Tuina Midterm Flashcards

1
Q

General contraindications

A

1.Infectious diseases (acute/chronic communicable diseases)
2.Hemorrhagic diseases
3.Cancer (esp. skin cancer or lymph cancer)
4.Bone fractures
5.Dermatitis/Open skin lesions
6.Caution with joint replacements

IHCBDJ

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2
Q

Gun

A

Rolling

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3
Q

Gun areas of use

A

Most common on the back, also the legs posteriorly and laterally, all around the shoulder, and down the medial aspect of the arms.

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4
Q

Gun Function

A

Moves qi and blood, and stasis generally - think dampness
warms the jing-luo and tissues and expels cold,
dredges channels, lubricates joints,
relieves pain.

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5
Q

Gun Depth

A

Superficial to tendon level

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6
Q

Gun Method

A

Place the yin hand on the body. The active hand rolls from hypothenar eminence across back of hand to the first knuckle (index finger) and back again. Wrist flexes to near 90º as the arm extends forward.

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7
Q

Gun Common Mistakes

A

flipping elbow, punching, scrubbing, unidirectional roll, using the knuckles.

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8
Q

Gun Variation

A

short roll, knuckle roll, forearm roll.

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9
Q

Na

A

Grasping

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10
Q

Na Area of Use

A

cordlike soft tissues, such as musculotendinous regions of shoulder, upper back and limbs; front and back of legs, SCM

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11
Q

Na Function

A

*Disperse excess,
*soften and relax muscles,
*relieve pain, benefit the qi,
*release the surface (induce sweating) for heat, cold and damp,
*restore consciousness

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12
Q

Na Depth

A

superficial to tendon level

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13
Q

Na Method

A

grasp using the finger pad, engage the soft tissue, and lift it perpendicularly off the bone using laogong. Once the qi and blood has arrived, make a quick release to vibrate the tissue all the way into the joint.
Sudden release creates a shock wave to move qi and blood into the tendons

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14
Q

Na body position common Mistakes

A

Improper body mechanics, or using your shoulders instead of your legs and dantian to lift the tissue.

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15
Q

Na Improper release

A

– don’t let fingers slip, use enough force to keep the tissue on lock.
NO PINCHEYness – use lao gong

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16
Q

An

A

Pressing

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17
Q

An area of use

A

anywhere on the body

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18
Q

An Function

A

*Disperses accumulation of qi and damp
- INDIRECTLY it can move the blood b/c of the connection with the qi
*open the channel and relieve pain,
*relax the muscle and tendon and relieving spasm,
*resuscitation on jing-well points and Du 26;

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19
Q

An Depth

A

Superficial to organ and bone

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20
Q

An method

A

There are various methods of pressing, but most common is using the thumbs or fingers with one hand supporting the other.
*In either case, start slowly with good body mechanics.
*As you connect with the patients’ body, do your best to listen through your hands. Be even in pressure and speed moving in to the body or limb.
*Reduce pressure with inhalation by 25%, and increase the pressure slightly with each exhalation. The name of the game is to follow the patients’ tissues to find the release.
Pay attention to the patient’s breathing!!!!!!
the key is the breath to the door of deeper release in the patients body
INTENTION is a big Piece – the concept of {Ting - listening, with heart}
Pressing too hard, leaning with no connection to dantian, and allowing our own joints to collapse or hyperextend with pressure is not correct.

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21
Q

An release

A

*requires Space - how can we provide this?
*Pressing has the image of waves moving outward, as in a stone cast into water.
*takes various forms
-changes in breathe, softening, lengthening of tissues, heat or cold release, pulsation, tremor or trembling/spasm of muscle, fluid movement, borborygmus, twitching and emotional release
*OUR JOB IS TO STAY PRESENT

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22
Q

An Common Areas of Use

A

Rib facets, lumbar spine, acu-points, abdomen, ashi pt.
Points to press –
*huantiao Gb30 weizhong Ub40, chengfu UB36
* fengfu Du16, tianzhu Ub10, fengchi GB20,
*tianliao, SJ15, jianjing gb21, Quchi/hegu LI 11/4,
*zusanli St 36, zhongwan (cv12), Qihai Ren 6 , tianshu St 25

