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Case Studies > CASE STUDIES EXAM 1 > Flashcards

CASE STUDIES EXAM 1 Flashcards

1
Q

INFLUENTIAL POINTS -

Hui Meeting Points
ZANG
FU
QI
BLOOD
A

ZANG: LV-13
FU: REN-12
QI: REN-17
BLOOD: BL-17

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2
Q 
INFLUENTIAL POINTS / HUI MTG POINTS - 
SINEW
VESSELS
BONE
MARROW
A

SINEW: GB-34
VESSELS: LU-9
BONE: BL-11
MARROW: GB-39 (benefits sinews & bones, like weakness/contraction & pain of limbs)

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3
Q 
COMMAND POINTS - Disorders of...
Head & Nape
Face & Mouth
Chest & Lateral Costal Region
Abdomen
Back & Lumbar Region
Resuscitation
A 
LU-7: Head & Nape
LI-4: Face & Mouth
PC-6: Chest & Lateral Costal Region
ST-36: Abdomen
BL-40: Back & Lumbar Region
DU-26: Resuscitation
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4
Q

FX of REN-12

A
  1. Transforming & Distributing the Essence of Food & Drink throughout the Body
  2. Tonify ST Qi, ST Yin & SP Qi to Resolve Phlegm
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5
Q

CHANNELS / REGIONS

A

12 Primary Ch, 12 Divergent Ch
Luo-Conn Ch, 12 Sinew/Muscle Ch
8 Extraordinary Channels
12 Cutaneous Regions

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6
Q

8 EXTRAORDINARY CHANNELS

A

CHONG Mai, DAI Mai, DU Mai, REN Mai
YANG QIAO Mai, YIN QIAO Mai
YANG WEI Mai, YIN WEI Mai

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7
Q

8 EXTRAORDINARY CHANNELS

CHONG MAI - PENETRATING Vessel

A

Sea of BLOOD
Influence Abdomen, Uterus, Chest, Heart
Counterflow of Qi, Ab Urgency, Gynecological Disorders, Atrophy of Leg

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8
Q

8 EXTRAORDINARY CHANNELS

DAI MAI - GIRDLING Vessel

A

Vertical Path to 12 PRIMARY Channels
Influence the Genitals, Waist, Hips,
Treats Ab fullness, waist & lumbar spine, Leucorrhea, DH in lower burner, mensus, infertility, weakness of legs

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9
Q

8 EXTRAORDINARY CHANNELS

DU MAI - Governing Vessel

A

Governs all YANG Channels
Provides Heat (Yang Qi) to warm all Organs & Ch
Influences Fx of Brain, Head & Sense Organs
Strengthens Constitution & Immunity
Regs Fx of Uterus, KD, HT, Brain & Channels
Influences all Channels d/t conn w/Ren & Chong

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10
Q

8 EXTRAORDINARY CHANNELS

YANG QIAO MAI - Yang Motility Vessel

A

Dominates ACTIVITY
Influences Lat Aspect of Leg, Back, Neck, Head & Eyes
Treats Daytime Epilepsy, Insomnia, tight muscles on side of leg, eversion of foot

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11
Q

8 EXTRAORDINARY CHANNELS

YIN QIAO MAI - Yin Motility Vessel

A

Dominates QUIETNESS
Influences Inner side of legs, Abdomen & Eyes
Treats Night time Epilepsy, Genital pain, Inversion of Foot

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12
Q

8 EXTRAORDINARY CHANNELS

YANG WEI MAI

A

Dominates EXTERIOR - Tai Yang, Shao Yang
Balances YANG QI
Treats Bi-Polar, OCD, excessive Anger, Vertigo, Alt Fever & Chills

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13
Q

8 EXTRAORDINARY CHANNELS

YIN WEI MAI

A

Dominates INTERIOR - Qi in YIN Ch & Organs (esp. HT, LU, ST, SP)
Treats chest pain, cardiac/epigastric pain, ab pain & ext. genitalia, mental instability, low self esteem, lack of will power

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14
Q

8 EXTRAORDINARY CHANNELS

REN MAI - Conception/Directing Vessel

A

Sea of YIN Channels - helps reg Qi of all YIN Ch
Influences Ab, thorax, LU, throat, face
Important in Reproductive system - esp. women
Treats issues w/ fertility, conception, pregnancy, childbirth, menopause

