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NCCAOM Channels- Pts
Prep for the Boards
| Question | Answer |
|---|---|
| Anmian | Behind the ear, midway between GB20 and SJ17, pt is found close to GB12 except posterior and slightly superior, perpendicular 0.5 to 1 cun, treats insomnia and pacifies the Liver, good for headache, tinnitus, palpitations |
| Bafeng | On the dorsum of the foot, between the toes, 0.5 cun proximal to the margin of the web, oblique insertion, directed proximally, 0.5 to 1 cun, clears heat and dissipates swelling |
| Baichongwo | 3 cun proximal to the superior border of the patella, in a tender depression on the bulge of the vastus medialis muscle. (1 cun above SP10) clears heat from the blood, sores of the lower region, itching of the skin, perpendicular 1-1.5 cun |
| Bailao | at the back of the neck, 2 cun superior to DU14, 1 cun lateral to the midline, perpendicular 0.5-0.8 cun, tx: scrofula, cough dyspnoea |
| Bitong | at the highest point of the naso-labial groove, transverse insertion towards the bridge of the nose 0.3 to 0.5 cun, tx: rhinitis, allergic rhinitis, nasal congestion and discharge, nosebleed, nasal polyps |
| GB20 | Below the occiput, approximately midway between DU16 & GB12, in the hollow between the origins of the SCM and trapezius muscles, slightly oblique inferior insertion in the direction of the channel, 1 to 1.5 cun, eliminates wind, headache of any region |
| GB12 | In the depression just posterior and inferior to the mastoid process, oblique inferior insertion 0.5-1cun, tx: eliminates wind, benefits head, and alleviates pain, good for insomnia, swelling of neck, head wind, pain behind the ear, essential point |
| SJ17 | Behind the earlobe, between the ramus of the mandible and the mastoid process, in the depression just superior to the paplable transverse process of the 1st cervical verterba, perpendicular towards opposite ear 0.5-1 cun, helps ear, clears heat |
| SP10 | 2 cun proximal to the superior border of the patella, in a tender depression on the bulge of the vastus medialis muscle, perpendicular or oblique insertion 1 to 1.5 cun, tx irregular menstruation, dysmenorrhoea, amenorrhoea, cools blood, eczema, itching |
| Baxie | When the hand is made into a fist, six of these points lie in the depression b/w the metacarpal heads. perpendicular insertion along the line between the shafts of the metacarpal bones, 0.5 to 1 cun, clears heat, for pain, swelling, and stiffness |
| Dannangxue | Between 1 and 2 cun distal to GB34 on the right leg, where there is maxiumum tenderness, perpendicular 1-1.5 cun, known for treatin chronic cholecystits (inflammation of the gallbladder) |
| Dingchuan | 0.5 to 1 cun lateral to the depression below the spinous process of the 7th cervical vertebra, perpendicular- oblique insertion towards the spine, 0.5 to 1 cun, calms dyspnoea and wheezing and stops cough, good for acute asthma |
| Erbai | on the flexor aspect of the forearm, 4 cun proximal to PC7, either side of the tendon of flexor carpi radialis, perpendicular insertion 0.5 to 1 cun or obllique proximal insertion 1 to 1.5 cun, treats prolapse of rectum and hemorrhoids |
| Erjian | when the ear is folded forwards, this point lies at the apex of the ear, perpendicular insertion 0.1 cun or prick to bleed, moxibustion 3-5 cones, clears heat and dissipates swelling, benefits eye and throat, good for pain and swelling of the eyes |
| Heding | In the depression at the midpoint of the superior border of the patella. perpendicular insertion 0.5-1 cun, activates qi and blood and benefits the knee joint, secondary point in treatment of disorders of the knee joint |
| Huatuojiaji | 0.5 to 1 cun lateral to the depression below the spinous process of the 12 thoracic and 5 lumbar vertebrae, perpendicular oblique insertion towards the spine, needling these points help stimulate the appropriate spinal nerve, help the 5 zang and 6 fu |
| Jianqian/Jianneiling | On the anterior aspect of the shoulder joint, midway between the anterior axillary crease and LI15, perpendicular insertion 1 to 1.5 cun, oblique or oblique transverse. for stiffness and pain of the anterior aspect of the shoulder: paralysis, immobility |
