Thigh and Groin Points Flashcards
Bl 36: CHENGFU Receiving Support
Find the crease between her buttock and her thigh – the gluteal fold. The point is at the mid-point of this crease, or the mid-point of the posterior surface of her thigh, directly below Bl 54.
To find the mid-point, either trace up the line that lies between the bellies of her biceps femoris muscle, or trace a line down from
Bl 54.
(Bl 54 is approximately 3 cun lateral to the mid-line, in line with Bl 53, or the Outer Bladder Line, on a level with the 4th sacral foramen.)
Bl 37: YINMEN Thigh Gate
This point is on an imaginary line connecting Bl 36 – Bl 40, whose length is 14 cun. The point lies at 8 cun superior to the popliteal crease (or 6 cun below Bl 36) on the mid-line of the back of the thigh, between the biceps femoris and the semitendinosus muscles.
Bl 38: FUXI Superficial Cleft
Find the lateral end of the popliteal crease, and the large tendon of the biceps muscle of the thigh (biceps femoris). This point lies 1 cun superior to the popliteal crease, just medial to the tendon.
Bl 39: WEIYANG Crooked Yang
Find the lateral end of the popliteal crease, and the large tendon of the biceps muscle of the thigh (biceps femoris). This point lies just medial to the tendon, on the crease.
It is roughly 1 cun lateral to Bl 40.
Bl 40: WEIZHONG Crooked Middle
On the mid- point of the popliteal crease, between the two large tendons (of the biceps femoris and the semitendinosus muscles). Bend the knee to establish the principal crease at the flexure of the knee. Feel the seam of the centre of the gastrocnemius from Bl 57, through Bl 56 and 55, and extend this line to the knee crease. This will bring you to the mid-point between the two large tendons. Feel for the hollow of the point.
This is called a ‘vagabond’ point, in that occasionally one may have to move it a little lateral, in order to avoid the popliteal vein or popliteal lymphatic glands if any of these have become prominent at the centre of the crease.
GB 31: FENGSHI Wind Market
With the patient lying on her back, find an imaginary line from the prominence of the greater trochanter to the head of the fibula. GB 31 lies on this line, or on the mid-line of the lateral surface of the thigh, 9 cun superior to the flexure of the knee, on the posterior border of the vastus lateralis muscle.
You may now wish to put the patient in the recovery position to feel the hollow of the point more easily.
On many people, but not all, there is a rough guide that when the patient is standing upright, with her arms hanging loosely at her sides, GB 31 is found directly below the place where the tip of her middle finger touches her thigh.
NB: Classical texts state that GB 31 is found ‘at the spot touched by the tip of the middle finger’. Some classical texts include ‘at 7 cun above the lateral surface of the knee’. This has been interpreted in some modern textbooks as 7 cun above the popliteal crease and in others as 7 cun above the upper border of the patella (as described above). All texts agree that the tip of the middle finger gives a helpful rough guide. On the majority of people the tip of the middle finger brings the point to an area roughly 7 cun above the superior border of the patella, or 9 cun superior to the popliteal crease.
GB 32: ZHONGDU Middle Ditch
On the mid-line of the lateral surface of the thigh, 7 cun superior to the flexure of the knee, or 2 cun inferior to GB 31. It lies between the vastus lateralis and the biceps femoris muscles.
GB 33: XIYANGGUAN Knee Yang Gate
The point lies 1 cun superior to the flexure of the knee. Flex the knee fully to identify the lateral end of the crease. Placing your finger at the end of the crease, straighten out your patient’s leg and move your finger 1 cun proximally to locate the depression on the lateral epicondyle of the femur. The point lies here between the bone and the tendon (biceps femoris muscle).
St 31: BIGUAN Thigh Gate
14 cun superior to the flexure of the knee.
With the patient lying with her foot pointing up towards the ceiling, imagine a line from the most lateral edge of the anterior superior iliac spine to the superior-lateral corner of the patella. The point is at the intersection of this line and a horizontal line drawn from the level of the perineum.
Feel here for the rather pronounced hollow of the point.
