Basic anatomy in acupuncture course day 1 pm
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basic Anatomy in Acupuncture module La Consolacion College Manila Christ healing center
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Basic anatomy in acupuncture course day 1 pm
- 1. Ryan Em C. Dalman, MD-MBA
- 2. Afternoon Topics Basic Anatomy Biological Organization Vessels (Artery, Vein, Nerve) Basic Physiology Relevance in Acupuncture Bone, Ligament, Tendon, Cartilage, Fascia, Muscle Skin, hair and nails TCM principles Recall Activity Outline
- 4. Cell Cella – Latin for “small room” basic structural, functional, and biological unit of all known living organisms Biological Organization
- 5. Examples of cells Osteocyte Biological Organization
- 6. Examples of cells Osteocyte Adipose Biological Organization
- 7. Examples of cells Osteocyte Adipose Hepatocyte Biological Organization
- 8. Examples of cells Osteocyte Adipose Hepatocyte Myocyte Biological Organization
- 9. Tissue an ensemble of similar cells from the same origin that together carry out a specific function Biological Organization
- 10. Organ a group of tissues in a living organism that have been adapted to perform a specific function Biological Organization
- 11. Organ Systems a group of organs that work together to perform one or more functions Biological Organization
- 14. Neuron Constitutes the anatomical, physiological, genetic, and functional unit of the nervous system Nerve
- 15. Nervous Tissue Group of neurons formed together to perform functions mainly as a Communications System from the Brain to the target organs (and vice versa) Nerve
- 16. Functions Allows a person to experience sensations such as: Sight Smell Touch Taste Hearing Movement of both voluntary and involuntary muscles Nerve
- 17. Blood Vessel a tubular structure carrying blood through the tissues and organs; a vein, artery, or capillary. Blood Vessels
- 18. Artery any of the muscular-walled tubes forming part of the circulation system by which blood (mainly that which has been oxygenated) is conveyed from the heart to all parts of the body “A for Away from the heart” Blood Vessels
- 19. Vein any of the tubes forming part of the blood circulation system of the body, carrying in most cases oxygen- depleted blood toward the heart “V for Vack to the heart” Blood Vessels
- 21. Puncturing a… Nerve: Electric Shock Vein: Slight bleeding Artery: Sharp pain with stronger bleeding/hematoma formation Relevance in Acupuncture
- 24. Arterial Puncture Most obvious sign… bleeding Relevance in Acupuncture
- 25. Prevention of Arterial Puncture Investigate for bleeding problems and regular intake of anticoagulants (aspirin, clopidogrel, etc) Relevance in Acupuncture
- 26. Prevention of Arterial Puncture Always refer to Anatomy textbooks if you are not familiar with the points Relevance in Acupuncture
- 27. Relevance in Acupuncture Prevention of Arterial Puncture Retract needle if it is pulsating
- 28. Severe complications of Arterial Punctures: Traumatic Aneurysm Hemothorax Hemorrhagic peritonitis Relevance in Acupuncture
- 29. Aneurysm Bulge in the wall of an artery Relevance in Acupuncture
- 30. Traumatic Aneurysm Relevance in Acupuncture
- 31. Symptoms of Traumatic Aneurysm Progressively growing, pulsating tender lump What to do??? Refer to a physician Relevance in Acupuncture
- 32. Prevention of traumatic aneurysm Look and feel for arteries before needling Press point using your thumb, using the nail to shield the vessels Relevance in Acupuncture
- 33. Prevention of traumatic aneurysm Refer to anatomy books if you are not familiar with the area In removing needles near arteries, press the area using a cotton ball for 30-60 seconds For patients with bleeding disorders, choose fewer points and reduce depth in needling Relevance in Acupuncture
- 34. Relevance in Acupuncture Hemothorax Presence of blood in the pleural space source of blood: chest wall, lung parenchyma, heart, or great vessels
