole body yin
Sp 6 (3 Yin Intersection)
Nourish Yin, Calm Shen
Genital area problems: Man and Women
Sp 6 (3 Yin Intersection)
Stop Pian: Dysmenorrhea
xi cleft point
Sp 8 (Earth Pivot)
Sp 9 vs. St 40
Sp 9 = Damp
St 40 = Phlegm (phlegm in lungs & mind)
Regulate water
Damp-Heat
Cold-Damp
Edema, Lin Syndrome
Sp 9 (Yin Mound Spring)
Keep blood in the vessels -gui pi tang Skin problems (+LI11 + UB40) Cool blood & move blood (+UB17) -mu dan pi, chi shao
Sp 10 (Sea of Blood)
Supports ST 25: Abdominal Pain
Liver overacting Sp type abdominal pain
Sp 15 (Great Horizontal)
Control all the minute Blood connecting channels
Generalized pains: blood stasis, moving muscular pain, phantom pain, (really good for fibermyalgia)
Luo Point of all major collateral channels
Sp 21
H5, H6, H7, H8, H9
P4
H5= Qi (controls tongue) H6= Yin (night sweating) -> tonify yin H7= Blood (calm shen) H8= Fire (Heat) H9= Orfice P4= Pain in the chest
H Heat transferring to SI -> SI Heart
Tonify Heart Qi
Aphasia
H5 (Connecting Village)
Nourish Heart Yin
Stop night sweating (+K7)
H6 (Yin Cleft)
Nourish Heart Blood
Calm Shen basic point (+Sp 6 +Anmian)
H7 (Spiritual Gate)
Clear Heart Heat (+LI11)
T: Red tip or Redder tip
H8 (Lesser Mansion)
Open the Heart orifices
Phlegm misting the mind
Phlegm Fire Harassing the Heart
Mania or Shen Disturbance
H9 (Lesser Surge)
Pu Gong Ying (Dandelion)
Empirical point: Promote lactation
Breast abscess
(+ Ren 17 + St18)
SI 1 (Lesser Marsh)
Pain on neck and spine (+ UB62)
Vertex HA
Du confluent point = opening = master
SI 3 (Back Ravine)
Primary channels of vertex HA
Liv, UB, Du
Brighten the eyes
eye issues d/t xu
age related eye issues
floaters d/t Liv Blood Xu
SI 6 (Nursing the Aged)
eye issues (more d/t W-H, LYR) => xu eye issues
GB 20
xu eye issues
GB 37
Difficulty in rotating the neck (+ Luo Zhen)
Tortcolis
Luo-connecting point
SI-7 (Branch to the Correct)
Benefits the ears: tinnitus, deafness, ear issues
SI 19 (Auditory Palace)
Channel crossing points for the ear?
GB, SJ, SI
crossing point of Yang Qiao, Yin Qiao, Stomach, Small Intestine
insomnia
somnolence
UB 1 (Bright Eyes)
Somnolence (tonify UB62, sedate K6, even ____)
UB 1
Insomnia (tonify K6, sedate UB62, even _____)
UB 1
Local point: Occipital Headache
Clears the brain
UB 10 (Celestial Pillar)
Distal Points for Occipital Headache
UB 60, SI 3
Bone Bi Syndrome
Promote bone formation in children
Prevent Bone degeneration in the elderly
Treat bone deformities in chronic arthritis
Bone influential Point
UB 11 (Great Shuttle)
Release Exterior Wind: W-H, W-C
UB 12 (Wind Gate)
Release Exterior Wind (+ LI 4)
UB 12
Prevent Cold (+ moxa ST36 )
UB12
what channel crosses at UB 12
Du Channel
basic point for cough/asthma (& xu of Lungs)
Back Shu of Lung
UB 13
basic point for palpitation (& any type of heart issues)
back shu of heart
UB15
basic point for jaundice (& Liver Blood Xu)
back shu of Liver
UB 18
basic point for chronic diarrhea (& weak spleen)
back shu of spleen
UB 20
basic point for lower back pain (& kidney disorder)
back shu of Kidney
UB 23
Gall Bladder (jaundice)
UB 19
Stomach (tonify Stomach) -> not so much CAM
UB 21
San Jiao (water metabolism) [+ SJ4]
UB 22
Large Intestine (constipation) & excess conditions to regulate Qi
UB25
Urinary Bladder (Lin Syndrom) & other UB issues
UB28
Po (Corporeal Soul)
-intense grief, spirit
UB 42
Shen (Mind)
UB 44
Hun (Ethereal Soul)
UB 47
Yi (Thought)
UB 59
Zhi (Will Power)
UB 52
something stuck in the chest Blood Stasis or Blood Regulation problems asthma hiccough basic point blood influential point: Regulate Blood
UB 17 (Diaphragm Shu)
very chronic disease with great debility
-> diabetes, cancer, fibermylaga
1 cun below UB 42
UB 43 (Vitals)
Tonify lung & Tonify whole body (+ Du 12 + UB 13)
UB 43
Moxa this point to treat TB
UB 43
Move Blood Stasis Regulate menstruation (Blood stasis leading to menstruation) most important out of 4 bone hole