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15
Q

4 STAGES OF PENETRATION (WEN BING)

A

Wei
Qi
Ying or Nutritive
Blood

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16
Q

QI LEVEL - 4 BIGS

A

Fever
Thirst
Sweating
Pulse

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17
Q

EFP at YING LEVEL

A

Chronic conditions at this level
People start to waste away, disease consumes weight and Body Fluids
Low-grade fever, Yin has contained Heat a little so that it isn’t as exuberant
Fever usually comes and goes
Herbs must be used

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18
Q

EFP at BLOOD LEVEL

A 
General fever, Reckless Blood
Extreme restlessness; irritability
Insomnia, Stuttering
Very dark skin eruptions
Tremors; convulsions; seizures
Less fluids allow Wind to enter vessels
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19
Q

IDENTIFICATION OF PATTERNS ACCORDING TO 4 LEVELS - DEFENSIVE QI or WEI LEVEL

A

Wind Heat
Summer Heat
Dry Heat
Damp Heat

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20
Q

IDENTIFICATION OF PATTERNS ACCORDING TO 4 LEVELS - QI LEVEL

A 
Lung Heat (Heat in Chest and Diaphragm)
Stomach Heat
Intestines Dry Heat
Gall Bladder Heat
Damp Heat in Stomach and Spleen
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21
Q

IDENTIFICATION OF PATTERNS ACCORDING TO 4 LEVELS - NUTRITIVE or YING LEVEL

A

Heat in the Nutritive Qi Level

Heat in the Pericardium

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22
Q

IDENTIFICATION OF PATTERNS ACCORDING TO 4 LEVELS - BLOOD LEVEL

A 
Heat victorious moving Blood
Heat victorious stirring Wind
Empty Wind agitating in the Interior
Collapse of Yin
Collapse of Yang
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23
Q

SOAP - O,P,Q,R,S,T for Pain

A 
O = Onset, P = Provocation &/or Alleviation
Q = Quality of Pain, R = Region & Radiation
S = Severity, T = Time (history)
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24
Q

Fx of Xi Cleft Points

A

Where Qi & Blood gather & plunge more deeply.
Mainly used to treat acute conditions and pain.
Yin channels (Lu, Sp, Ht, Ki, Pc, Liv) have add’l action of treating disorders of blood.

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25
Q

Fx of YUAN SOURCE Points

A

Points where the ORIGINAL QI surfaces & lingers.
Mostly use to TONIFY YIN organs.
However the YANG Source Points are mostly used in EXCESS patterns to expel pathogenic factors.

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26
Q

Fx of LUO CONNECTING Points treat

A

Disorders of their INT/EXT related Ch or Zangfu.
Disorders in REGIONS reached by Luo-Conn Ch.
PSYCHO-EMOTIONAL disorders.
Can be used in FULL and EMPTY conditions.

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27
Q

Fx JING-WELL Points

A

Clear HEAT, Restore CONSCIOUSNESS and Rescue COLLAPSE.

Has strong action for CLEARING EXCESS PATHOGENIC factors

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28
Q

Fx SHU STREAM Points treat

A

Disorders of the ZANG.
Feeling of HEAVINESS in the body & JOINT PAIN
Shu-stream points on the Yin channels are the primary points for tonifying & harmonizing their respective zang.

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29
Q

Fx of CUTANEOUS REGIONS

A

CIRCULATE QI & BLOOD (especially the Wei Qi to the body’s surface)
REG FX of SKIN & PORES
STRENGTHEN body’s IMMUNITY
Directly related to LU Qi

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30
Q

Fx of DIVERGENT CHANNELS

A

Dist QI & BLOOD to HEAD & FACE.
Integrate areas not conn. by Primary Ch
Strengthen the YIN-YANG Relationship btw INT/EXT paired CH & Zangfu.
Branch out from the 12 primary and have no specific points of their own.

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31
Q

HEADACHE by Dx - TOP OF HEAD

A

Usually LV
Most often LV Bld def- dull, improves w/lying down
LV Yang Rising - Sharp
Could also be Qi and Blood def or Ht Blood def

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32
Q

HEADACHE by DX - SIDES OF HEAD

A

Usually GB
Liv Yang Rising, Liv Fire, Liv Wind
Mainly sharp, throbbing

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33
Q

HEADACHE by DX - ONE SIDED

A

GB channel
Liv Yang Rising, Liv Fire
It is said that L side def and R side excess but this is not always true.