- 35. Relevance in Acupuncture Hemothorax - Presentation Most common symptoms: chest pain and dyspnea Most common sign: Tachypnea If with substantial blood loss: hypotension and tachycardia
- 36. Relevance in Acupuncture Hemorrhagic Peritonitis Peritonitis Inflammation of the inner lining of the abdominal cavity
- 37. Relevance in Acupuncture Hemorrhagic Peritonitis Symptoms Fever, chills, abdominal pain/dyscomfort Sign Temp – 38o C Tachycardia Oliguric/anuric Abdominal tenderness
- 38. Bone, Ligament, Tendon, Cartilage, Fascia, Muscle
- 39. Bone substance that forms the skeleton of the body Stores calcium 213 bones in the body Bone
- 40. 4 types Long, short, flat, and irregular Bone
- 41. Function Structural support Permits movement and locomotion Protects vital organs Provides an environment for blood production Etc. Bone
- 42. Bone
- 43. Bone
- 44. Composed of 50-70% minerals, 20-40% organic matrix, 5-10% water, <3% lipids VERY HARD! Devoid of Nerves Bone
- 45. TCM Principles Kidney: Dominating the bone Stores essence which produces marrow found in bone and spine. This nourishes the bone Bone
- 46. A fibrous tissue that connects bones to other bones and serves to support internal organs A.k.a articular ligament, articular larua, fibrous ligament, or true ligament Ligament
- 47. Have a vascular overlying layer called “epiligament” which also has a lot of sensory and proprioceptive nerves Functions Lifting loads Load relax Joint Proprioception Ligament
- 48. Specialized connective tissue that connects muscles to bones Relatively inelastic Has cells and neurovascular supply Tendon
- 49. TCM Principles Liver: controls the tendons Tendon
- 50. A tough, elastic, fibrous connective tissue found in various parts of the body, such as the joints, outer ear, and larynx Cartilage
- 52. Articular Cartilage Provides frictionless motion Resists compressive forces Cartilage
- 53. Cartilage No nerves No blood Vessels No direct source of repair Cartilage
- 54. A sheet or band of fibrous connective tissue enveloping, separating, or binding together muscles, organs, and other soft structures of the body. Fascia
- 55. Group of soft tissue fibers that contain protein filaments that produces contraction that changes the shape and length of the cell Muscle
- 56. 3 types Skeletal Muscle Cardiac Muscle Smooth Muscles Muscle
- 58. Muscle
- 59. TCM Principles Spleen: Dominating the muscles and four limbs Lung: Dominates dispersing Muscle
- 60. Muscles are thick and fibrous tissues Pain in removing the needles that have been rotated Relevance in Acupuncture
- 62. Largest organ in the body Most important function: Barrier! Skin
- 63. Skin
- 64. Skin
- 65. TCM Principles Heart: Dominating the blood and vessels, manifesting on the face Heart Qi – reflected in changes in both pulse and complexion Lung: Dispersing Pores are the gates of Qi Skin
- 66. Hair Derivative of skin Found all over the body except: palms, soles, etc.
- 67. 3 types Lanugo, Vellus, Terminal Hair
- 68. Hair
- 69. Main function in mammals Conservation of heat DOES NOT APPLY ON HUMANS! Hair
- 70. Main function in humans… Sexual attraction Hair
- 71. TCM Principles Kidney: manifesting in the hair Hair is both the surplus of blood and the outward manifestation of the Kidney Hair
- 72. Nail Derivative of skin Remnant of the mammalian claw Protects finger tip
- 73. Nail
- 74. TCM Principles Liver: manifests in the nails Nail
- 75. Relevance in Acupuncture Puncturing a Hair Follicle – can be very painful! Remove and replace needle immediately
- 76. Recall!
- 77. Which of the following allows you to feel different sensations? a) Artery b) Vein c) Nerve d) Tendon Recall!
- 78. Which of the following brings oxygenated blood from the heart to the target organs? a) Artery b) Vein c) Nerve d) Tendon Recall!
- 79. Which of the following will cause a punctured needle to pulsate? a) Artery b) Vein c) Nerve d) Tendon Recall!
