9:00 AM – 4:30 PM
12:30 PM – 1 PM: Lunch

Upper Extremity

Neuroanatomy / Acupuncture Point Location / Nerve Palpation

• Identification of Nerves:
  • Brachial Plexus
  • Radial Nerve
  • Median Nerve
  • Ulnar Nerve
  • Axillary Nerve
• Key Fascia Interrelationships:
  • Connections extending into the neck
• Joint Mobilization and Biomechanics:
  • Shoulder
  • Elbow
  • Carpal Bones
  • Interphalangeal Joints
• Understanding and Palpating the 1st Rib

Acupuncture Safety for Upper Extremity

• Avoiding Cephalic Vein: Points LI5, LI7
• Avoiding Radial Artery: Points LU8, LU9
• Brachial Artery / Vein: Point PC3
• Avoiding Lung Points: Refer to points avoiding the lung

Neuro-Integrative Acupuncture

• Prone Position:
  • Suprascapular Fossa (SI12, LI16)
  • Infrascapular Fossa (SI11)
  • Axillary Nerve (Quadrangular Space SI9)
  • Radial Nerve (Triangular Interval TE13)
• Supine Position:
  • Brachial Plexus
  • Supraclavicular Area (ST12)
  • Under Subclavius (ST13)
  • Scalenes (Classical LI17)
  • Axilla (HT1)
• Medial Arm:
  • Ulnar Nerve (SI8)
  • Median Nerve (PC3)
  • Musculocutaneous Nerve:
    • Bicep Branch (LU3)
    • Brachialis Branch (LU4)
  • Medial Brachial Cutaneous Nerve (HT2, HT3)
• Forearm:
  • Median Nerve (PC5-PC9)
  • Radial Nerve (LU7, LU8, LI4)
  • Lateral Antebrachial Cutaneous Nerve
  • Musculocutaneous Nerve (LU5-LI6)
  • Ulnar Nerve (SI8, HT4-HT9)

Lower Extremity

Neuroanatomy / Acupuncture Point Location / Nerve Palpation

• Thigh:
  • Femoral Nerve (SP12)
  • Obturator Nerve:
    • Anterior Branch (LR10)
    • Posterior Branch (LR11)
  • Lateral Femoral Cutaneous Nerve (GB27)
  • Ilioguinal Nerve (ST29)
  • Genitofemoral Nerve:
    • Femoral Branch (GB28)
    • Genital Branch (ST30)
  • Saphenous Nerve (KI10, LR8)
• Leg:
  • Saphenous Nerve (LR7, SP9, LR4, SP5)
  • Deep Peroneal Nerve (ST36, LR2, LR3)
  • Superficial Peroneal Nerve (GB34, GB37-39)
  • Medial Dorsal Cutaneous Nerve (GB41-43)
• Key Fascia Interrelationships:
  • Connections extending into the lower back
• Joint Mobilization and Biomechanics:
  • Acetabulo-femoral Joint
  • Knee
  • Ankle Joint
• Identification of Nerves:
  • Femoral Nerve
  • Superficial Fibular / Peroneal Nerve
  • Saphenous Nerve
  • Intermediate Cutaneous Nerves
  • Sural Nerve
  • Lateral and Medial Plantar Nerves
  • Sciatic Nerve

Acupuncture Safety

• Femoral Artery and Nerve: Points SP11, SP12, LV12
• Popliteal Artery / Vein: Point BL40
• Sacral Foramina: Points BL31-BL34
• Sciatic Nerve: Point GB30
• Common Fibular Nerve: Point BL39
• Tibial Nerve: Point BL40
• Sural Nerve: Points BL60-66
• Posterior Tibial Nerve: Points KI3-KI6

Fascia

• Understanding the Fascia of the Iliotibial Tract:
  • Its multiple functions
• Iliacus and Psoas Fascial Sheet

