AA2 Point Locations Flashcards by Jonathan Malo

SI9

Location
Direction
Depth
Position

SI9

Location

1 cun above the posterior axillary fold when the arm is adducted, in between the teres muscles

Direction

Posterior to anterior. Do not direct the needle medially.

Depth

0.5 - 1.5 cun

Position

Sitting

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SI13

Location
Direction
Depth
Position

SI13

Location

Medial corner of the supraspinatus fossa

Direction

Perpendicular or oblique, direction toward supraspinous fossa. Too medial or too deep may cause pneumothorax. Stay on scapula.

Depth

0.3-0.5 cun

Position

Sitting

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SI14

Location
Direction
Depth
Position

SI14

Location

3 cun lateral to the midline at the level of the lower border of the spinous process of T1

Direction

oblique; inferior to superior and medially. Pick up tissue similar to GB 21. Avoiddeepperpendicularinsertiontoavoidpneumothorax.

Depth

0.3 - 0.5 cun

Position

Sitting

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LI14

Location
Direction
Depth
Position

LI14

Location

On the line connecting LI 15 and LI 11; 3 cun below LI 15. The point is located anterior and superior to the deltoid tubercle on the anterior margin of the deltoid.

Direction

perpendicular or oblique inferior to superior

Depth

0.8 - 1.5 cun

Position

Sitting

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LI16

Location
Direction
Depth
Position

LI16

Location

In the depression medial to the acromion and posterior to the acromioclavicular joint.

Direction

superior to inferior. For shoulder joint problems, direct the needle obliquely from medial to lateral and superior to inferior

Depth

1-1.5 cun

Position

Sitting

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LU2

Location
Direction
Depth
Position

LU2

Location

Medial to the coracoid process and just inferior to the clavicle in the infraclavicular fossa, 6 cun lateral to the midline.

Direction

anterior to posterior, slightly medial to lateral and superiorly

Depth

0.5-1 cun

Caution: Risk of pneumothorax if needled in wrong direction or depth.

Position

Sitting

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LU3

Location
Direction
Depth
Position

LU3

Location

On the anterolateral aspect of the arm, 3 cun below the axillary fold, in the groove between the biceps and the humerus, on the radial side of biceps brachii. Anterior and inferior to LI 14.

Direction

lateral to medial on a horizontal plane

Depth

0.5-1 cun

Position

Sitting

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SI8

Location
Direction
Depth
Position

SI8

Location

Midpoint between the medial epicondyle and the olecranon in the ulnar groove. Locate the point with the elbow flexed.

Direction

perpendicular, or proximal to distal or distal to proximal along the ulnar nerve. Needle direction should be toward the pain.

Depth

0.3 - 0.8 cun

Position

Supine

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HT3

Location
Direction
Depth
Position

HT3

Location

Midpoint between the medial epicondyle and the bicipital aponeurosis on the transverse cubital crease, in the depression.

Direction

Perpendicular

Depth

0.5-1 cun

Position

Supine

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LU5

Location
Direction
Depth
Position

LU5

Location

On the transverse cubital crease on the lateral side of the bicipital aponeurosis.

Direction

intra-articular, perpendicular (use Betadine® or Stanhexidine® for deep insertion)

Depth

0.5 - 1 cun

Position

Supine

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LI12

Location
Direction
Depth
Position

LI12

Location

1 cun superolateral to LI 11 on the supracondylar ridge of the humerus, at the insertion of brachioradialis, and extensor carpi radialis longus.

Direction

perpendicular

Depth

1 -1.5 cun

Position

Supine

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LI5

Location
Direction
Depth
Position

LI5

Location

At the base of the anatomical snuff box, just distal to the radial styloid process, between the tendons of extensor pollicis longus and brevis.