UB 32 (Second Bone Hole)
Regulate water metabolism: Edema
Lower He-Sea point for SJ
UB 39 (Bend Yang)
UB 22, SJ4, UB 39
Moving water points
Summer Heat Blood Heat (for skin) Lower Back Command point
UB 40 (Bend Middle)
UB 40 + SP 10 + LI11
Blood Heat (for skin)
abundant Qi & Xue
Yangming
Xue>Qi
Taiyang, Jueyin
Qi > Xue
Shaoyang, Shaoyin, Taiyin
Empirical distal point for hemorrhoids
between the gastrocenemius muscle: resembles the anus
UB 57 (Mountain Support)
Weakness of the legs
Low back pain
distal point: low back pain, sciatica
UB 58 (Taking Flight)
UB 58 + K 3
Host Guest Treatment: (walking issues, numbness)
Head & Shoulder:
Taiyang (occipital) headache, shoulder, neck pain or ridgity
Backache Upper back pain
resembles neck
UB 60 (Kunlun Mountains)
Outer leg tension
Yang Qiao confluent point (opening point for Yang Qiao)
UB 62 (Extending Vessel)
SI 3 + UB 62
Spine, Brain
Daytime epilepsy
UB 62
Night time epilepsy
K 6
vertex headache Breech baby (moxa): for fetus malposition easy labor (needle): oxytocin hormone
UB 67 (Reaching Yin)
Restore Consciousness
Coma
Excess above, deficiency below
K 1 (Gushing Spring)
Origin of Stomach channel
LI 20
Origin of Heart channel
Heart
Loss of consciousness d/t Qi & Blood Xu
DU 26 + Du 20
Clear Xu Heat
Ying Spring point
K 2 (Blazing Valley)
Tonify Kidney Qi, Yang, Yin, Essence
Yuan source point -> tonify any xu
K 3 (Great Ravine)
K 3 + K6 + Ren 4
Kidney Yin
K3 + K7 + Du4
Kidney Yang
Insomnia or Somnolence
K6 + UB 62
Nourish Throat
Kidney not grasping Lung
(H & K not communicating)
K6 + L7
Constipation
K6 + SJ6
Nourish whole body Yin
K6 + SP6
Nourish Heart/Kidney Yin
K6 + H6
Nourish Yin of body & Kidneys
opening point for Yin Qiao
K6 (Shining Sea)
K6 vs. K7
K6 (Kidney Yin): Liu Wei Di Huang Wan {+Ren4}
: Zuo Gui Wan
K7 (Kidney Yang): Jin Gui Shen Qi Wan {+Du4}
: You Gui Wan
Tonify Kidney Yang
K7
K7 + LI4
Regulate spontaneous sweating (daytime)
K7 + H6
Night time sweating
Sprematorrhea (men)
K 12 (Great Manifestation)
irregular menstruation (women, excess)
K14 (Fourfold Fullness)
male & female fertility issues
K12, K14
Asthma d/t K not receiving Qi
Calm Shen
2nd intercostal space
K 25 (Cleft Gate)
Mind Seal
calm shen
K 23
Spirit Burial-ground
calm shen
K24
Spirit Storehouse
calm shen
K25
Apex of the heart
K22
Chest pain d/t blood stasis, arrhythmia, palpitations
xi-cleft point (acute case): chest pain
P 4 (Cleft Gate)
Stop chest pain
P4
Nourish H Yin
H6
Empirical Point for malaria: Qing Hao, Cao Guo
non-substantial phlegm: Phlegm misting the Mind
P5 (Intermediary Courier)
Controls Sea of Blood (Chong)
Opens the chest => controls qi in the chest
Harmonize the Stomach: any qi reversal in S => regulate qi
Opens yin wei
Calms the Shen
Regulate Qi in the upper & middle Jiao
P 6 (Inner Pass)
Carpal tunnel syndrome
Warm febrile disease (vs. H7)
calm shen (harsher than H7)
source point for H channel
P7 (Great Mound)
Water Metabolism
yuan source point
SJ 4 (Yang Pool)
disperse W-H
ear infection, tinnitus, deafness } more d/t excess
Any type of exterior invasion
opening point for Dai
SJ 5
SJ6 + GB34
Hypochondriac pain
SJ6 + GB31 (itchy skin from wind)
Herpes Zoster
Calm shen:
schizophrenia and split personality combined, bi polar,
any heavy mental disorder
meeting area of 3 Hand Yang Muscle Merdian
GB 13 (Root Spirit)
External Wind & Internal Wind -> treats excess better than xu Clear Heat -> most d/t LYR, Liver Fire Eye Infection (excess eye conditions)
GB 20 (Wind Pond)
Shoulder/Neck pain: relax tendon/ stiffness
women: breast abscess, promote lactation,
retention of placenta after childbirth
CI: pregnancy
GB 21 (Shoulder Well)
Damp Heat: jaundice, gallstones
Acute case of GB
Front Mu of GB
GB 24 (Sun and Moon)
GB 24 + GB 34 +LI 11
Jaundice, Gallstones
1st exterior point of Dai Mai
gynecological point: leukorrhea, etc.
