Hecker / Steveling / Peuker / Kastner / Liebchen Color Atlas of Acupuncture

36 Pages·2016·3.95 MB·English

Hecker / Steveling / Peuker / Kastner / Liebchen
Color Atlas of Acupuncture
Reading excerpt
Color Atlas of Acupuncture
of Hecker / Steveling / Peuker / Kastner / Liebchen
Publisher: MVS Medizinverlage Stuttgart

http://www.narayana-verlag.com/b11868
In the Narayana webshop you can find all english books on homeopathy, alternative medicine
and a healthy life.
Copying excerpts is not permitted.
Narayana Verlag GmbH, Blumenplatz 2, D-79400 Kandern, Germany
Tel. [phone]
Email [email protected]
http://www.narayana-verlag.com
254 (cid:1) ExtensorMuscleofFingers
DescriptionoftheMuscle
Origin: Lateral epicondyle of humerus,
annular and collateral ligaments of
radius,fasciaoflowerarm.
Insertion:Dorsalaponeurosis;proximal
tothemiddlefingerjoints,theaponeuro-
sisdividesintotheulnarandradialten-
dinous portions that reunite distally to
thejointinanaponeurosisandinsertat
thebaseoftheterminalphalanges.
Innervation:Deepbranchofradialnerve
(C6toC8).
Action: Extends finger joints, extends
wrist,andsupportsulnarabduction.
TriggerPointsoftheExtensorMuscleof
Fingers
PreliminaryRemarks
Trigger points are found here predomi-
nantlyinthemusclebelliesoftheexten-
sor muscles of the ring and middle fin-
gers.Activationoftriggerpointsusually
takes place through chronic strain. As-
sociatedtriggerpointsareoftenalsopre-
sentinthefingermusclesandtheexten-
sormuscleofwrist.
ExaminationofTriggerPoints
Typical local twitch responses can be
triggered in the middle of the muscle
bellyintheregionofthetriggerpoints.
TherapyofTriggerPoints
Targetedintramuscularstimulationwith
subsequent passive stretching of the
muscle is effective within a short time.
Conventional needling and therapeutic
localanesthesiamayalsobeconsidered.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
TriggerPointsoftheExtensorMuscleofFingers 255
TriggerPointsandAreasofPain
Projection
(cid:2) ExtensorMuscleofFingers,Trigger
Point1
Thetriggerpointofthemiddlefingerex-
tensorisfoundclosetotheelbowinthe
region of the muscle belly. Typical pain
projectionrunsalongthemuscleintothe
1 middlefinger;nowandthenpainisalso
localizedovertheproximalflexioncrease
ofthewrist.
(cid:2) ExtensorMuscleofFingers,Trigger
Point2
Thetriggerpointoftheringfingerexten-
sorliesdistalandulnartotriggerpoint1.
Its area of pain projection reaches into
theringfingeranduptowardtheradio-
2 humeraljoint.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
256 (cid:1) ExtensorMuscleofFingers
ImportantAcupuncturePointsandTheir
Localizations
LI-8 LI-11
Location:4CundistaltoacupointLI-11.
LI-10
LI-9
LI-9 LI-8
Location:3CundistaltoacupointLI-11.
LI-10
Location:2CundistaltoacupointLI-11.
LI-11
Location:Lateraltotheradialendofthe
flexioncreaseofelbowwhenthelower
armisflexedatarightangle,inadepres-
sionbetweentheendofthecreaseand
thelateralepicondyleintheregionofthe
longradialextensorofthewrist.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
AcupuncturePointsoftheExtensorMuscleofFingers 257
TB-4
Location:Slightlyulnartothecenterof
thedorsalflexioncreaseofthewrist(the
joint space between radius, ulna, and
proximalwristboneseries),ulnartothe
tendonoftheextensormuscleoffingers,
radial to the tendon of the extensor
muscleoflittlefinger.
TB-9
TB-5
TB-8
Location: 2 Cun proximal to acupoint
TB-6 TB-4,betweentheradiusandulna,ona
TB-5
lineconnectingacupointTB-4andthetip
oftheolecranonprocessofulna.
TB-4
TB-6
Location: 3 Cun proximal to acupoint
TB-4,betweentheradiusandulna,onthe
lineconnectingacupointTB-4andthetip
oftheolecranon.
TB-8
Location: 4 Cun proximal to acupoint
TB-4,betweentheradiusandulna.
TB-9
Location: 7 Cun proximal to acupoint
TB-4 on the line connecting acupoint
TB-4andthetipoftheolecranon.Hence,
on the connecting line described, the
pointlies1Cunproximaltothemiddle
between acupoint TB-4 and the flexion
creaseofelbow.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
258 (cid:1) PronatorTeresMuscle
DescriptionoftheMuscle
Origin: Humeral head: medial epicon-
dyle of humerus; ulnar head: coronoid
processofulna.
Insertion: Lateral surface of radius and
pronatortuberosity.
Innervation:Mediannerve(C6andC7).
Action: Pronates the forearm and con-
tributestoflexionoftheelbowjoint.
TriggerPointsofthePronatorTeres
Muscle
PreliminaryRemarks
Trigger points are usually found in the
proximalpartofthemusclebelly.Their
activationiscausedbyrepetitiveprona-
tionoftheforearm,eitherthroughexces-
sive workload or through chronic stress
fromsports(e.g.,occasionaltennisplayer
withpoorservingtechnique).