9:00 AM – 4:30 PM
12:30 PM – 1 PM: Lunch

Abdominal and Pelvic Cavity

• Fascia:
  • Three Layers of Thoracolumbar Fascia
  • Lumbar Interfascial Triangle / Lateral Raphe of the Lumbar Region
• Visceral Organ and Fascia Palpation / Identification
• Vascular Anatomy
• Spinal Anatomy / Biomechanics
• Thoracic and Lumbar Joint Mobilization Techniques
• Peritoneal and Infra-peritoneal Cavities
• Palpation / Needling Techniques:
  • Sacral Foramen
  • Femoral Nerve
• Identification and Needling:
  • Ilioinguinal Nerve
  • Lateral Cutaneous Nerve of the Thigh
  • Femoral Nerve
  • Obturator Nerve (Anterior and Posterior Divisions)
  • Posterior Cutaneous Nerve of the Thigh
  • Sciatic Nerve
  • Anterior Ramus of L1, L2, L3

Acupuncture Safety

• Avoiding the Kidney:
  • Points BL22, BL23, BL51, BL52
• Avoiding the Peritoneal Cavity:
  • Ren Meridian: REN3-13, REN14, REN15
  • SP13-16, ST22-30, GB25, GB26
  • KI11-13 (Bladder), KI14-21 (Peritoneal Cavity)
  • Bladder: KI11-13, ST28, ST39, REN2-4
• Avoiding the Liver and Spleen:
  • Point LV13
• Avoiding the Bladder:
  • KI11-13

9:00 AM – 4:30 PM
12:30 PM – 1 PM: Lunch

Thoracic and Neck Cavities

• Cardiopulmonary System:
  • Overview of the heart and lungs
  • Pleural Attachments
  • Techniques for Palpating the Pericardium
  • Vascularization of the Neck
• 1st Rib Biomechanics and Adjustment
• Thoracic and Cervical Joint Adjustments and Biomechanics
• Acupuncture Point Location:
  • Identifying acupuncture points on the thorax and neck

Safety Measures for Abdomen / Thorax

• Avoiding the Lungs:
  • Points to Avoid: PC1, SJ15, LI16, SI12, SI13, SI14, SI15, SP17-SP21, LU1, LU2, HT1, LV14, BL41-BL50, KI23-27, ST14-18, GB21-24
• Avoiding the Carotid Artery:
  • Points to Avoid: LI17, LI18, SI17
• Avoiding the Spinal Cord:
  • Points to Avoid: Du15, Du16 (at C0-C1, C1-C2)
• Avoiding the Subclavian Artery:
  • Points to Avoid: ST11-13
• Identification of Key Structures:
  • Phrenic Nerve
  • Accessory Nerve
  • Anterior Rami Forming Roots of the Brachial Plexus
  • Stellate Ganglia
  • Long Thoracic Nerve

9:00 AM – 4:30 PM
12:30 PM – 1 PM: Lunch

Cranial Cavity

• Foramen Review: Examination of the foramina in the skull.
• Acupuncture Point Location: Identification of acupuncture points in the cranial region.
• Dural Attachments: Understanding the attachments of the dura mater within the cranial cavity.
• Vascularization of the Head: Overview of the blood supply to the head.
• Cranial Nerve Palpation: Techniques for palpating cranial nerves.
• Origins and Functions of Cranial Nerves: Study of the 12 cranial nerves, including their origins, functions, and the foramina through which they pass to the neurocranium.

Acupuncture Safety

• Avoiding the Carotid Artery: Points to avoid include SI17, ST9, ST10.
• Avoiding the Temporal Artery: Points to avoid include SJ22.
• Avoiding the Eye Area: Points to avoid include ST1, ST2 (infraorbital nerve), BL1.
• Avoiding the Facial Artery/Vein: Point to avoid includes ST5.
• Avoiding the Vertebral Artery: Targets include GB20.
• Avoiding the Spinal Cord: Points to avoid include Du 15, Du 16 (at C0-C1, C1-C2).

Schedule

• 9:00 AM – 4:30 PM
  • 12:30 PM – 1 PM: Lunch

Dissection: Epidermis and Superficial Layers

• Reflect the epidermis.
• Expose and identify the superficial layers of cutaneous nerves.
• Examine vascularization.

Upper Back

• Cervical Cutaneous Region:
  • Dorsal rami of cervical spinal nerves (C2-C8).

Middle Back

• Thoracic Cutaneous Region:
  • Dorsal rami of thoracic spinal nerves (T1-T12).

Lower Back

• Lumbar Cutaneous Region:
  • Dorsal rami of lumbar spinal nerves (L1-L5).