- 80. Which of the following connects muscles to bones? a) Ligament b) Fascia c) Cartilage d) Tendon e) Bone Recall!
- 81. Which of the following connects bones to bones? a) Ligament b) Fascia c) Cartilage d) Tendon e) Bone Recall!
- 82. Which of the following is devoid of nerves and has no direct blood supply? a) Ligament b) Fascia c) Cartilage d) Tendon e) Bone Recall!
- 83. Arrange the steps in the Biological Organization in sequence: a) Organ Systems b) Tissue c) Cell d) Organ Recall!
- 93. www.yinyanghouse.com Gawkrodger, David (2002). Dermatology: An Illustrated Colour Text, 3rd Ed. Zhu, Hong Zhen (2006). Running a Safe and Successful Acupuncture Clinic. References
Hinweis der Redaktion
- Sight – colors, light, dark, shapes, sizes Smell – fragrant, woody, non-citrus fruity, sharp/pungent, chemical, minty, sweet Touch – light and heavy, sharp, soft, pain, temperature, location Taste – sweet, salty, sour, bitter, umami Hearing –
- Acupuncture injury can occur to arteries, veins or capillaries. Because arterial blood is under higher pressure, blood loss will be more significant than in the case of punctures to the other vessels. That is why our discussion here will focus on arteries.
- The obvious sign of a puncture is bleeding, which may spurt or seep from the wound, or collect under the skin as a bruise or hematoma.
- If patients have bleeding problems or are taking anticoagulants regularly, avoid treating any points that are close to larger blood vessels When treating patients who take anticoagulants, even when using only the safest points, it is recommended that a cotton ball is used to press on each point for a few seconds just after withdrawing each needle.
- Detailed knowledge of anatomy is crucial when treating points over medium- or large-sized blood vessels. It is a good idea to consult textbooks before placing needles, until you have enough clinical experience to be completely familiar with the surface projections of major vessels
- If the needle is pulsing, it should be backed off, whether or not de qi has been reached. If I have not sensed de qi, I will leave the needle there while I work on the other treatment points. Then I return to this point, and gently rotate the needle to obtain de qi. It is important to remember that de qi is not necessarily achieved by more depth.
- Severe complications of arterial puncture include traumatic aneurysm, hemathorax or hemorrhagic peritonitis, depending on the site of the wound.
- An aneurysm is a bulge in the wall of an artery. The bulge generally occurs in a weak spot in the arterial wall. Traumatic aneurysm. A traumatic aneurysm, shown on the left, is also called a false aneurysm. It is caused by an injury, including that from an acupuncture needle. The illustration on the right is a ‘true’ aneurysm, the bulging that results from a weakness in the vessel’s wall
- When an acupuncture needle injures an artery or one of its branches it causes internal bleeding; the surrounding tissue, including blood platelets and fibrin, collects in a mass around the wound. As arterial blood continues to flow into the bulge, the mass grows and its wall thickens. The pulsing pressure of arterial blood in this mass will be palpable, and can be heard through a stethoscope The whole process can take several weeks, or even up to a year to develop before ischemic and pressure symptoms cause the patient to see a physician Any aneurysm can be ruptured or become infected. These factors further complicate accurate diagnosis and treatment
- This injury can be prevented by looking and feeling for arteries before insert-ing needles. When you see that a blood vessel is near the desired acupoint, press the end of the thumb of your other hand into the patient’s skin, gently pushing away and protecting the vessel. The thumbnail becomes a shield, as well as a guide for the needle as it is inserted.
- Peritonitis is defined as inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein.
- Peritonitis is defined as inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein.