Direction

perpendicular

Depth

0.3 - 0.5 cun

Position

Supine

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LU7

Location
Direction
Depth
Position

LU7

Location

1.5 cun proximal to the radiocarpal joint (LI 5), on the radial side of the radial styloid process, just proximal to the insertion of the brachioradialis muscle, in the cleft between the tendons of brachioradialis and abductor pollicis longus.

Direction

oblique, proximal to distal

Depth

0.3 - 0.5 cun

Position

Supine

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SI3

Location
Direction
Depth
Position

SI3

Location

When a loose fist is made, the point is found on the ulnar aspect of the hand, at the end of the skin fold just proximal to the head of the 5th metacarpal bone, where the skin changes color and texture.

Direction

perpendicular

Depth

0.5 - 0.7 cun

Position

Supine

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SI6

Location
Direction
Depth
Position

SI6

Location

On the dorsal aspect of the forearm, with the palm of the hand facing the chest, in the groove between the ulnar head and the radius, just proximal to the radio-ulnar ligament.

Direction

angle of 45 degrees obliquely between the radius and the ulna

Depth

1.0 – 1.5 cun

Position

Supine

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Baxie

Location
Direction
Depth
Position

Baxie

Location

With the hand in a loose fist, points are located on the web between the heads of the metacarpals at the junction of the red and white skin. Between the first and second fingers, the point is closer to the thumb. There are eight points in all.

Direction

towards the interspaces of the metacarpal bones

Depth

0.5 - 1.5 cun

Position

Supine

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GV15

Location
Direction
Depth
Position

GV15

Location

On the midline of the neck, directly above the spinous process of C2, approximately 1 cun below the lower margin of the external occipital protuberance.

Direction

Aim towards the tip of the nose so that the needle remains on a horizontal plane

Depth

0.5 – 1 cun

Position

Sitting or prone

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BL10

Location
Direction
Depth
Position

BL10

Location

On the level above the C2 spinous process (same as GV 15) 1.3 cun lateral to the midline, in the depression on the lateral aspect of the trapezius.

Direction

perpendicular posterior to anterior

Depth

0.5 – 1 cun

Position

Sitting or prone

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GV16

Location
Direction
Depth
Position

GV16

Location

On the midline of the neck between the occiput and C1. Identify the lower margin of the occiput and insert just below. The point is also approximately 1 cun above the upper margin of C2 spinous process.

Direction

Aim towards the tip of the nose so that the needle remains on a horizontal plane

Depth

0.5 – 1 cun

Position

Sitting

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C4 & C5

Location
Direction
Depth
Position

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C4 & C5

Location

The landmarks used to identify these points are the mastoid process and the posterior margin of the sternocleidomastoid muscle. All the points are located along the posterior margin of the sternocleidomastoid muscle at the following levels:

C4 Upper margin of the thyroid cartilage

C5 Lower margin of the thyroid cartilage

Direction

Lateral to medial

Depth

1 cun

Position

supine with neck rotated to contralateral side is ideal; side lying or sitting are other options

GB21

Location
Direction
Depth
Position

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GB21

Location

On the midpoint of the line connecting the lower margin of C7 spinous process and the lateral aspect of the acromion.

Direction

Tap the needle through the skin, then pick up the skin and underlying muscle and insert the needle posterior to anterior and inferior to superior into the muscle.

Depth

0.5 - 0.8 cun

Position

Sitting

BL31

Location
Direction
Depth
Position

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BL31

Location

Approximately 1 cun lateral to the midline in the first sacral foramen.

Direction

perpendicular to the skin, into the first sacral foramen

Depth

1 - 1.5 cun

Position

Prone

BL32

Location
Direction
Depth
Position

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BL32

Location

Approximately 1 cun lateral to the midline in the second sacral foramen at the level of the lower border of the SI joint.

Direction

perpendicular to the skin, into the second sacral foramen

Depth

1 - 1.5 cun

Position

Prone

BL53

Location
Direction
Depth
Position

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BL53

Location

3 cun lateral to the midline at the level of the S2 foramen or the lower edge of the SI joint, just lateral to the sacrum.