Sacral Cutaneous Region

• Sacral Cutaneous Region:
  • Dorsal rami of sacral spinal nerves (S1-S5).

Gluteal Region

• Superior Cluneal Nerves:
  • Innervate the skin of the upper buttocks.
• Middle Cluneal Nerves:
  • Innervate the skin of the middle buttocks.
• Inferior Cluneal Nerves:
  • Innervate the skin of the lower buttocks.

Schedule

• 9:00 AM – 4:30 PM
  • 12:30 PM – 1 PM: Lunch

Dissection: Epidermis and Superficial Layers

• Reflect the epidermis.
• Expose the superficial layers of cutaneous nerves in the upper and lower extremities.
• Identify vascularization.

Upper Extremity

• Anterior Arm
  • Superior Lateral Cutaneous Region:
    • Innervation: Branch of the axillary nerve (C5-C6).
    • Location: Lower deltoid area.
  • Medial Cutaneous Region:
    • Innervation: Medial cutaneous nerve.
    • Location: Medial side of the upper arm.
  • Inferior Lateral Cutaneous Region:
    • Innervation: Inferior lateral cutaneous nerve.
    • Location: Lateral aspect of the upper arm.
• Posterior Arm
  • Posterior Cutaneous Region:
    • Innervation: Posterior cutaneous nerve.

Lower Extremity

• Anterior Leg
  • Anterior Femoral Region:
    • Innervation: Anterior cutaneous branches of the femoral nerve (L2-L4).
  • Lateral Femoral Region:
    • Innervation: Lateral femoral cutaneous nerve (L2-L3).
  • Medial Femoral Region:
    • Innervation: Obturator nerve (L2-L4).
  • Anterior Crural Region:
    • Innervation: Saphenous nerve (a branch of the femoral nerve, L3-L4).
  • Lateral Crural Region:
    • Innervation: Superficial fibular (peroneal) nerve (L4-S1).
• Posterior Leg
  • Posterior Femoral Region:
    • Innervation: Posterior cutaneous nerve of the thigh (S1-S3).
  • Posterior Crural Region:
    • Innervation: Sural nerve (S1-S2).
• Foot
  • Dorsum of the Foot:
    • Innervation: Superficial fibular (peroneal) nerve (L4-S1) for most of the dorsum; deep fibular (peroneal) nerve (L5) for the skin between the first and second toes.
  • Plantar Region:
    • Innervation: Medial and lateral plantar nerves (branches of the tibial nerve, L4-S3).
  • Heel Region:
    • Innervation: Medial calcaneal branches (from the tibial nerve, S1-S2).
  • Toes:
    • Innervation: Digital nerves from the medial and lateral plantar nerves (for the plantar surface) and from the superficial fibular nerve (for the dorsal surface).

Schedule

• 9:00 AM – 4:30 PM
  • 12:30 PM – 1 PM: Lunch

Neuroanatomy / Acupuncture Point Location / Nerve Palpation

• Identification of Nerves:
  • Brachial plexus
  • Radial nerve
  • Median nerve
  • Ulnar nerve
  • Axillary nerve
• Key Fascia Interrelationships:
  • Connections into the neck
• Joint Mobilization and Biomechanics:
  • Shoulder
  • Elbow
  • Carpal bones
  • Interphalangeal joints
• Understanding and Palpating the 1st Rib

Acupuncture Safety for the Upper Extremity

• Avoiding the cephalic vein (LI5, LI7)
• Avoiding the radial artery (LU8, LU9)
• Avoiding the brachial artery/vein (PC3)
• Refer to points avoiding the lung

Neuro-Integrative Acupuncture

• Prone Position:
  • Suprascapular fossa (SI12, LI16)
  • Infrascapular fossa (SI11)
  • Axillary nerve (Quadrangular space, SI9)
  • Radial nerve (Triangular interval, TE13)
• Supine Position:
  • Brachial plexus
  • Supraclavicular area (ST12)
  • Under the subclavius (ST13)
  • Scalenes (classical, LI17)
  • Axilla (HT1)
• Medial Arm:
  • Ulnar nerve (SI8)
  • Median nerve (PC3)
  • Musculocutaneous nerve:
    • Biceps branch (LU3)
    • Brachialis branch (LU4)
  • Medial brachial cutaneous nerve (HT2, HT3)
• Forearm:
  • Median nerve (PC5-PC9)
  • Radial nerve (LU7, LU8, LI4)
  • Lateral antebrachial cutaneous nerve
  • Musculocutaneous nerve (LU5-LI6)
  • Ulnar nerve (SI8, HT4-HT9)