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34
Q

HEADACHE by Dx - TEMPLES

A

GB channel
Liv Fire, Liv Yang Rising, Liver Wind
Throbbing

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35
Q

HEADACHE by Dx - BEHIND THE EYES

A

LV channel
LV Blood def if dull
LV Yang Rising if sharp/severe

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36
Q

HEADACHE by Dx - BACK OF HEAD

A

KD Def manifesting on the BL channel

If acute, it is due to external Wind, usually accompanied by stiffness of neck and back

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37
Q

HEADACHE by Dx - FOREHEAD

A

ST channel: ST def-dull, ST heat-sharp
Sometimes due to Dampness/Phlegm- in this case, heavy sensation in the head, fuzziness, dizziness, blurred vision.
If after Wind Cold/Heat, it cold be from Wind not being expelled.

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38
Q

HEADACHE by Dx - WHOLE HEAD

A

If CHRONIC, it is due to KD YIN or KD Essence DEF, they will be dull accompanied by FEELING of EMPTINESS.
If ACUTE, due to invasion of EXT WIND, they will be SHARP & SEVERE.

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39
Q

Dx by TYPE OF HA PAIN - DULL

A

Generally indicates Empty conditions

Qi def, Blood def, Liv Blood def, Ki def

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40
Q

Dx by TYPE OF HA PAIN - FEELING OF HEAVINESS

A

Dampness/Phlegm preventing clear Yang from ascending to head and turbid Yin from descending.
Phlegm is more obstructive to the “orifices” and sense organs causing dizziness and blurred vision.

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41
Q

Dx by TYPE OF HA PAIN - DISTENDING (THROBBING)

A

Typically LV Yang or LV Fire and will present on sides of head.
Also due to Exterior Wind Heat which will affect whole head.

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42
Q

Dx by TYPE OF HA PAIN - STIFF

A

Usually invasion of Wind Cold

If Chronic and accompanied by stiff shoulders and neck, it indicates Liv Yang Rising.

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43
Q

Dx by TYPE OF HA PAIN - PULLING

A

Internal Liv Wind

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44
Q

Dx by TYPE OF HA PAIN - STABBING, BORING

A

Fixed in one place, intense, and chronic, indicates Blood Stasis

45
Q

Dx by TYPE OF HA PAIN - FEELING OF EMPTINESS

A

Def of Ki Yin or Yang

46
Q

DX According to Amelioration and Aggravation

WEATHER

A

Worse with heat -Liv Yang Rising or Liv Fire
Worse with cold -Yang def
Worse with damp weather -Dampness or Phlegm
Better with app of cold -LV Yang Rising or LV Fire

47
Q

DX According to Amelioration and Aggravation

TIME OF DAY

A

Chronic HA worse during day-indicate def of Qi/Yang, or Dampness.
Chronic HA worse at during evening- indicate def of Blood or Yin (could cause Yang Rising)

48
Q

DX According to Amelioration and Aggravation

ACTIVITY / REST

A

Worse w/activity- Def Qi or Blood
Better w/activity-LV Yang Rising or Phlegm
Better w/rest or lying down- Def Qi or Blood
Worse lying down- Dampness or Phlegm

49
Q

Western Differential Dx

INTRACRANIAL - INFLAMMATORY

A

Meningitis: inflammation of the meninges occurring during a febrile disease, often starts during a viral infection such as influenza or bacterial infection such as respiratory or ear infection, occur mainly in children before the age of 5.
Symptoms: severe HA, fever, vomiting, neck rigidity and if severe, mental confusion.
Test: Brudzinski’s, positive if with patient lying supine and chest held firmly to bed, try to flex the neck, in meningitis this will cause involuntary flexion of hips.

50
Q

Western Differential Dx

NON INFLAMMATORY - VASCULAR

A

Migraine: most frequent cause of recurrent HA, consists of initial constriction of head arteries followed by vasodilatation of vessels causing throbbing. Attacks are precipitated by stress, consumption of cheese, chocolate, red wine, contraceptive pill.
Symptoms: mainly unilateral and usually around the eye, severe, throbbing, photophobia, nausea, vomiting.

