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54 Cards in this Set

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  • Back
Acupuncture treatment is contraindicated for patients who are:
Weak and deficient, overly fatigued,
overly hungry, overly full, very drunk or very angry.
What acupuncture points are forbidden for pregnant women, especially in early pregnancy?
All points on lower abdomen and lumbosacral region. Also points with strong descending actions and points that induce labor.
What points induce labor?
LI 4,SP 6, UB 60, UB 67, GB 21
ESPECIALLY DURING EARLY PREGNANCY.
When is it inappropriate to needle children?
-children whose fontenel has not not fully closed (generally 2yrs old and under) do not needle vertex pts, DU 21,DU 22.

-children who are uncooperative
What landmarks have forbidden points?
Nipple - ST 17

Umbilicus- Ren 8
Blood Vessels and Nerves should be carefully avoided. Name the points and their corresponding vessel.
LU 8 and LU 9-radial artery.
Ht 1- axillary artery.
St 9 - carotid artery
Sp 11 and Sp 12- femoral artery
St 42 - dorsalis pedis artery
When should deep needle insertion be avoided?
When important internal organs are underneath.
What are the caution points @ the junction of the head and neck and why?
DU 15, DU 16, UB10 perp..5 - .8
GB12 oblique .3 - .5
GB 20 .5 - .8 towards the inner canthus of the opposite eye.

CAUTION MEDULLA OBLONGATA
What is the most dangerous point on the body?
GB 12 medulla oblongata
What are the caution points between the spinous processes and why?
DU 4 - 14 Caution spinal cord
Give the needling depths and direction for the caution points between the spinous processes.
DU 4/5 - perp. .5 - 1.0

DU 6 - 14 oblique superior .5 - 1.0
Name the corresponding vertebra.
DU 14 - C7 DU 13 - T1
DU 12 -T3 DU 11 - T5
DU 10 - T6 DU 9 - T7
DU 8 - T9 DU 7 - T10
Du 6 - T11 DU 5 - L1 DU 4 - L2
What are the caution points on the chest and why?
Needling depths?
KD 22 - 27, ST 12 - 18 , LV 14 , GB 22 - 24 , Sp 17-21 All obl..3-.5 except ST 12 perp. .3-5
LU 1 &2 oblq lat .5-.8 PC 1 oblq . 2-.4
Pleural cavity- Pneumothorax
What are the caution points on the upper back and why?
UB 11-21( T1- T12)- oblq .5-.7
UB 41-50(T2-T12)- oblq .3-.5
SI 14&15- perp..3-.7
SJ 15 & GB 21 perp..3-.5
Pleural cavity-Pneumothorax
What are the cautions on the mid-back and why?
UB 22&23
UB 57&52

Caution Kidney
What are the caution points on the upper abdomen and why?
Ren 13 - 15
KD 20&21
ST 19
ST 20 right side
Caution Liver
What might make a patient prone to bleed and what precautions should be taken?
Blood disorders, patient taking blood thinners.
Use thinner needles with a slow withdraw and cotton cover.
In managing an acupuncture accident what should you generally be prepared to do?
Evaluate the situation and respond quickly.
What are the six types of acupuncture accidents?
Fainting
Stuck needle
Bent needle
Broken needle
Bleeding and Residual sensation
What are the signs and symptoms of fainting?
dizziness, oppression of chest, nausea, pallor, cold sweating, cold extremities, weak pulse, hypotension, loss of consciousness
What are the causes of fainting?
Patient- nervous tension,hunger, fatigue,extreme weakness,
uncomfortable posistion.
Practitioner- overly forceful manip.causing excess.stimulation
There are 5 steps to manage fainting.Describe the first 3 steps.
Remove all needles.
Have patient lie down w/legs slightly elevated.
Offer patient warm drinks.
Describe the last two steps to manage fainting.
-For severe cases use fingernail or needle certain points to revive, such as DU 26, LI 4, ST 36, PC 6, DU 25, KD 1, PC 9.