Schedule

• 9:00 AM – 4:30 PM
  • 12:30 PM – 1 PM: Lunch

Schedule

• 9:00 AM – 4:30 PM
  • 12:30 PM – 1 PM: Lunch

Schedule

• 9:00 AM – 4:30 PM
  • 12:30 PM – 1 PM: Lunch

Schedule

• 9:00 AM – 4:30 PM
  12:30 PM – 1 PM: Lunch

Schedule

• 9:00 AM – 4:30 PM
  12:30 PM – 1 PM: Lunch

Cranial Base vs. Facial Bones

Cranial Base The cranial base, also known as the base of the skull, forms the foundation of the cranium and supports the brain. It includes:

• Occipital Bone: Forms the posterior and inferior parts of the skull and houses the foramen magnum, through which the spinal cord passes.
• Sphenoid Bone: Located centrally at the base of the skull, it articulates with several other cranial bones and contributes to the formation of the orbits and nasal cavity.
• Ethmoid Bone: Situated between the eyes, forming part of the nasal cavity and the medial wall of the orbit.
• Temporal Bones: Located on the sides of the skull, including the petrous part, which houses the inner ear structures, and the squamous part, which contributes to the cranial base.

Facial Bones The facial bones form the anterior part of the skull and are crucial for the structure and function of the face. They include:

• Nasal Bones: Form the bridge of the nose.
• Maxillae: Form the upper jaw and part of the hard palate.
• Zygomatic Bones: Create the prominence of the cheeks and part of the orbit.
• Palatine Bones: Form the posterior part of the hard palate and part of the nasal cavity.
• Lacrimal Bones: Located in the inner part of the eye socket.
• Inferior Nasal Conchae: Located within the nasal cavity.
• Vomer: Forms part of the nasal septum.

Review of Cranial Foramen, Contents, and Functions

• Foramen Magnum
  • Location: Base of the occipital bone.
  • Contents: Spinal cord, vertebral arteries, spinal accessory nerve (CN XI).
  • Function: Passage for the spinal cord to connect with the brain and for vertebral arteries to supply blood to the brain.
• Optic Foramen (Optic Canal)
  • Location: Sphenoid bone.
  • Contents: Optic nerve (CN II), ophthalmic artery.
  • Function: Allows the optic nerve to transmit visual information from the eye to the brain and the ophthalmic artery to supply blood to the eye.
• Superior Orbital Fissure
  • Location: Between the greater and lesser wings of the sphenoid bone.
  • Contents: Oculomotor nerve (CN III), trochlear nerve (CN IV), abducent nerve (CN VI), trigeminal nerve (CN V1) – ophthalmic branch, superior ophthalmic vein.
  • Function: Passage for nerves controlling eye movements and sensation to the forehead and upper eyelid, and for the superior ophthalmic vein.
• Foramen Rotundum
  • Location: Sphenoid bone.
  • Contents: Maxillary nerve (CN V2).
  • Function: Allows the maxillary nerve to pass from the skull to the face, providing sensory innervation to the midface region.
• Foramen Ovale
  • Location: Sphenoid bone.
  • Contents: Mandibular nerve (CN V3), accessory meningeal artery, lesser petrosal nerve.
  • Function: Passage for the mandibular nerve to the jaw and lower face, as well as for vessels and nerves related to the cranial meninges.
• Foramen Spinosum
  • Location: Sphenoid bone.
  • Contents: Middle meningeal artery and vein, branch of the mandibular nerve (CN V3).
  • Function: Provides a route for the middle meningeal artery and vein to supply the dura mater and cranial cavity.
• Jugular Foramen
  • Location: Between the temporal and occipital bones.
  • Contents: Internal jugular vein, glossopharyngeal nerve (CN IX), vagus nerve (CN X), accessory nerve (CN XI).
  • Function: Passage for major veins and cranial nerves involved in swallowing, vocalization, and parasympathetic functions.
• Hypoglossal Canal
  • Location: Occipital bone.
  • Contents: Hypoglossal nerve (CN XII).
  • Function: Provides a route for the hypoglossal nerve, which controls tongue movements.
• Mental Foramen
  • Location: Mandible (body of the mandible).
  • Contents: Mental nerve (branch of the mandibular nerve, CN V3), blood vessels.
  • Function: Allows the mental nerve and vessels to supply sensation to the lower lip and chin.
• Infraorbital Foramen
  • Location: Maxilla.
  • Contents: Infraorbital nerve (branch of the maxillary nerve, CN V2), blood vessels.
  • Function: Provides passage for the infraorbital nerve and vessels to supply sensation to the lower eyelid, cheek, and upper lip.