Direction

perpendicular to the skin

Depth

1 - 1.5 cun

Position

Prone

BL54 * Location * Direction * Depth * Position

BL54 **Location** 3 cun lateral to the midline at the level of the S4 foramen, about 1 cun above the sacral hiatus **Direction** perpendicular to the skin **Depth** 1.5 – 2 cun **Position** Prone

CV3 * Location * Direction * Depth * Position

CV3 **Location** On the anterior midline, 4 cun below the centre of the umbilicus, or 1 cun above the superior borderof the symphysis pubis. **Direction** obliquely, generally in the direction of the flow of the meridian, inferior to superior **Depth** 0.5 - 0.8 cun. Do not go past the resistance felt at the linea alba. **Position** Supine

ST21 * Location * Direction * Depth * Position

ST21 **Location** 2 cun lateral to the midline, at the level of CV 12 (4 cun above the centre of the umbilicus) **Direction** oblique, 45° angle to the skin or less, towards the midline **Depth** 0.7 – 1 cun **Position** Supine

ST25 * Location * Direction * Depth * Position

ST25 **Location** 2 cun lateral to the midline, level with the centre of the umbilicus **Direction** oblique, 45° angle to the skin or less, towards the midline **Depth** 0.7 - 1.2 cun **Position** Supine

ST2 * Location * Direction * Depth * Position

ST2 **Location** In the infraorbital foramen (palpate for depression) in line with the pupil when the eye is looking straight ahead, approximately 1 cun below the pupil. **Direction** perpendicular, slightly oblique inferior to superior **Depth** 0.2-0.3 cun **Position** Supine

ST6 * Location * Direction * Depth * Position

ST6 **Location** 1 cun anterior and superior to the angle of the mandible. For easier localization, ask the patient to clench the teeth to bulge the masseter muscle. The point is right in the prominence of the masseter muscle. **Direction** Perpendicularly **Depth** 0.3 – 0.5 cun **Position** Supine

SI19 * Location * Direction * Depth * Position

SI19 **Location** On the face, anterior to the tragus of the ear, posterior to the condyle of the mandible, in the middle of the groove / depression appearing when the mouth is slightly open. **Direction** Perpendicularly, lateral to medial. **Depth** 0.5 – 1.5 cun **Position** Supine

BL2 * Location * Direction * Depth * Position

BL2 **Location** On the medial end of the eyebrow at the medial superior corner of the orbital fossa near the supratrochlear notch. **Direction** oblique either medial to lateral along the eyebrow or superior to inferior. **Depth** 0.3-0.5 cun **Position** Supine

TE23 * Location * Direction * Depth * Position

TE23 **Location** In the depression on the lateral end of the eyebrow at the lateral superior corner of the orbital fossa. **Direction** obliquely, superior to inferior or lateral to medial along eyebrow **Depth** 0.3 - 0.5 cun **Position** Supine

GB14 * Location * Direction * Depth * Position

GB14 **Location** On the forehead, in line with the pupil when looking straight ahead or the midpoint of the eyebrow or the superior orbital margin and 1 cun above the superior orbital margin (2 cun below the hairline), right on the supraorbital foramen. **Direction** oblique superior to inferior, towards the middle of the eyebrow or toward the pain. **Depth** 0.5-1 cun **Position** Supine

GV20 * Location * Direction * Depth * Position

GV20 **Location** On the midline of the head, midway between the external occipital protuberance (EOP) and the anterior hairline. This distance is measured as 10 cun; therefore, the point is 5 cun anterior to the superior border of the EOP and 5 cun posterior to the anterior hairline. **Direction** oblique ~15-20° posterior to anterior aiming into the loose connective tissue of the scalp **Depth** 0.5-1 cun **Position** Prone

GB29 * Location * Direction * Depth * Position

GB29 **Location** On the midpoint of the line between the ASIS and the most prominent aspect of the posterior portion of the greater trochanter. Locate this point in side lying. **Direction** intra-articular, lateral to medial and slightly inferior **Depth** 1 – 3 cun **Position** Sidelying

