Forearm

Question 1

List 2 taught points in the forearm and describe their location

Answer 1

1. TE5

On the dorsal aspect of the forearm, 2 cun proximal to the wrist crease corresponding to the radiocarpal joint between the radius and the ulna in the interosseus space

2. PC6

On the flexor surface of the forearm, 2 cun proximal to the wrist crease between palmaris longus and flexor carpi radialis longus.

Question 2

TE5 location and needling technique

• Location
• Insertion
• Depth

Answer 2

TE5

Location

On the dorsal aspect of the forearm, 2 cun proximal to the wrist crease corresponding to the radiocarpal joint between the radius and the ulna in the interosseus space

Insertion:

perpendicular

Depth:

0.5 - 1 cun

Question 3

Describe the relevant TE5 anatomy

Muscles (1)

Nerves (2)

Vessels (4)

Answer 3

TE5 anatomy

Muscles:

1. Extensor digitorum communis

Nerves

1. posterior cutaneous nerve of the forearm C5-8
2. Deeper: posterior interosseus nerve (deep branch of the radial nerve) C5-T1

Vessels:

1. posterior interosseous arteries + veins
2. anterior interosseous arteries + veins

Question 4

List 5 neuroanatomical indications for TE5

Answer 4

TE5 indications

1. Inflammation of the forearm extensor tendons
2. Tenosynovitis
3. Tennis elbow
4. Problems in hand, wrist and elbow
5. Motor problems of the arm and elbow, tremor

Nb sympathetic switch.

Contraindicated in pregnancy

Question 5

PC6 location and needling technique

1. Location
2. Insertion
3. Depth

Answer 5

PC6

Location:

On the flexor surface of the forearm, 2 cun proximal to the wrist crease between palmaris longus and flexor carpi radialis longus.

Insertion:

perpendicular

Depth: 0.5 - 1 cun

Question 6

Describe the relevant PC6 anatomy

• Muscles (3)
• Nerves (superficial: 3; deep: 2)
• Vessels (4)

Answer 6

PC6 anatomy

Muscles:

1. palmaris longus
2. flexor carpi radialis
3. flexor digitorum superficialis

Nerves:

• Superficial*
  1. medial cutaneous nerves of the forearm
  2. lateral cutaneous nerves of the forearm
  3. palmar cutaneous branch of the median nerve in the skin
• Deep*
  1. median nerve
  2. anterior interosseous (C5 –T1)

Vessels:

1. median artery and vein
2. anterior interosseus artery and vein

Question 7

List 5 neuroanatomical indications for PC6

Answer 7

PC6 indications

1. tendonitis of palmaris longus, flexor carpi radialis longus, and any problems with flexor tendons
2. medial epicondylitis
3. tenosynovitis
4. carpal tunnel syndrome
5. contracture of the elbow and arm

Nb parasympathetic switch