!

Basic Anatomy Course in Acupuncture

Ryan Em C. Dalman, MD-MBA

!Afternoon Topics " Basic Anatomy

! Biological Organization ! Vessels (Artery, Vein, Nerve)

" Basic Physiology " Relevance in Acupuncture

! Bone, Ligament, Tendon, Cartilage, Fascia, Muscle ! Skin, hair and nails

" TCM principles ! Recall Activity

Outline

!Biological Organization

!" Cell

! Cella – Latin for “small room”

! basic structural, functional, and biological unit of all known living organisms

Biological Organization

!" Examples of cells

! Osteocyte

Biological Organization

!" Examples of cells

! Osteocyte ! Adipose

Biological Organization

!" Examples of cells

! Osteocyte ! Adipose ! Hepatocyte

Biological Organization

!" Examples of cells

! Osteocyte ! Adipose ! Hepatocyte ! Myocyte

Biological Organization

!" Tissue

! an ensemble of similar cells from the same origin that together carry out a specific function

Biological Organization

!" Organ

! a group of tissues in a living organism that have been adapted to perform a specific function

Biological Organization

!" Organ Systems

! a group of organs that work together to perform one or more functions

Biological Organization

!Biological Organization

!Nerve, Artery, Vein

!" Neuron

! Constitutes the anatomical, physiological, genetic, and functional unit of the nervous system

Nerve

!" Nervous Tissue

! Group of neurons formed together to perform functions mainly as a Communications System from the Brain to the target organs (and vice versa)

Nerve

!" Functions

! Allows a person to experience sensations such as: " Sight " Smell " Touch " Taste " Hearing

! Movement of both voluntary and involuntary muscles

Nerve

!" Blood Vessel

! a tubular structure carrying blood through the tissues and organs; a vein, artery, or capillary.

Blood Vessels

!" Artery

! any of the muscular-walled tubes forming part of the circulation system by which blood (mainly that which has been oxygenated) is conveyed from the heart to all parts of the body

“A for Away from the heart”

Blood Vessels

!" Vein

! any of the tubes forming part of the blood circulation system of the body, carrying in most cases oxygen-depleted blood toward the heart

“V for Vack to the heart”

Blood Vessels

!Cardiovascular System

!" Puncturing a…

! Nerve: Electric Shock ! Vein: Slight bleeding ! Artery: Sharp pain with stronger bleeding/hematoma

formation

Relevance in Acupuncture

!Relevance in Acupuncture

!Relevance in Acupuncture

!" Arterial Puncture

! Most obvious sign… bleeding

Relevance in Acupuncture

!" Prevention of Arterial Puncture

! Investigate for bleeding problems and regular intake of anticoagulants (aspirin, clopidogrel, etc)

Relevance in Acupuncture

!" Prevention of Arterial Puncture

! Always refer to Anatomy textbooks if you are not familiar with the points

Relevance in Acupuncture

!Relevance in Acupuncture

" Prevention of Arterial Puncture ! Retract needle if it is

pulsating

!" Severe complications of Arterial Punctures:

! Traumatic Aneurysm ! Hemothorax ! Hemorrhagic peritonitis

Relevance in Acupuncture

!" Aneurysm

! Bulge in the wall of an artery

Relevance in Acupuncture

!" Traumatic Aneurysm

Relevance in Acupuncture

!" Symptoms of Traumatic Aneurysm

! Progressively growing, pulsating tender lump

! What to do??? Refer to a physician

Relevance in Acupuncture

!" Prevention of traumatic aneurysm

! Look and feel for arteries before needling ! Press point using your thumb, using the nail to shield

the vessels

Relevance in Acupuncture

!" Prevention of traumatic aneurysm

! Refer to anatomy books if you are not familiar with the area

! In removing needles near arteries, press the area using a cotton ball for 30-60 seconds

! For patients with bleeding disorders, choose fewer points and reduce depth in needling

Relevance in Acupuncture

!Relevance in Acupuncture

" Hemothorax ! Presence of blood in

the pleural space ! source of blood:

" chest wall, lung parenchyma, heart, or great vessels

!Relevance in Acupuncture

" Hemothorax - Presentation ! Most common symptoms:

" chest pain and dyspnea ! Most common sign:

" Tachypnea ! If with substantial blood

loss: hypotension and tachycardia

!Relevance in Acupuncture

Hemorrhagic Peritonitis " Peritonitis

! Inflammation of the inner lining of the abdominal cavity

!Relevance in Acupuncture

Hemorrhagic Peritonitis " Symptoms

! Fever, chills, abdominal pain/dyscomfort

" Sign ! Temp – 38o C ! Tachycardia ! Oliguric/anuric ! Abdominal tenderness

!

Bone, Ligament, Tendon, Cartilage, Fascia, Muscle

!" Bone

! substance that forms the skeleton of the body ! Stores calcium ! 213 bones in the body

Bone

!" 4 types

! Long, short, flat, and irregular

Bone

!" Function

! Structural support ! Permits movement and locomotion ! Protects vital organs ! Provides an environment for blood production ! Etc.