-MOXA on lower Abdominal points such as Ren 4,6, 8
How might you prevent fainting?
Eliminate the causes. DUH
Name the 3 major causes of fainting during acupuncture.
First time patients.
Patients position.
Not managing prodrome.
Discuss prevention of fainting in first time patients.
Explain the procedure.
Use fewer points.
Use only light/gentle manipulation.
What patient position should be used to prevent fainting?
Lying position.
What are the prodromes of fainting that should be watched for?
Changes in facial expression and complexion.
What is the definition of a stuck needle?
A needle that is difficult or impossible to manipulate.
What are the causes of a needle becoming stuck?
Nervousness of the patient causing muscle spasm.
Practitioner twists needle w/ too wide of amplitude. Or only twists needle in on direction.
How should a stuck needle be managed if it is due to a nervous patient?
Relax / Reassure the patient.
-Let needle rest
-Massage around point
-Insert needle nearby to relax muscle spasm
How should a stuck needle be managed if it is due to improper twisting?
Turn needle slightly in opposite direction until it loosens.
What is the definition of a bent needle?
The handle angle has changed. Lifting and thrusting is not possible.
What are the possible causes of a bent needle?
Insertion was too forceful-kept pushing when encountering hard surface-tendon/bone.
Patient changed position during Tx.
Needle is hit by an object- flying saucer etc.
How do you manage a bent needle?
Stop manipulation.
Withdraw needle slowly if possible.
If angle is large- withdraw slowly along the bend direction.
If moved, restore patient to original position, then withdraw needle.
What must never be done when removing a bent needle?
Never pull out the needle by force - it may cause it to break!!!
What can be done to prevent a bent needle?
Gentle manipulation of needle.
Position the patient comfortably- remind them not to move.
Remove any objects that the needle could possibly hit.
What are the possible causes of a broken needle?
-poor quality needles
-too forceful of manipulation-muscle spasm
-patient changes position
-bent needle is ridgidly withdrawn - breaks!
First rule in managing a broken needle?
STAY CALM and ask the patient not to move to avoid the needle sinking deeper.
If broken needle is visible above the skin, how should it be removed?
Remove with tweezers.
If broken needle is at skin level, how should it be removed?
Gently push surrounding tissues to expose needle and then remove with tweezers.
If broken needle is completely underneath the skin, how should it be removed?
Seek immediate medical attention.
What should be done to prevent a broken needle?
-inspect needles prior to Tx
-do not manipulate needles w/excessive force
-remind patient to remain still
-don't remove bent needle by force
-don't insert needle up to handle
What are the signs and symptoms of bleeding (hematoma)?
-local swelling
-patient feels distended pain after needle is withdrawn.
What is the cause of a hematoma?
A blood vessel was punctured and pressure was not applied to the site with a cotton ball after needle was withdrawn
How should a hematoma be managed?
Apply direct pressure to needling site.
-vein - 30 sec to 1 min
-artery - up to 5 min
How can hematomas be prevented?
-Familiarity with anatomy to avoid large vessels
-slow needle insertion after skin level - vessels will move out of the way
Why are point around the eyeballs more likely to bleed?
Loose tissues/large blood supply
Describe needling practices for needling point around the eyeball.
-Locate very accurately
-after initial insertion proceed very slowly
-after proper depth is achieved- NO MANIPULATION
withdraw needle very slowly, press site immediately - 1 min
Describe what is meant by residual sensations.
-local discomfort after needle is withdrawn
i.e. soreness, distension, heaviness, tingling
What is the major cause of residual sensations?
Overly forceful manipulation
How do you prevent residual sensations?
Be careful not to be overly forceful during manipulation.
How should residual sensations be managed?
-reassure patient it will resolve in 1 to 2 days
-gently massage needling area
-use moxa on area to increase qi and blood