- 4 types Long bones - clavicles, humeri, radii, ulnae, metacarpals, femurs, tibiae, fibulae, metatarsals, and phalanges Short bones - carpal and tarsal bones, patellae, and sesamoid bones Flat bones - skull, mandible, scapulae, sternum, and ribs Irregular bones - vertebrae, sacrum, coccyx, and hyoid bone
- Functions of bones: provide structural support for the rest of the body permit movement and locomotion by providing levers for the muscles protect vital internal organs and structures provide the environment for hematopoiesis within the marrow spaces provide maintenance of mineral homeostasis and acid-base balance serve as a reservoir of growth factors and cytokines
- Devoid of Nerves – hence no pain when punctured
- Epiligament – vascular hence has the propensity to bleed when injured Functions: 1. Light load, relatively compliant. As load gets heavier, it becomes stiff; Hence it helps prevent injury 2. Load Relax - loads/stresses decrease within the ligament if they are pulled to constant deformations 3. Joint Proprioception – referred to as the conscious perception of limb position in space
- They are relatively inelastic and have a tensile strength similar to stainless steel They are living structures possessing cells and neurovascular supply
- Liver nourishes the tendons
- No nerves – Pain free No blood vessels – no bruising, viable after death, no source of repair
- Skeletal Muscle – Voluntary muscles anchored by tendons to bones and is used to effect skeletal movement such as locomotion and in maintaining posture Cardiac Muscle – involuntary muscle and is found only in the heart Smooth Muscle - involuntary muscle" is found within the walls of organs and structures such as the esophagus, stomach, intestines, bronchi, uterus, urethra, bladder, blood vessels, and the arrector pili in the skin (in which it controls erection of body hair)
- The dispersing/distributing function of the lung that defensive Qi and blody fluid are distributed to the whole body to warm and moisten the muscles, skin, and hair
- Pain on removal of a needle at the end of the treatment is normally the result of one of two factors: either the patient is nervous or cold, which has contracted their muscles, or the rotation of the needle in one direction during the treatment has caused muscle fibers to twine around and grip the needle. Yanking it straight out will mean severe discomfort for the patient. If the needle has been turned clockwise during treatment, first rotate it slightly in the opposite direction before removing it. Secondly, use the tips of the fingers to tap the muscles surrounding the point to relax the muscles and allow the needle to be more easily withdrawn
- The skin is one of the largest organs in the body, having a surface area of 1.8m and making up about 16% of the bodyweight It has many functions, the most important of which is as a barrier to protect the body from noxious external factors and to keep the internal systems intact
- 3 layers: 1. Epidermis
- The dispersing/distributing function of the lung that defensive Qi and blody fluid are distributed to the whole body to warm and moisten the muscles, skin, and hair
- Hairs are found over the entire surface of the skin, with the exception of the skin of the palms, soles, glans penis, and vulval introitus.
- Lanugo – fine and long, formed in the fetus at 20 weeks gestation, normally shed before birth, but may be seen in premature babies Vellus – short, fine, light colored, cover most of the body surfaces Terminal – longer, thicker, darker, found on the scalp, eyebrows, eyelashes, pubic, axillary, and beard
- In most mammals, hair or fur plays an essential role in survival, especially in the conservation of heat; this is not the case in humans. Scalp hair in humans does function as a protection against the cancer-inducing effects of ultraviolet radiation; it also protects against minor injury.
- It’s main function in human society is as an organ of sexual attraction, and therein lies its importance to the cosmetics industry.
- The nail is a phylogenetic remnant of the mammalian claw and consists of a plate of hardened and densely packed keratin It protects the finger tip and facilitates grasping and tactile sensitivity in the finger pulp
- Nails become soft, thin, withered, deformed, or chipped when liver blood is deficient
- When a needle goes into a hair follicle (Fig. 9.7), it can be very painful; the tissue is very tight so trying to push it deeper just makes the pain worse. Withdraw the needle immediately, discard and replace with a new needle, being careful to avoid the follicle
- Answer: C
- Answer: A
- Answer: A
- Answer: D
- Answer: A
- Answer: A
- Answer: C B D A
- Please describe the anatomical position/movement: kid’s Left upper extremity Kid’s right upper extremity Kid’s right lower extremity
- Please describe the anatomical position/movement: Right upper extremity Left lower extremity
- Please describe the anatomical position/movement: Manny’s right upper extremity
- Please describe the anatomical position/movement: Left upper extremity Trunk Left lower extremity
- Describe the position of the mole
- Describe the position of the mole