| Lanweixue | approximately 2 cun distal to ST36 on the right leg, perpendicular insertion 1-1.5 cun, activates qi and blood, clears heat and fire poison from the LI, tx acute and chronic appendicitis, paralysis of the lower limb, drop foot, indigestion |
| Luozhen | On the dorsum of the hand, in the depression just proximal to the second and third metacarpophalangeal joints, perpendicular or oblique insertion directed proximally 0.5 to 1 cun, helps qi and blood in neck region |
| Pigen | |
| Shiqizhuixue/Shiqizhuixia | On the midline of the lower back, in the depression below the spinous process of the 5th lumbar vertebra, perpendicular insertion 0.5 to 1 cun, tx pain of the lumbar region and legs, difficult urination, fetus pressing on the bladder, tonifies kidneys |
| LI15 | |
| ST36 | |
| Sifeng | |
| Sishencong | |
| Taiyang | At the temple, in the tender depression approximately 1 cun posterior to the midpoint b/w the lateral extremity of the eyebrow and outer canthus of the eye, perpendicular 0.5 to 0.8 cun, transverse towards gb8 1 to 1.5 cun, oblique anteriorly 0.3 to 0.5 |
| Weiguanxiashu | |
| Xiyan/Neixiyan | |
| Yaotongxue | |
| Yaoyan | In the depression approximately 3.5 cun lateral to the lower border of L4, perpendicular insertion 1 to 1.5 cun, strengthens kidneys and benefits lumbar region, good for kidney deficiency lumbar pain, back pain |
| Yintang | |
| Yuyao | |
| Zigongxu | |
| GB8 | |
| what can acupuncture can be compared to? | To a subcutaneous or intramuscular injection |
| When did NCCAOM develop guidelines and recommendatons for the safety and clean practice of acupuncture? | 1984 |
| What does the CNT manual reflect? | an understanding of the best practices in the field of acupuncture clinical techniques. Best practices are defined as, "activities, disciplines, and methods that are available to identify, implement, and monitor the available evidence in healthcare |
| How does CNT manual define acupuncture? | It is the insertion of needles into the skin where the therapeutic effect is expected to come primarily from the act of inserting, manipulating, and/or retaining the needles in specific locations |
| paresthesia | an abnormal sensation, typically tingling or pricking (pins and needles) caused chiefly by pressure on or damage to peripheral nerves |
| What are the most common adverse events associated with acupuncture? | needles site bleeding, superficial hematoma, and needle site pain |
| hematoma | a bad bruise (an injury causes blood to collect and pool under the skin) |
| where is bleeding more common when performing acupuncture? | needling of the scalp and the pinna/auricle of the ear due to the vascular anatomy of the se structures |
| what is best to do when removing needles from the ear and scalp to prevent bleeding? | acupuncturists should apply cotton or gauze to prevent bleeding when removing the needles in these areas and hold that cotton against the scalp or pinna a few seconds longer |
| What is another factor to consider if a patient is easily to bruise or bleed? | anticoagulant medications may increase the tendency for bruising and bleeding. some supplements may also have this effect. obtaining a complete medication and supplement history will help assess |
| Which acupuncture points lie over or are next to major vessels? | LU9, HT7, ST9, ST12, ST13, ST42, SP11, HT1, LV12, BL40 |
| List the arteries and veins associated with each point | LU9(radial artery) HT7(ulnar artery), ST9(Carotid artery), ST12(supraclavicular artery and vein), ST13(subclavian artery), ST42(dorsalis pedis artery), SP11(femoral artery), HT1 (axillary artery), LV12 (femoral artery and vein) BL40 (popliteal artery) |
| what is common for a patient with chronic pain to develop with acupuncture? | It is common for a patient to develop allodynia (a painful response to a normally innocuous stimulus) or hyperalgesia (an increased response to a painful stimulus) |
| what can happen or develop with a patient who presents with common chronic pain presenting with fibromyalgia? | The patient may have an increased sense of pain from either hyperalgesia or allodynia |
