Flashcards in Acupuncture Deck (33):
How can acupoints be located?
by palpation for tenderness as well as changes in the tension or stickiness of the skin and tissue is a common way of locating acupoints
What did the chinese map
the common tender and functional points, and found channel asssociations in humans. Acupoints were not assigned to channels in animals in China as was done in man
How are acupoints named?
- CHINA - traditional names
- ENGLISH: according to channels (e.g LU1-LU9)
What is another name for channel?
What type of free nn endings are targeted for most effect?
What is the bladder meridian?
a channel that runs whole length of body
What is Shu Xue?
- Shu = communication with, passing through
- Xue = hole or outlet, 3D
= together means acupoints (a misnomer) which is a concept that describes a conduit communicating with the internal organs via the vascular system (Jingluo)
Outline acupuncture segmental effects
- somato-visceral reflexes
- inhibit (down-regulate) central sensitisation, upregulate endogenous opioids, opioid receptors at injured tissue and in CNS
- inhibit nerve growth factor and C Fos expression at WDR (wide dynamic range receptors)
How is an animal examined prior to acupuncture?
- point sensitivity noted at each level, each spinal segment, sum of the findings is evaluated in context of the hx and complaint
Palpation findings - list
- superficial vs deep
- splinting, guarding
- mm fasiculation
- trigger points
- allodynia / hyperaesthesia
- abnormal tone
- fascial drag
What is the parasympathetic system concerned with?
conservation and restoration of energy as it causes a reduction in HR and BP and facilitates digestion/ absorption and excretion of waste
What is the sympathetic system concerned with?
enables body to be prepared for fear, flight or fight. Includes increase HR, BP and CO, divert BF from skin and splanchnic vessels to skl. mm, increased pupil size, bronchiolar dilation, contraction of sphincters and metabolic changes such as metabolism of fat and glycogen.
What part of spinal cord does parasympathetic cord originate?
cranial and sacral
What part of the spinal cord does sympathetic cord originate?
What does chronic stress cause?
activation of SNS (anxiety, sleep deprivation, gut dysfunction) --> inactivation in P/S. Acupuncture --> normalisation in autonomic function
T/F: it is proposed that central inhibition of sympathetic activity occurs in acupuncture and plays a role in analgesia
What is sympathetic associated pain syndrome?
- unknown aetiology
- increased SNS tone --> decreased BV supply --> increased pain
Local effects - acupuncture needling
- proiinflammatory and vasoactive peptides including calcitonin gene-related peptide, SP, SST, VIP, opioids - improves tissue function and has trophic effects on glands
- increased local opioids (endorphins) and up-regulation of their receptors in the DRG and local tissues takes a few days
Central effects - acupuncture needling
- LIMBIC SYSTEM: emotional, affective reactions with decreased anxiety, increases pain threshold
- PAG and SOMATOSENSORY CORTEX: descending pain inhibition, reduced sympathetic tone and genome for up-regulation of endogenous opioid release
- HYPOTHALAMUS: ACTH, MSH, OT, vasopressin interactions and feedback systems supported
- Autonomics normalisation
How does acupuncture affect the limbic-paralimbic-neocotrical system?
Acupuncutre modulates it (determined by functional MRI = fMRI)
- mediates its anti-pain, anti-anxiety and other therapeutic activities via this neural circuit
- plays a central role in the affective and cognitive dimensions of pain as well as regulation and integration of emotion, memory processing, autonomic, endocrine, immunological and sensorimotor functions
List acupuncture variables
- # points needles
- superficial vs deep
- amount and type of needle manipulation
- Duration: brief or up to 20 minutes (chronic pain)
- # and frequency of tx (1-2 times a week for 2-5 weeks, according to symptoms and response, then wider gas)
- Patient variables: hyper or hyposensitive to needle, frail or robust, strong to weak responders
What enzyme increases in patients refractory to acupuncture?
CCK increases (an anti-opioid, like morphine in refractory end-stage cancer patients)
How many tx are usually required to cause a response?
usually 3 tx (more severe cases quicker to respond. In people, 5-8 tx to decide if you are responsibe or not to tx).
Can manual tx such as chiropractics be done alongside acupuncture?
What is 't touch'?
a forma of massage that is easy to teach owners.
What is myofascial pain syndrome?
- involves dysfunctional motor end plates (trigger points, TPs) and central sensitisation
- not responsive to NSAIDs or other pharma
- TPs deactivated by needling brings pain relief, combined with physical therapy to control
What type of pain can acupuncture relieve?
inflammatory and neuropathic
Can acupuncture restore homeostasis in body systems?
Yes - it can restore homeostasis in: autonomic (involuntary), nervous system, immune system and hormonal system
How does acupuncture relieve pain? 3
- up-regulates body's opioid systems
- reduces pain signals via serotonergic descending inhibition
- reduce anxiety (limbic system effects)
What is the role of acupuncture?
- chronic pain (MSK - OA, disk)
- reduce NSAIDs, steroids and other meds
- geriatrics (medication side effects concerns)
- competition under banned substance rules
- chronic visceral disease
- respiratory: infectious and non-infectious
-GI; often resistant to medication efforts
- autonomic dysfunction (dry eyes, functional bladder, bowel incontinence)