BL36 * Location * Direction * Depth * Position

BL36 **Location** Midpoint of the gluteal fold **Direction** posterior to anterior **Depth** 1.5 – 2 cun **Position** Prone

LR10 * Location * Direction * Depth * Position

LR10 **Location** 2 cun distal to the pubic ramus or 3 cun distal to the superior border of the symphysis pubis, in the lateral aspect of adductor longus, either on the muscle or lateral to it **Direction** perpendicular **Depth** 1 - 1.5 cun **Position** Supine

SP12 * Location * Direction * Depth * Position

SP12 **Location** On the midpoint of the line between the ASIS and the pubic symphysis (CV 2), just inferior to the inguinal ligament (in the femoral triangle) and lateral to the femoral artery (needle may pulsate). CAUTION: Insertion must be inferior to the inguinal ligament, as above the inguinal ligament is into the abdominal cavity. **Direction** perpendicular to the skin, palpate for the femoral artery pulsation and insert just lateral **Depth** 1 - 1.5 cun **Position** Supine

Medial knee eye * Location * Direction * Depth * Position

Medial knee eye **Location** With the knee flexed to 90°, medial to the patellar tendon in the depression above the tibia and below the femur at the knee joint. **Direction** Intra-articular,anteriortoposterior,aimingsomewhatlaterally **Depth** 1 - 1.5 cun **Position** Supine

ST35 * Location * Direction * Depth * Position

ST35 **Location** With the knee flexed to 90°, lateral to the patellar tendon in the depression above the tibia and below the femur at the knee joint. **Direction** intra-articular, anterior to posterior, aiming somewhat medially. Use special caution with increased fluid in joint **Depth** 1 - 1.5 cun **Position** Supine

SP10 * Location * Direction * Depth * Position

SP10 **Location** When the knee is flexed, the point is 2 cun proximal to patella, in line with the medial border of the patella, just above the medial condyle of the femur on the bulge of vastus medialis muscle. **Direction** perpendicular **Depth** 0.7 - 1.5 cun **Position** Supine with knee flexed

BL37 * Location * Direction * Depth * Position

BL37 **Location** 6 cun below BL 36 on the midline of the posterior aspect of the thigh, or 8 cun above the middle of the popliteal crease. **Direction** perpendicular **Depth** 1 - 1.5 cun **Position** Prone

KI5 * Location * Direction * Depth * Position

KI5 **Location** 1 cun inferior to K3 in the depression anterior and superior to the medial side of the calcaneal tuberosity. **Direction** medial to lateral **Depth** 0.3 - 0.5 cun **Position** Supine

KI6 * Location * Direction * Depth * Position

KI6 **Location** In the groove, 1-1.5 cun below the most prominent point of the medial malleolus, where the skin changes colour and texture. **Direction** perpendicular **Depth** 0.3 - 0.5 cun **Position** Prone

Bafeng * Location * Direction * Depth * Position

Bafeng **Location** Midpoint between the toes (interdigital space) where the skin changes color and texture **Direction** oblique, aim between the metatarsal bones. **Depth** 0.5 – 1 cun **Position** Supine

ST41 * Location * Direction * Depth * Position

ST41 **Location** On the anterior ankle joint line (identify by dorsiflexing the foot) in the depression between the tendons of extensor digitorum longus on the lateral side and extensor hallucis longus on medial side. **Direction** intra-articular, anterior to posterior **Depth** 0.5 - 0.7 cun **Position** Supine

ST44 * Location * Direction * Depth * Position

ST44 **Location** Between the second and third toes, 0.5 cun proximal to the margin of the web, in the depression distal and lateral to the second MTP joint. **Direction** perpendicular **Depth** 0.5 - 0.7 cun **Position** Supine

AA2 Point Locations Flashcards

(48 cards)