Elbow

Question 1

List the 3 taught elbow points and describe their location

Answer 1

Elbow points

1. Large Intestine 10

2 cun distal to LI 11 on the line connecting LI 11 and LI 5 in the depression between brachioradialis and extensor carpi radialis longus

2. Large Intestine 11

On the transverse cubital crease, midpoint between the lateral edge of the biceps aponeurosis and the most prominent point of the lateral epicondyle, in the depression between extensor carpi radialis longus and brachioradialis

3. Pericardium 3

On the transverse cubital crease on the medial side of the bicipital aponeurosis

Question 2

LI10 location and needling technique

• Location
• Insertion
• Depth

Answer 2

LI10

Location

2 cun distal to LI 11 on the line connecting LI 11 and LI 5 in the depression between brachioradialis and extensor carpi radialis longus

Insertion:

Perpendicular.

Depth:

1-1.2 cun

Question 3

Describe the relevant LI10 anatomy

• Muscles (5)
• Nerves (2)
• Vessels (2)

Answer 3

LI10 anatomy

Muscles:

1. brachioradialis
2. Extensor carpi radialis longus
3. Extensor carpi radialis brevis
4. Extensor digitorum
5. Extensor carpi ulnaris

Nerves:

1. posterior cutaneous nerve of the forearm C5-8
2. Radial nerve C5-T1

Vessels:

1. branches of the radial recurrent artery and vein

Question 4

List 3 neuroanatomical indications for LI10

Answer 4

LI10 indications

1. Lateral epicondylitis
2. Myofascial pain/strain of extensor carpi radialis brevis
3. Any inflammation involving the lateral aspect of the elbow

Question 5

L11 location and needling technique

• Location
• Insertion
• Depth

Answer 5

L11 location and needling technique

Location

On the transverse cubital crease, midpoint between the lateral edge of the biceps aponeurosis and the most prominent point of the lateral epicondyle, in the depression between extensor carpi radialis longus and brachioradialis

Insertion

Aim towards the midpoint of the elbow joint (bicipital aponeurosis).

Depth

1-1.5 cun

Question 6

L11 relevant anatomy

• Muscles (3)
• Nerves (1, deeper 1)
• Vessels (2)

Answer 6

L11 anatomy

Muscles

1. Extensor carpi radialis longus
2. Extensor carpi radialis brevis
3. Brachioradialis

Nerves

1. posterior cutaneous nerve of the forearm C5-8
   * Deeper*
2. radial nerve C5 –T1

Vessels

1. Radial recurrent artery and vein

Question 7

List 6 neuroanatomical indications for L11

Answer 7

Nb. Sympathetic Switch

Musculoskeletal: Pain/inflammation of the lateral aspect of the elbow

1. Lateral epicondylitis
2. Sprain/strain of the lateral collateral ligament of the elbow
3. Sprain/strain of the common extensor tendon
4. Radial tunnel syndrome
5. Tendonitis of extensor carpi radialis brevis, supinator and anconeus muscles
6. Osteoarthritis of the elbow

Question 8

PC3 location and needling technique

• Location
• Insertion
• Depth

Answer 8

PC3 location and needling technique

Location

On the transverse cubital crease on the medial side of the bicipital aponeurosis

Insertion

Intra-articular, perpendicular, into the cubital fossa

Depth

0.5 - 1 cun

Question 9

Describe relevant PC3 anatomy

• muscles (1)
• nerves (1; deeper - 1)
• vessels (2)

Answer 9

PC3 anatomy

Muscles

pronator teres

Nerves

1. medial cutaneous nerve of the forearm C8-T1
   * Deeper*
2. median C6 –T1

Vessels

1 & 2 brachial artery and vein

Question 10

List 3 indications for PC3

Answer 10

PC3 indications

1. Medial epicondylitis (golfer’s elbow)

Nb. combine with PC 6 for median nerve stimulation

2. Medial collateral ligamentous strain,
3. Arthritis of the elbow.