| what does caffeine do to the treatment? | caffeine consumption may also affect the patient's pain perceptions by increasing anxiety and therefore increasing pain perception |
| What are the most common adverse events in acupuncture? | needle site bleeding, superficial hematoma, and needle site pain |
| What can increase needle site bleeding? | anticoagulants |
| needle pain causes | poor technique, needle sites where alcohol remains, needling into dense connective tissue such as tendons, periosteum, and perimysium, excessive needle manipulation, or needling into a nerve |
| What should you inform patients to prevent fainting? | put them in supine position with knees elevated for the first time, explain acupuncture in detail, inform patients they should eat 1-2 hours before acupuncture, limit needle manipulation for the first treatment |
| How do you avoid a stuck needle? | Identify depth of the needle insertion, utilize proper stimulation techniques for needles inserted below the subcutaneous level |
| How do you respond to a stuck needle? | if stuck rotate needle in opposite direction if it was rotated in one direction, stimulate the area with finger manipulation, tapping or another needle insert, can leave needle in for a few mins then try again |
| Aggravation of symptoms | occurs as a result of acupuncture or an infrequent, but consistent basis, can be an AE OR a "Menken or Mengen Phenomenon" aka "healing crisis" |
| transient | lasting only for a short time, impermanent |
| Pneumothorax | defined aa the abnormal presence of air in the space between the lung and the wall of the chest (pleural cavity) which prevents lung expansion |
| Pneumothorax from acupuncture is known as what? | an example of iatrogenic pneumothorax |
| Symptoms of acupuncture-related pneumothorax | can present immediately or hours later, can be dyspnea (SOB) on exertion, tachypnea (increased respiratory rate), chest pain, dry cough, cyanosis, and diaphoresis/sweating |
| Who is at increased risk of a pneumothorax? | cigarette smokers and marijuana smokers, and those suffering from lung disease such as chronic asthma, emphysema, and COPD, patients with lung cancer or corticosteroids , also marfan syndrome, homocystinuria, and thoracic endometriosis |
| points most frequently associated with pneumothorax and infrequent | most frequent:GB21, BL13, ST12, CV22; infrequent: BL18. Ren 15, 14, SI9, SI13, and Dingchuan |
| What pneumothorax risk points do Peuker and Gronemeyer identify? | ST11, ST12, LU2, ST13, KD27, ST12-18 |
| How do you avoid organ and central nervous system injury with acupuncture? | observe safe needling depth, and angles to avoid cardiac injury, avoid penetration at a sternal foramen, use an oblique angle, needlign DU22 is PROHIBITED for infants |
| Autogenous infection source | the patient infected by themselves |
| Cross infection | infection from practitioner to others |
| Define Moxibustion | The heating of a point on the skin utilizing moxa in various forms. |
| What is the most common herb used in Moxa? | Artemisia Vulgaris also known as mugwort |
| What has moxibustion been reported to be effective for? | A wide variety of conditions such as musculoskeletal complaints, gastrointestinal symptoms, gynecologic disorders, breech presentations, stroke rehabilitation, and complementary care for cancer symptoms, to the treatment of infectious disease |
| subcutaneous | situated or applied under the skin |
| Where is direct or scarring moxa contraindicated? | sensitive areas of the body, such as the face, nipples, genitalia, and hairline |
| Points to be cautious or prohibited for direct or scarring moxa | ST1, 2, ST8, BL1, BL2, SJ23, LI19, LI20, ST9 |
| What does cupping create? | Cupping creates therapeutic petechiae and ecchymosis that appear in round or "nummular" areas |
| echhymosis | a discoloration of the skin from bleeding underneath, bruising |
| petechiae | round spots that appear on the skin as a result of bleeding |
| Which are variations of dry cupping? | fire cupping and suction cupping |
| What conditions is cupping used for? | to treat conditions including acute or chronic pain, mild to severe conditions such as colds, flu, fever; respiratory problems such as asthma, bronchitis, and emphysema, functional internal organ problems, musculoskeletal, and fixed pain |