Bone

!Bone

!Bone

!" Composed of 50-70% minerals, 20-40% organic

matrix, 5-10% water, <3% lipids

" VERY HARD! " Devoid of Nerves

Bone

!" TCM Principles

! Kidney: Dominating the bone " Stores essence which produces marrow found in bone

and spine. This nourishes the bone

Bone

!" A fibrous tissue that connects bones to other bones

and serves to support internal organs " A.k.a articular ligament, articular larua, fibrous

ligament, or true ligament

Ligament

!" Have a vascular overlying layer called “epiligament”

which also has a lot of sensory and proprioceptive nerves

" Functions ! Lifting loads ! Load relax ! Joint Proprioception

Ligament

!" Specialized connective tissue that connects muscles to

bones " Relatively inelastic " Has cells and neurovascular supply

Tendon

!" TCM Principles

! Liver: controls the tendons

Tendon

!" A tough, elastic, fibrous connective tissue found in

various parts of the body, such as the joints, outer ear, and larynx

Cartilage

!" 3 types

Cartilage

!" Articular Cartilage

! Provides frictionless motion ! Resists compressive forces

Cartilage

!" Cartilage

! No nerves ! No blood Vessels

" No direct source of repair

Cartilage

!" A sheet or band of fibrous connective tissue

enveloping, separating, or binding together muscles, organs, and other soft structures of the body.

Fascia

!" Group of soft tissue fibers that contain protein

filaments that produces contraction that changes the shape and length of the cell

Muscle

!" 3 types

! Skeletal Muscle ! Cardiac Muscle ! Smooth Muscles

Muscle

!Skeletal Muscles

!Muscle

!" TCM Principles

! Spleen: Dominating the muscles and four limbs ! Lung: Dominates dispersing

Muscle

!" Muscles are thick and fibrous tissues

! Pain in removing the needles that have been rotated

Relevance in Acupuncture

!Skin, Hair, Nail

!" Largest organ in the body " Most important function: Barrier!

Skin

!Skin

!Skin

!" TCM Principles

! Heart: Dominating the blood and vessels, manifesting on the face " Heart Qi – reflected in changes in both pulse and

complexion ! Lung: Dispersing

" Pores are the gates of Qi

Skin

!Hair

" Derivative of skin " Found all over the body

except: palms, soles, etc.

!" 3 types

! Lanugo, Vellus, Terminal

Hair

!Hair

!" Main function in mammals

! Conservation of heat # DOES NOT APPLY ON HUMANS!

Hair

!" Main function in humans…

! Sexual attraction

Hair

!" TCM Principles

! Kidney: manifesting in the hair " Hair is both the surplus of blood and the outward

manifestation of the Kidney

Hair

!Nail

" Derivative of skin " Remnant of the

mammalian claw " Protects finger tip

!Nail

!" TCM Principles

! Liver: manifests in the nails

Nail

!Relevance in Acupuncture

" Puncturing a Hair Follicle – can be very painful!

" Remove and replace needle immediately

!Recall!

!" Which of the following allows you to feel different

sensations? a) Artery b) Vein c) Nerve d) Tendon

Recall!

!" Which of the following brings oxygenated blood from

the heart to the target organs? a) Artery b) Vein c) Nerve d) Tendon

Recall!

!" Which of the following will cause a punctured needle

to pulsate? a) Artery b) Vein c) Nerve d) Tendon

Recall!

!" Which of the following connects muscles to bones?

a) Ligament b) Fascia c) Cartilage d) Tendon e) Bone

Recall!

!" Which of the following connects bones to bones?

a) Ligament b) Fascia c) Cartilage d) Tendon e) Bone

Recall!

!" Which of the following is devoid of nerves and has no

direct blood supply? a) Ligament b) Fascia c) Cartilage d) Tendon e) Bone

Recall!

!" Arrange the steps in the Biological Organization in

sequence: a) Organ Systems b) Tissue c) Cell d) Organ

Recall!

!Recall!

Supination Pronation Flexion Extension Depression Elevation Protraction Retraction Inversion Eversion Rotation Circumduction Abduction Adduction Dorsiflexion Plantar Flexion Palmar Flexion

!Recall!

Supination Pronation Flexion Extension Depression Elevation Protraction Retraction Inversion Eversion Rotation Circumduction Abduction Adduction Dorsiflexion Plantar Flexion Palmar Flexion

!Recall!

Supination Pronation Flexion Extension Depression Elevation Protraction Retraction Inversion Eversion Rotation Circumduction Abduction Adduction Dorsiflexion Plantar Flexion Palmar Flexion

!Recall!

Supination Pronation Flexion Extension Depression Elevation Protraction Retraction Inversion Eversion Rotation Circumduction Abduction Adduction Dorsiflexion Plantar Flexion Palmar Flexion

!Recall!

Superior Inferior Anterior Ventral Posterior Dorsal Medial Lateral Proximal Distal Ipsilateral Contralateral

!Recall!

Superior Inferior Anterior Ventral Posterior Dorsal Medial Lateral Proximal Distal Ipsilateral Contralateral

!Recall!

Superior Inferior Anterior Ventral Posterior Dorsal Medial Lateral Proximal Distal Ipsilateral Contralateral

!Recall!

A

B

Superior Inferior Anterior Ventral Posterior Dorsal Medial Lateral Proximal Distal Ipsilateral Contralateral

!Recall!

Superior Inferior Anterior Ventral Posterior Dorsal Medial Lateral Proximal Distal Ipsilateral Contralateral

!" www.yinyanghouse.com " Gawkrodger, David (2002). Dermatology: An

Illustrated Colour Text, 3rd Ed. " Zhu, Hong Zhen (2006). Running a Safe and

Successful Acupuncture Clinic.

References