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23
Q

An Common Mistakes

A

Using too much force, and inadequate qi from the practitioner – must sink the qi to the level needed, rather than using strength – Listen with the hands/fingers/elbows
CI in pregnancy – li 4, jian jing, sp 6, ub 67/60. Also the sacrum, abd, Ren 8, xyphoid, st 1 ub 1

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24
Q

Yaohuan

A

Rocking

25
Q

Yaohuan Areas of use

A

Thorax, vertebrae, hips and shoulders

26
Q

Yaohuan Function

A

*Relax muscle and joint
*relieve spasm
* mobilize joints,
*regulate qi and blood, calm spirit and relax the nerves to
*This is also a diagnostic technique - more common with goldfish rocking.

27
Q

Yaohuan Depth

A

Tendon and ligament level into the joint

28
Q

Yaohuan Method

A

*uses the rhythmic action to move waves of energy through the body…
*round your back and hollow chest, with legs and feet steady on the ground to make the movement –
*go to full range of motion, and stay engaged in the tissues -
* without abandoning the point from which you rock - for the best therapeutic effect.

29
Q

Yaohuan Ribcage technique

A

*Hands together, sink into SI 9/10 and press to take up the slack
*Rock in a connected way, i.e. don’t release the slack taken up. Movement is directly across the back.
*Can open the lungs/ribcage to tx cough, open the whole thoracic spine, very calming.
*caution of floating ribs!
Key point - move from dantian

30
Q

Goldfish Rocking

A

*Subset of rocking – form undulating action like a fish in water.
*Not to edge of ROM! - more of a continuous wave to create a fishy movement.
*Sink in to the Earth, and sink fingers between vertebral processes (HTJJ) to soften the soft tissues, thereby bringing blood and qi to the area.
*Use T3 to L5, do 3 passes – the third time’s the charm.
Especially for back, Sacroiliac, and leg pain
**
Calms shen
*diagnostic as well.
-Lets us see how some parts move in relation to others.

31
Q

Rocking common mistakes

A
  • too fast = shearing action
  • too slow = no wave action
    *not sinking deeply enough
    *gripping the spinous process
    *Access the limits of ROM for rocking the ribs and hips, but not goldfish.

CI – suspected spine and or rib Frx.

32
Q

Tui

A

Pushing

33
Q

Tui area of use

A

*Applied to thoracic area, pushing relieves stag of qi in the chest to treat cough and asthma;
*It will also release the rib and spinal facets, and the associated musculature.
*Any channel

34
Q

Tui Function (3)

A

*warm and dredge jing-luo;
*Move qi, xue and damp stasis;
*Relieve stagnation and excess, tightness and/or restriction.

35
Q

Tui Depth

A

superficial to muscle, tendon and organ level.

36
Q

Tui Method

A

*palm root
*knuckles,
*thumb, thumb root or
*forearm and elbow.
*Generally the body is aligned behind the arm or chosen tool
*forward movement is generated by the body and the feet.
*mind the elbow -

Pushing is a linear tech, as opposed to pressing which is static.

37
Q

Primary technique of tui is with

A

forearm

38
Q

Forearm tui

A
  • uses the strength of the rolling and stretching action in combo with the knife edge and - keeping the arm strong
    – externally rotate the radius and ulna.
    Good to use on the traps and GB/UB channel –
    *Elbow ok but cautiously use on traps and erector spinae, as well as large muscles of the legs.
    *We can double thumb push (pull) down the yang channel on the arms.
    *Pushing with the thumb and thumb knuckle on the jingluo of the head = tx head-cold and sinusitis –
    -can use a silk scarf/mild oil to reduce friction.
    *Can also use on intercostal, pectorals, and sternum to reduce ke ni (cough)
    *Early stage edema can use gentle tui fa to relieve.
    *Digestive disorders just make use of common sense to correct the pathological direction of Qi flow, e.g. clockwise to move with intestinal qi, and visa versa.
39
Q

Rou

A

Round Rubbing

40
Q

Rou Function

A

*Regulate and tonify Qi in the points and channels
*Disperses stagnation to relieves tight muscles and spasm,
*calms the shen.