51
Q

Western Differential Dx

CEREBRAL HEMORRHAGE

A

More frequent in men over 40, intense head pain, neck rigidity, vomiting followed by loss of consciousness.

52
Q

Western Differential Dx

NEOPLASTIC - CEREBRAL TUMOR

A

Uncommon cause of HA, but if HA become progressively worse in terms of frequency, duration, intensity and are accompanied by vomiting, intellectual impairment, tumor may be suspected.

53
Q

Western Differential Dx

HYPERTENSIVE - ESSENTIAL HYPERTENSION

A

Persistent HBP without apparent cause. HA manifests usually on vertex or occipital, also neck muscles stiffness, tinnitus, irritability, and of course HBP.

54
Q

Western Differential Dx

HYPERTENSIVE - SECONDARY HYPERTENSION

A

HBP secondary to other factors like Ki disease, other manifestations are tiredness, edema, high albumin (protein) in the blood.

55
Q

Western Differential Dx

CRANIAL - SINUSITIS

A

Inflammation of the sinuses, HA is clearly located on the face (frontal, ethmoidal, maxilary), other symptoms include nasal congestion, feeling of muzziness of the face.

56
Q

Western Differential Dx

CRANIAL - OTITIS MEDIA

A

Common in small children confusing earache with HA, sometimes accompany by fever.

57
Q

Western Differential Dx

EXTRA CRANIAL - GLAUCOMA

A

Raised intraocular fluid pressure, rare before middle age, pain is around of behind the eyes, easily mistaken for migraine, worse in the evening, accompanied by haloes ad blurred vision.

58
Q

Western Differential Dx

CERVICAL SPONDYLOSIS

A

Includes arthritis and disc degeneration of the cervical area, causes occipital HA extending to the neck and upper shoulder area, X-rays will show narrowing of the intervertebral spaces and/or osteophyte formation.

59
Q

Western Differential Dx

TRIGEMINAL NEURALGIA

A

Inflammation of one or more of the 3 trigeminal nerves (part of the cranial nerves), usually seen in elderly, pain is unilateral, very intense, pain can occur on the forehead, eye, cheek, temple, and/or jaw depending on the affected nerve.

60
Q

HA - LV Yang Rising vs. LV Fire

A

LV FIRE: There IS an actual PATHO FACTOR- HEAT.
LV YANG RISING: An IMBALANCE btw YIN/YANG but NO PATHO FACTOR.
Same symptoms as Liv Yang but Liv Fire also has thirst, scanty dark urine, constipation, red eyes, red tongue/yellow coating. Same type of HA as Liv Yang but more intense, tends to be more fixed location and more often presents with nausea/vomiting.

61
Q

HA BEFORE MENSES

A

HA Worse - LV Yang Rising or LV Qi Stagnation

62
Q

CHANNELS - FROM MOST SUPERFICIAL TO DEEPEST

A 
Cutaneous regions
Minute collateral
Sinew/Muscle channels
Lou-connecting channels
Primary channels
Divergent channels
Extraordinary channels
63
Q 
FRONT MU POINTS
PC
HT
LV
GB
A

PC: REN-17
HT: REN-14
LV: LV-14
GB: GB-24

64
Q 
FRONT MU POINTS
SP
SI
SJ
ST
A

SP: LV-13
SI: REN-4
SJ: REN-5
ST: REN-12

65
Q 
FRONT MU POINTS
BL
KD
LI
LU
A

BL: REN-3
KD: GB-25
LI: ST-25
LU: LU-1

66
Q

ETIOLOGY OF BACK PAIN

A 
Excessive Physical Work
Excessive sexual activity
Pregnancy and Childbirth
Invasion of External Cold and Dampness
Overwork
Inadequate Exercise
67
Q

MOST COMMON PATHOLOGIES - BACK PAIN

Retention of Damp

A
  • When cold predominates
  • When Damp predominates
  • When cold and damp are the cause, the lower back ache is a form of Bi Syndrome
68
Q

MOST COMMON PATHOLOGIES - BACK PAIN

Stagnation of Qi & Blood

A
  • Characterized by a severe, stabbing pain
  • Pain becomes worse and better with light exercise (worse with overexertion)
  • Tender to touch
  • Does not respond to weather changes
  • Much worse with standing or sitting. It is also
  • Unaffected by the application of heat.
  • Marked rigidity and stiffness of the back muscles and inability to flex, extend or turn the waist
69
Q