-> d/t xu, not excess
GB 26 (Girdling Vessel)
Sciatica
Crossing point of GB & UB
GB 30 (Jumping Round)
Skin Disease (itchy quality): urticaria, herpes zoster general skin problem: (+ LI11 + SP10 + UB40) Herpes Zoster (+ SJ6)
GB 31 (Wind Market)
Clear Damp-Heat
Soothe Liver Qi (Qi Stagnation esp. w/distenstion)
Sinew Influential Point
-> muscle tendon issues going on
GB 34 (Yang Mound Spring)
Benefits the eyes: improves eye sight, eliminates “floaters”
-> Liver Blood Xu
GB 37 (Bright Light)
These herbs: Shi Jue Ming, Jue Ming Zi match what point?
GB 37
Herbs for these points:
GB 37 vs. GB 20
GB 37 = Gou Qi Zi
GB 20 = Ju Hua
Du 20, UB 67, Liv 2, Liv 3
Jueyin (Vertex) Headache
GB 41, Taiyang, GB 8
Shoayang (Temporal) Headache
S 44, S 8, LI 4
Yangming (forehead) Headache
B 60, B 10, L 7
Taiyang (Occipital) Headache
Builds white blood cells
Marrow influential point
location anterior to the femur
GB 39 (Suspended Bell)
GB 39 + B 11
Bone Bi Syndrome
GB 39 + S 36 (moxa)
Prevent Wind Stroke
Strengthen GB mental aspects:
- lack of courage, difficult making decisions
GB Xu
=> GB Qi Xu
GB 40 (Mound Ruins)
Any issues affecting the side of the body
Shaoyang (temporal) HA = Chai Hu, Chuan Xiong
Dai Mai confluent point: vaginal discharge, etc.
GB 41 (Foot Falling Tears)
Cold in the Liver channel
- Anuresis, shrinking of the sputum or vagina - Vertex HA, vomiting of clear fluids
Liv 1 (Large Pile)
Warm Liver Channel
Moxa (Liv 1)
Clear Liver Fire
Often used for excess in the Liver channel
Long Dan Cao, Xia Ku Cao, Jue Ming Zi
Liv 2 (Moving Between)
Herb: Bai Shao Tonify + Sedate (excess & xu) Stop Spasm Qi Stagnation, LYR, Liver Fire *Yuan Source that Sedates & Tonfies
Liv 3 (Great Surge)
Liv 3 + Liv 8
Tonify Liver Blood
Liver luo channel flow to genital area:
Pripism, itching, vaginal discharge
Luo connecting point
Innervation: Saphaneous (.3-.5 subcutaneously)
: 5 cun above medial mallelous
Liv 5 (Woodworm Canal)
Tonify and Sedate
He Sea: Tonify Liver Blood
Eliminate Damp: Dampness in Liv/GB
Liv 8 (Spring at the Bend)
Soothe Liver Qi (esp. Liv o/a Spleen) Relieve Food Stagnation Benefit the Spleen and Stomach Front Mu of Spleen Influential of Zang Origin of Dai Mai
Liv 13 (Camphorwood Gate)
where do DU, Chong, & Ren originate?
Originate in lower abdomen & emerge at Ren 1
Hypochondriac pain: excess/deficiency
Liv 14 (Cycle Gate)
Liv 13 vs. Liv 14
Liv 13 = Liv overact Spleen
Liv 14 = Liv overact Stomach
Empirical point for jaundice
SI 4 (Wrist Bone)