9:00 AM – 4:30 PM
12:30 PM – 1 PM: Lunch

Cranial Nerves

The cranial nerves are twelve pairs that originate from the brain and brainstem, serving functions related to sensation, movement, and autonomic control in the head and neck.

• Olfactory Nerve (CN I)
  • Function: Sensory (smell)
  • Location: Olfactory bulbs beneath the frontal lobe
  • Pathway: Passes through the cribriform plate of the ethmoid bone
• Optic Nerve (CN II)
  • Function: Sensory (vision)
  • Location: Optic chiasm and optic tract
  • Pathway: Passes through the optic foramen (optic canal) in the sphenoid bone
• Oculomotor Nerve (CN III)
  • Function: Motor (eye movements, pupil constriction)
  • Location: Emerges from the midbrain
  • Pathway: Passes through the superior orbital fissure
  • Branches: Superior division (levator palpebrae superioris, superior rectus), inferior division (medial rectus, inferior rectus, inferior oblique)
• Trochlear Nerve (CN IV)
  • Function: Motor (eye movements – superior oblique muscle)
  • Location: Emerges from the midbrain
  • Pathway: Passes through the superior orbital fissure
• Trigeminal Nerve (CN V)
  • Function: Mixed (sensory and motor)
  • Location: Emerges from the pons
  • Branches:
    • Ophthalmic (V1): Sensory (forehead, upper eyelid) – passes through the superior orbital fissure
    • Maxillary (V2): Sensory (midface, upper jaw) – passes through the foramen rotundum
    • Mandibular (V3): Sensory (lower face, lower jaw) and motor (muscles of mastication) – passes through the foramen ovale
• Abducent Nerve (CN VI)
  • Function: Motor (eye movements – lateral rectus muscle)
  • Location: Emerges from the pons
  • Pathway: Passes through the superior orbital fissure
• Facial Nerve (CN VII)
  • Function: Mixed (motor for facial expressions, sensory for taste, parasympathetic for saliva and tear production)
  • Location: Emerges from the pons
  • Pathway: Passes through the internal acoustic meatus and stylomastoid foramen
  • Branches: Temporal, zygomatic, buccal, mandibular, and cervical
• Vestibulocochlear Nerve (CN VIII)
  • Function: Sensory (hearing and balance)
  • Location: Emerges from the pons/medulla junction
  • Pathway: Passes through the internal acoustic meatus
  • Branches: Cochlear nerve (hearing), vestibular nerve (balance)
• Glossopharyngeal Nerve (CN IX)
  • Function: Mixed (sensory for taste and throat sensation, motor for pharyngeal muscles, parasympathetic for salivation)
  • Location: Emerges from the medulla
  • Pathway: Passes through the jugular foramen
  • Branches: Pharyngeal branch, lingual branch (taste)
• Vagus Nerve (CN X)
  • Function: Mixed (sensory, motor, and parasympathetic functions in the thorax and abdomen)
  • Location: Emerges from the medulla
  • Pathway: Passes through the jugular foramen
  • Branches: Superior laryngeal nerve, recurrent laryngeal nerve, and branches to the heart, lungs, and digestive tract
• Accessory Nerve (CN XI)
  • Function: Motor (trapezius and sternocleidomastoid muscles)
  • Location: Arises from the medulla and spinal cord
  • Pathway: Passes through the jugular foramen
  • Branches: Spinal part and cranial part (joins the vagus nerve)
• Hypoglossal Nerve (CN XII)
  • Function: Motor (tongue movements)
  • Location: Emerges from the medulla
  • Pathway: Passes through the hypoglossal canal