MOST COMMON PATHOLOGIES - BACK PAIN

Kidney Deficiency

A
  • Pain is dull and comes in bouts
  • Better w/rest & worse when pt is overtired
  • Aggravated by sexual activity.
  • If from Def of KD Yang, may be a cold sensation
  • Might be slight improvement with heat
  • KD deficiency is more common in the middle-aged and elderly. It happens in children when it is hereditary or from over-exertion from work or sports.
70
Q

MOST COMMON PATHOLOGIES - BACK PAIN

LV Qi Stagnation

A
  • Can cause acute or chronic backache
  • LV is involved in 2 ways: (1) It affects the sinews of the spine & (2) it has a sphere of influence on the lower jiao that, when stagnant, causes contraction, spasm and stiffness.
  • Etiology is emotional stress such as anger, resentment, frustration, guilt
  • Frequently occurs against a background of Kidney deficiency.
71
Q

LBP: There is considerable interaction between the pathologies

A

Repeated invasion of Cold Dampness leads to permanent retention of Cold Dampness in the back muscles. This weakens the KD as Cold Damp interferes with KD’s transformation of Water and leads to Kidney Def, and on the other hand, it obstructs the circulation of Qi and Blood in the area and gives rise to stagnation of Qi and Blood.

72
Q

ACUPUNCTURE - TAI YANG / GR YANG STAGE
Invasion of WC with Cold Predominance
Invasion of WC with Wind predominance

A

UB 12 with cupping, Lu 7, LI 4. Moxa

UB 12 with cupping, Lu 7, LI 4, GB 20, St 36

73
Q

ACUPUNCTURE - TAI YANG / GR YANG STAGE

Invasion of WH (also mentioned in SHL)

A

LI 4, LI 11, Lu 7, UB 12, SJ 5

74
Q

ACUPUNCTURE - TAI YANG / GR YANG STAGE
Accumulation of Blood
Accumulation of Water

A

UB 62, SI 3 (in combo), UB 39, SI 5, UB 22, Sp 10, Liv 1

Ren 9 (Water Separation), Ren 3, Lu 7, UB 22 (SJ), UB 39 (lower He Sea SJ)

75
Q

ACUPUNCTURE - YANG MING / BR YANG STAGE
Channel Pattern
Organ Pattern

A

LI 11, Du 14, P3, St 44, St 43

LI 11, Du 14, P 3, St 44, St 43, St 25 (Front Mu Li), Sp 15, St 37(Lower He Sea Li), Sp 6

76
Q

ACUPUNCTURE - SHAO YANG / LESSER YANG

A

SJ5, SJ 6, GB 41, Du 13

77
Q

ACUPUNCTURE - TAI YIN / GREATER YIN STAGE

A

Ren 12, UB 20, St 36, Sp 9, Moxa

78
Q

ACUPUNCTURE - SHAO YIN / LESSER YIN
Cold Transformation
Hot Transformation

A

UB 23, Ren 4, Ren 6, Ren 8, K 7, K 3. Moxa

Ren 4, Ren 6, K 3, K 6, Sp 6.

79
Q

ACUPUNCTURE - JUE YIN / TERMINAL YIN

A

Liv 3, LI 4, Sp 4, and P 6

80
Q

POINT - ACUTE LBP
Lower Part of Back
(whether unilateral or bilateral)

A

UB-40

81
Q

POINT - ACUTE LBP

If the pain is unilateral and slightly higher, level with the navel

A

SI-3

82
Q

POINT - ACUTE LBP

If there is a pain in the leg between the UB and GB line

A

UB-58

83
Q

POINT - ACUTE LBP
If the pain is unilateral and radiates down one leg. It is also selected when the pain radiation down the leg affects more than one channel.

A

UB-62

84
Q

POINT - ACUTE LBP

If walking is difficult. From this point one should obtain a needling sensation that radiates up the UB channel.

A

UB-59

85
Q

LBP ACUTE conditions usually due to

A

Cold Dampness or

Qi & Blood Stagnation

86
Q

NEEDLING for Acute LBP

A

1st - Needle Distal point, manipulate vigorously while pt. gently flexes and turns waist (while standing) - needles retained for 15 mins.
2nd - Distal needles are removed. Pt lays down for Local points to be needled.