| when did cupping start as a modality in hospitals in China and elsewhere? | 1950 |
| How long are cupping jars usually left on? and what is the maximum | typically, cups are left on patient's skin for 2-10 minutes, but may be left for up to 20 minutes |
| what is empty cupping | means cups are removed after suction without delay |
| Needle cupping | practitioner applies the acupuncture needle first, then applies the cups over the needles, this method should be applied with caution and needles inserted at an oblique angle |
| when do reactions from cupping resolve? | typically a few days to 2 weeks |
| where should you avoid cupping? | over lesions, rashes, injuries, or breaks in the skin barrier, in studies, the use of cupping on herpes zoster has been used, but practitioners should be specifically trained in cupping for active skin lesions |
| Safety Guidelines for Wet Cupping | - must wear gloves and protective eyewear -eat wet cup should be thoroughly cleaned - skin can be cleaned with 70% isopropyl alcohol or soap water or another method, but must be cleaned immediately before cupping - steril lancets or plum blossom |
| when blood is present in cupping, what is essential? | utilizing PPE including gloves and eye protection when blood is present in a cup |
| if cupping is performed on intact skin, how do you disinfect? | it would be using soap and water and then disinfected with appropriate intermediate level disinfectant. these are seen as non-critical reusable devices |
| if cupping is performed on nonintact skin how do you disinfect? or wet cupping? | need to be cleaned with soap and water, removed of lubricant if used and before disinfecting with high-level disinfectant. these are seen as semi-critical reusable devices |
| What must a solution contain to be approved for clinical use when cleaning cupping jars? | A solution must at least contain 7.5% hydrogen peroxide solution along with other chemicals because such solutions do not require special ventilation |
| what is recommended for wet cupping? | using disposable cups for wet cupping and dispose of used wet cups in the biohazard trash |
| petechiae | a small red or purple spot caused by bleeding into the skin, round brown purple spots caused by bleeding into the skin |
| ecchymosis | a discoloration of the skin resulting from bleeding underneath, typically caused by bruising |
| What skin reactions are there with cupping | swelling, petechiae, ecchymosis, and persistent hyperpigmentation. these reactions resolve in a few days to 2 weeks. sometimes blisters can appear called bullae (less common and usually in patients with anticoagulant meds (abx be taken) |
| The "dirty" fluids are transported downward from the Spleen-stomach to this organ for its second preparation from the clean fluids | Small Intestine |
| Zong Qi can be called? | Gathering Qi, Big Qi, and Chest Qi |
| The jin and ye fluids from our drink and food are first separated by the ?? | The spleen is the first organ to act on separating the pure from the impure. Maciocia 2015 pg 67 |
| In acupuncture, the Original Qi (yuan qi) is treated by? | needling yuan source points, needling and applying moxa to the Directing Vessel (Ren Mai) points below the navel, needling and applying moxa to DU4, Maciocia 2015 pg 52 |
| Where does yuan qi or original qi originate? | It originates between the Kidneys and below the navel |
| Nutritive Qi or Ying qi is closely related to what? | To blood |
| Original Qi facilitates the transformation of | Gathering Qi into True Qi; Food Qi into Blood |
| The Gate of Vitality is closely related to Original Qi (yuan qi) and shares its function of ? | Warming the organs |
| Defensive Qi (wei qi) is to Nutritive Qi (ying qi) as | Exterior is to Interior |
| What type of qi circulates with blood and blood vessels? | Nutritive Qi |
| Modern scientists equate Qi with...? | Energy and radioactive emanations, Maciocia pg 43-44 |
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Alyciaa20
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