The point lies just lateral to the sartorius muscle, which is the muscle that assists in lateral hip rotation and flexion. To identify the muscle, flex the knee towards the chest and rotate the lower leg medially as the hip rotates laterally.
St 32: FUTU Prostrate Hare
8 cun superior to the flexure of the knee.
With the patient lying with her foot pointing up towards the ceiling, imagine a line from the most lateral edge of the anterior superior iliac spine (the top of the hip bone at the side of the person’s waist) to the superior, lateral corner of the patella towards the lateral edge of the (rectus femoris) muscle. The point lies on this line, at 8 cun above the flexure of the knee, (or about 6 cun above the superior- lateral corner of the patella) towards the lateral edge of the rectus femoris muscle. A helpful method is to find St 31 at 14 cun superior to the flexure of the knee (the level of the perineum). Halve the distance from the knee to St 31 to find 7 cun, then move up 1 cun to find St 32 at 8 cun in the seam of the muscle You may also find it useful to highlight the muscles by asking your patient to raise their leg against the resistance of your hand whilst you feel for the point with your other hand as the muscle relaxes. If you press down when you have your finger on the point you should find that you are on the anterio-lateral edge of the femur.
In order to palpate the hollow of the point it is helpful first to relax the muscles of the person’s leg. Sit on the edge of the treatment table next to the person’s foot and then lift up her leg by the ankle to about 6” – 9” above the table. Now shake her leg to get the muscles of her thigh to relax. As the underlying tissue smoothes out you can run the index finger of your other hand from her knee up your imaginary line to 8 cun and feel for a dip in the underlying musculature. Put her leg down again and then feel for the hollow of the point.
St 33: YINSHI Yin Market
5 cun superior to the flexure of the knee. Draw an imaginary line from the anterior superior iliac spine to the superior, lateral corner of the patella. The point lies on this line at 5 cun above the flexure of the knee (or about 3 cun above the superior-lateral corner of the patella) on the lateral side of the rectus femoris muscle.
St 34: LIANGQIU Beam Mound
4 cun superior to the flexure of the knee. Draw an imaginary line from the anterior superior iliac spine to the superior, lateral corner of the patella. The point lies on this line at 4 cun above the flexure of the knee, (or about 2 cun above the superior-lateral corner of the patella) between the rectus femoris and vastus lateralis muscles.
St 35: DUBI Calf Nose
Find this point with the patient’s knee slightly flexed. Place a pillow under her knees in order to support them. The point is in the large hollow at the inferio- lateral corner of the patella (the ‘eye’ of the knee), just lateral to the patellar ligament, and between the patella and the tibia.
Sp 10: XUEHAI Sea of Blood
4 cun superior to the flexure of the knee.
The point lies in the middle of the medial side of the quadriceps femoris muscle (the vastus medialis). Identify this muscle by asking the patient to pull her knee backwards, flattening her leg down against the treatment table. The muscle will form a large bulge. The point lies in the centre or at the height of this large bulge.
Once you can easily visualise the approximate position of this point in the mound of muscle, there is a rough guide to help you go straight to it (providing that you and the patient are about the same size). Put your hand on the patient’s knee with the middle of your palm covering the body of her patella (L hand, R knee and vice versa). Lay your fingers down on her knee in an extended but relaxed and slightly spread position. Allow your fingers to swing to the lateral side of her patella. Let your thumb be at an angle of about 45 degrees to your index finger. The tip of your thumb will now touch the area of the point. Palpate the area to find its exact location.
The point is often found directly above Sp 9 and to help you locate the channel in this area, feel for the channel following through proximally from Sp 9.
Sp 11: JIMEN Basket Gate
10 cun superior to the flexure of the knee, or 6 cun superior to Sp 10. Find the line of the Spleen Channel running from Sp 10 – Sp 12 (Sp 12 is found 3.5 cun lateral to Ren 2 on the lateral side of the femoral artery). The point lies on this line, just anterior to the sartorius muscle. As a rough guide it is found two handbreadths above Sp10.