87
Q

CHRONIC LBP conditions are ALWAYS due to KD DEF that can be combined with retention of Cold Damp or Qi and/or blood stagnation…T/F?

A

TRUE

88
Q

LOCAL Points for Acute LBP are selected based on

A

Tenderness upon Palpation

89
Q

CHRONIC LBP - DISTAL POINTS

Men vs. Women

A

In MEN, needle SI-3 on LEFT and UB-62 on right.
In WOMEN, needle SI-3 on the RIGHT and UB-62 on the left and the REN channel points: Lu-7 on the left and K-6 on the right.
Remove needles in reverse order.

90
Q

SCIATICA - DISTAL POINTS USED

A 
UB-40
UB-57
UB-58
UB-62
GB-40 or GB-41 (if down GB Ch)
KD-4
91
Q

SCIATICA - LOCAL POINTS USED

A 
Tunzhong, UB 36 and 37 (pain from buttocks)
GB 30 & 31 (pain along GB Ch)
GB 34 (pain only to knee) 
GB 34 (pain in lower leg)
92
Q

Unless there is damp heat in the UB or GB channel, noxa is extremely beneficial for sciatica. This is best done with moxa pole and heating the area around the needle, especially UB 36 and UB 37…T/F?

A

TRUE

93
Q

The Most Common Pathogenesis of Back Pain

A

Chronic lower lumbar ligamentous strain (ligaments)
Spondylosis (synovial joints of vertebrae)
Spinal osteoarthritis (vertebrae)
Prolapsed lumbar disc (disc)

94
Q

Most common cause of nerve root compression

A

Prolapsed Lumbar Disc

95
Q

The most common disc to prolapse are those at

A

L4/L5 and L5/S1

96
Q

Area of pain small =

A

sprain and stagnation of Qi and Blood

97
Q

WHY USE SP-3 FOR CHRONIC LBP?

A

Spleen 3- Influences the spine and is good to select in chronic backache with obvious scoliosis of the spine.

98
Q

DIAGNOSIS - LBP

A

INVASION OF COLD: Worse in the morning on waking up and getting gradually better thru day
DEF OF KD: Better in the morning on waking up and gradually getting worse during the day
INVASION OF EXT COLD & DAMPNESS: Worse when the weather is cold and damp
SPRAIN OR KD DEF: Unrelated to weather

99
Q

Liver Qi stagnation can cause acute and chronic LBP…T/F?

A

TRUE. It frequently occurs against a background of Kidney deficiency.

100
Q

Additional Causes of Illness

A

Phlegm & Static Blood

101
Q

Six Exogenous Causes

A 
Wind
Cold
Damp
Summer-Heat
Fire
Dryness
102
Q

Seven Endogenous Causes

A

Joy, Anger, Worry (Anxiety), Over Thinking (Pensiveness/ Melancholy), Grief (Sadness), Fear, and Fright(Shock)

103
Q

Five Independent Causes

A 
Dietary Irregularity
Excessive Sexual activity 
Taxation/ Fatigue
Trauma
Parasites
104
Q

WEI LEVEL & PULSE

A

Wind Heat: Floating & Rapid
Summer Heat: Soggy & Rapid
Damp Heat: Soggy & Slow
Dry Heat: Floating & Rapid

105
Q

PULSE - BACKACHE DX

  1. Left Rear - Wiry and Floating:
  2. Left Rear - Fine and Deep, but also slightly Wiry:
  3. Left Rear position Tight:
A
  1. Acute backache or an acute exacerbation of a chronic back problem
  2. Chronic backache on a background of KD Def
  3. Invasion of Cold Dampness in the UB Channel
106
Q

TX (Points) for Wind Cold

A

LU-7, LU-6, UB-12

107
Q

TX (Points) for Wind Heat

A

LI-4, LI-11, SJ-5

108
Q

WC enters via…

WH enters via…

A

WC - Skin

WH - Mouth &/or Nose

109
Q 
PULSES by LEVEL
Wei
Qi
Ying
Blood
A

Wei = floating, Rapid
Qi = Rapid, Full
Ying = Thin, Rapid
Blood (Heat) = Wiry, Rapid
Blood (Collapse of Yin/Empty Wind) = Rapid, Thready
Blood (Collapse of Yang) = Hidden, Slow, Scattered

Case Studies (6 decks)

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