Themediannervepassesunderneaththe
pronatorteresmuscle,andsometimesit
runsthroughthemuscle.Compressionof TherapyofTriggerPoints
thenervemayleadtoacharacteristicen-
trapmentneuropathythatmayfinallyre- Thereisariskofdamagingthemedian
semblecarpaltunnelsyndrome. nerve. Before dry-needling or injecting
thetriggerpoints,thecourseoftheme-
ExaminationofTriggerPoints diannervemustbeaccuratelyidentified.
Manual treatment by acupressure is
The muscle is easy to examine by deep anotheroption.
palpation in the cubital fossa. Palpation
triggers the characteristic radiation of
pain.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
TriggerandAcupuncturePointsofthePronatorTeresMuscle 259
TriggerPointsandAreasofPain
Projection
(cid:2) PronatorTreresMuscle,TriggerPoint
The main trigger point is found in the
musclebellyinthecubitalfossanearthe
origin of the muscle. The pain radiates
from the proximal anteroradial part of
theforearmtothewrist,whereitreaches
theproximalpalmarpartofthethumb.
ImportantAcupuncturePointsandtheir
Localizations
PC-3 HT-3 PC-3
Location:Ontheulnarsideofthetendon
ofthebicepsbrachiimuscle,intheelbow
crease.
HT-3
Location:Betweentheulnarendofthe
elbowcreaseandthemedialepicondyle
ofthehumeruswhentheelbowisflexed.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
260 (cid:1) SuperficialFlexorMuscleoftheFingers
DescriptionoftheMuscle
Origin:Humero-ulnarhead:medialepi-
condyleofhumerusandcoronoidprocess
ofulna.
Radialhead:anteriorsurfaceofradius.
Insertion: Four tendons insert on the
lateral bony ridges of the middle pha-
langesoffingersIItoV.
Innervation:Mediannerve(C7toT1).
Action:Flexesthemetacarpophalangeal
joints II to V and the proximal inter-
phalangealjointsIItoV.
Miscellaneous:Thetendonsofthedeep
flexormuscleofthefingerspassbetween
thepartsofthetendoninsertiononthe
endphalanges.
TriggerPointsoftheSuperficialFlexor
MuscleoftheFingers
PreliminaryRemarks
Theflexorsofthefingers,likethetensors
ofthefingers,aresuperficialmuscles.To
avoid damage to the nerves, deep nee-
dlingshouldneverbeperformed.Trigger
point activation is caused by chronic
strainduetomanualwork.Inparticular,
monotonous grasping movements acti-
vatethesetriggerpoints.
ExaminationofTriggerPoints
Itrequiresonlyslightpressuretopalpate
the trigger points in the middle of the
musclebelly.Thisisdonebygentlypal-
patingthroughtheulnarandradialflexor
musclesofthewristaswellasthepalmar
muscle. Accurate identification is con-
firmed by increased sensation of pain
whenpalpatingthetriggerpointswhile
simultaneously checking muscle func-
tion.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
TriggerPointsoftheSuperficialFlexorMuscleoftheFingers 261
TherapyofTriggerPoints
Damagetotheramificationsoftheme-
dian nerve and to the ulnar artery and
vein should be avoided by taking great
care during dry-needling or injection.
Thetriggerpointsareeasytoinactivate.
Subsequent stretching of the flexors by
dorsalextensionofthefingersisessential
for preventing relapses, and patients
shouldbeadvisedtodothisontheirown.
TriggerPointsandAreasofPain
Projection
Intheradialportionoftheflexormuscles,
thepainradiatesintothepalmarsideof
themiddlefinger;intheulnarportionit
radiatesintotheringfingerorlittlefin-
ger, sometimes with further projection
intothepalm.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag
262 (cid:1) SuperficialFlexorMuscleoftheFingers
ImportantAcupuncturePointsandtheir
Localizations HT-3
PC-3
LU-5 LU-5
Location:Radialtothebicepstendonsin
theelbowcrease.
LU-7
Location:Ontheradialsideofthefore-
PC-6
arm, in a V-shaped groove proximal to LU-7
thestyloidprocessoftheradius,1.5Cun HT-4
proximaltothecreaseofthewrist.The HT-5
PC-7
acupoint is located where the proximal
portion of the styloid process of the HT-7
radiusmergesintotheshaftoftheradius.
PC-3
Location:Ontheulnarsideofthetendon
ofthebicepsbrachiimuscle,intheelbow
crease.
PC-6
Location:2Cunproximaltothepalmar
flexioncreaseofthewristthatliesproxi-
mal to the pisiform bone, between the
tendons of the palmaris longus muscle
andtheradialflexormuscleofthewrist.
Asdescribedforthelocationofacupoint
HT-7,choosethewristcreasethatliesbe-
tweentheradiusandulnaontheoneside
andtheproximalrowofcarpalboneson
theother.Astheproximalrowofcarpal
bones is marked by the pisiform bone,
thecreaseinquestionislocatedproximal
tothepisiformbone.
PC-7
Location: In the middle of the palmar
flexioncreaseofthewristthatliesproxi-
mal to the pisiform bone, between the
tendons of the palmaris longus muscle
andtheradialflexormuscleofthewrist.
aus: Hecker u. a., Color Atlas of Acupuncture (ISBN 9783131252227) © 2008 Georg Thieme Verlag