Facial Acupuncture Points

Acupuncture Safety

• Avoiding Carotid Artery: Points to avoid: SI17, ST9, ST10
• Avoiding Temporal Artery: Point to avoid: SJ22
• Eye Area: Points to avoid: ST1, ST2 (infraorbital nerve), BL1
• Facial Artery/Vein: Point to avoid: ST5
• Vertebral Artery: Points to avoid: GB20
• Spinal Cord: Points to avoid: Du 15, Du 16 (at C0-C1, C1-C2)

Dura Attachments Review

• Falx Cerebri
  • Attachment Points:
    • Anteriorly: Crista galli of the ethmoid bone
    • Posteriorly: Tentorium cerebelli and internal occipital protuberance
  • Function: Separates the cerebral hemispheres; supports and stabilizes the brain
• Tentorium Cerebelli
  • Attachment Points:
    • Anteriorly: Sphenoid bone (clinoid processes)
    • Laterally: Petrous part of the temporal bones
    • Posteriorly: Internal occipital protuberance
  • Function: Separates the cerebellum from the occipital lobes; forms the tentorial notch for the brainstem
• Falx Cerebelli
  • Attachment Points:
    • Anteriorly: Internal occipital crest
    • Posteriorly: Tentorium cerebelli
  • Function: Partially separates the cerebellar hemispheres
• Diaphragma Sellae
  • Attachment Points: Sella turcica of the sphenoid bone
  • Function: Covers the pituitary gland; forms a protective dome

Dural Innervation Review

• Trigeminal Nerve (CN V)
  • Sensory Supply:
    • V1 (Ophthalmic Division): Anterior cranial fossa, frontal sinus, superior nasal cavity
    • V2 (Maxillary Division): Mid cranial fossa, maxillary sinus, parts of the nasal cavity
    • V3 (Mandibular Division): Posterior cranial fossa, parts of the dura mater, meningeal branches
• Vagus Nerve (CN X)
  • Sensory Supply: Provides sensory innervation to parts of the dura mater, particularly in the posterior cranial fossa
• Glossopharyngeal Nerve (CN IX)
  • Sensory Supply: Contributes to sensory innervation of the dura mater in the posterior cranial fossa
• Sympathetic Nerves
  • Sensory Supply: The sympathetic nerve plexus provides additional innervation to the dura mater, particularly in the cranial cavity

Key Points

• Dural Sinuses: Venous channels between dura mater layers draining blood from the brain. Major sinuses include the superior sagittal, inferior sagittal, straight, transverse, and sigmoid sinuses.
• Pain Sensation: The dura mater is sensitive to pain due to its rich sensory nerve supply, mainly from the trigeminal nerve, making dural irritation a cause of severe headaches or migraines.
• Clinical Relevance: Knowledge of dural attachments and innervation is crucial for diagnosing and managing conditions like meningeal irritation, dural sinus thrombosis, and various headache disorders.

Cranial Nerve Palpation

• Trigeminal Nerve (CN V)
  • Branches:
    • Ophthalmic Nerve (V1): Palpated at the forehead, above the orbit
    • Maxillary Nerve (V2): Palpated along the cheekbone area, beneath the orbit
    • Mandibular Nerve (V3): Palpated along the jawline, at the angle of the mandible
• Facial Nerve (CN VII)
  • Branches:
    • Temporal Branches: Palpable near the temple and forehead
    • Zygomatic Branches: Palpable near the zygomatic arch (cheekbone)
    • Buccal Branches: Palpable around the buccal region (cheek)
    • Mandibular Branches: Palpable near the mandible and lower jawline
    • Cervical Branches: Palpable along the lower neck, near the mandible
• Accessory Nerve (CN XI)
  • Location: Palpated along the posterior neck and upper trapezius muscle
• Hypoglossal Nerve (CN XII)
  • Location: Palpated beneath the mandible and along the tongue (less accessible for direct palpation)
• **Greater Occipital Nerve

Schedule:

• First half Supine (40 min lecture, 20 min practical / palpation)
• Second half Prone (40 min lecture, 20 min practical / palpation)

Supine Position:

• Clavicle: The collarbones extend from the sternum to the acromion process of the scapula and can be felt along the upper chest.
• Sternum: The breastbone in the center of the chest, including:
  • Manubrium: The upper part, felt at the top of the sternum.
  • Body of the Sternum: The central portion.
  • Xiphoid Process: The small, pointed tip at the bottom of the sternum.
• Ribs: Palpable along the sides of the chest, with noticeable costal cartilages where the ribs attach to the sternum.
• Humerus: The upper arm bone, especially its head near the shoulder joint.
• Radius and Ulna: The forearm bones, with the radius more lateral and the ulna more medial.
• Costal Cartilages: Cartilaginous extensions of the ribs connecting them to the sternum.
• Pelvis:
  • Iliac Crests: The top of the hip bones on either side.
  • Pubic Symphysis: The cartilaginous joint where the two sides of the pelvis meet at the front.
  • Greater Trochanter of the Femur: The bony prominence on the side of the hip, felt when the leg is rotated.
• Patella: The prominent kneecap at the front of the knee.
• Tibial Tuberosity: A bony prominence on the front of the tibia, just below the knee.
• Malleoli: The bony prominences on either side of the ankle:
  • Medial Malleolus: On the inner side of the ankle, part of the tibia.
  • Lateral Malleolus: On the outer side of the ankle, part of the fibula.

Prone Position:

• Occipital Protuberance: The bony bump at the base of the skull.
• Spinous Processes: The bony projections along the midline of the back, part of the vertebrae:
  • Cervical Spinous Processes: In the neck region.
  • Thoracic Spinous Processes: Extending down the mid-back.
  • Lumbar Spinous Processes: In the lower back.
• Scapula:
  • Spine of the Scapula: The ridge across the upper part of the shoulder blade.
  • Acromion Process: The bony prominence at the end of the spine of the scapula, forming the highest point of the shoulder.
• Iliac Crest: The top of the hip bones on either side, felt above the pelvis.
• Sacrum: The large, triangular bone at the base of the spine, above the coccyx and between the two hip bones.
• Coccyx: The small, triangular bone at the base of the sacrum.
• Greater Trochanter of the Femur: The prominent bony projection on the side of the hip, near the hip joint.
• Ribs: Extending from the spine around the torso.
• Thoracic Vertebrae: Palpated along the back, especially the spinous processes.
• Erector Spinae Muscles: Muscle groups along the spine that can make the underlying vertebrae more palpable.

Pneumothorax Safety and Prevention:

• LU 1 (Zhongfu): Located on the upper chest, just below the clavicle. Deep needling here can pose a risk to the lungs.
• LU 2 (Yunmen): Found in the supraclavicular fossa, close to the lung apex. Care should be taken to avoid deep insertion.
• PC 1 (Tianzong): In the 1st intercostal space, just lateral to the nipple. Near the lungs and heart, deep needling can risk pneumothorax.
• Ren 17 (Shanzhong): On the midline of the chest at the 4th intercostal space. Deep needling could potentially penetrate the pleura.
• GB 21 (Jianjing): On the upper trapezius muscle, close to the lung area. Risky if needled too deeply.

Avoiding Kidney Injury:

• BL 23 (Shenshu): Located on the lower back, near the L2 vertebra. Deep needling here could affect the kidneys.
• BL 22 (Sanjiaoshu): Slightly higher than BL 23, around the L1 vertebra, close to the kidney region.
• BL 24 (Qihaishu): At the L4 vertebra level, near the lower back and kidney area.
• BL 25 (Dachangshu): Also at the L4 vertebra level, slightly lateral and lower compared to BL 24.

Safety

• Pneumothorax – How to avoid
• What Pneumothorax feels like

Neuro Anatomical Patterns

• Heart 1
• GB21
• SJ 5, 6, 7
• Scapula 1/3 and pelvis 1/3
• GB30
• GB20

Palpation and Identification

• GB 31, 32, 33 34 – S1,S2,S3,S4
• GB 30 – Sciatic Nerve Exit
• BL 54, 55 – Cluneal nerves
• Sciatic nerve Tibial Nerve, Peroneal nerve (superficial and deep)
• Radial Nerve
• Unlar Nerve
• Median Nerve
• Heart 1
• Jing Well Points
• Thoracic Vertebra Rule of threes