41
Q

Rou Depth

A

skin and muscle to the viscera –
Used a lot on points, along the channels, and along the spine.
Can use the thumb, palm root
*Good on the abdomen, paraspinal muscles, along the channels;

42
Q

Rou Method

A

*can replace an fa with rou if necessary – rou is basically pressing in circles.
*Apply even pressure downward and make the circling motion.
*The circumference is determined by the body area being addressed.
*Moving out and away is dispersing and sedating;
*Tonify by using centripetal motion into the circle or toward the midline

43
Q

Rou on Back

A

find the spinous process, go slightly lateral, and sink to the muscle level and move up and out. Three passes is good and get a little deeper each time. Execute from T3 area to L5. Continue to the sacral foramina, do inner and outer set.
The idea is to sink the qi to the level of the rib head.

44
Q

Rou Common Mistakes

A

*Sliding on the skin.
*See the tissues moving;
*incorrect pressure at least to the level of the muscle, but not so deep that patient is in too much pain. We don’t want to scatter the qi and therefore cause stagnation.

Contraindication - Patient in sharp pain, and direct pressure on the bone.

45
Q

Bo

A

Plucking

46
Q

Bo Functions

A

*disperse and scatter qi into freedom
*free adhesions & relax,
*releases exterior
*resuscitation

47
Q

Bo Depth

A

muscle, tendon or ligament

48
Q

Bo Area of Use

A

back, shoulders, arms, legs, and neck, pectorals

49
Q

Bo Method

A

*Pluck across muscle or tendon similar to the way you would pluck a stringed instrument
*Sink beside and move across to pluck correctly
*Heavy stimulation sedates a hyper-tonic situation. Should produce a sore and distended feeling…
*light plucking can be used to tonify

50
Q

Bo Areas of Use

A

*Back - Erectors, latissimus dorsi, medial border of scapula and lateral border of tip of the scapula – also teres minor/major
* Adductors – esp gracilis –
-be careful over the femoral a. or the saphenous v..&raquo_space; sometimes bruising happens at adductors
*Arms- delts, triceps, biceps, and pronators, etc…
-Tx carpal tunnel Tx – the fingers should move.
*Pluck the pectorals
-Can reach over the arm to pluck over the ribs, or reach under the arms and across the body to opposite pectoral.
*Neck -
-SCM, scalenes; lightly and one side at a time, turning head to opposite direction, with elbow anchoring at opposite GB21.
*Knee – Behind the knee – popliteal fossa and peroneus…
-hands go medial and deep to tendon. Knee should be at 90º. Pluck soft for deficiency and opposite for excess. One trick is to use thumbs for the upper aspect of knee.

So actually, first it’s press in, then pluck.

51
Q

Bo Common Mistakes

A

*Not entering deeply enough to be therapeutic.
*Having too slow of release of the tissue - pluck quickly

CI: on children, the elderly or recently traumatized tissue, as well as overly deficient patient. Or if the action causes too much pain.

52
Q

Yao

A

Circling/waving

53
Q

Yao Function

A
  • reintegrate joint complexes
    *increase mobility of joints
    *reduce pain and increase stability
    *diagnostic to examine action and relationship of joints,
54
Q

Yao Depth

A

tendon, joint level

55
Q

Yao Area of Use

A

The joints, as in the hips, knees and ankles as well as wrist, elbow and shoulder.

56
Q

Yao Method

A

circumduction, keep limb/digit straight and rotate it proximal through ROM

Hips –
-cephalad hand above the knee and caudal hand on the foot, with tigers mouth in the Bl 63, loosely supporting the foot. Move foot up and down the plane beneath the sits bone, while allowing the knee to circle with the most ROM possible, both directions. Foot everts as knee goes medial, and inverts when knee travels laterally.

*Ankle –
-medial hand thumb at K1, with knife-edge of hand engaging the St 41 area and dorsiflexing ankle; cup the ankle with lateral hand, thumb at Gb40 and ring/middle finger at K3. Gently rotate thru ROM with mild traction.

57
Q

Yao Mistakes

A

Moving too quickly or heavy handed, lack of full ROM, moving beyond ROM, not observing Dx attributes

58
Q

Yao Contraindicated

A

CI – using to assess lateral movement of knee, meniscus or collateral ligament tears. Extreme caution in hip and knee replacement.