Hand

Question 1

List the 2 taught hand points and describe their location

Answer 1

1. LI4

At the level of the midpoint of the second metacarpal, between the first and second metacarpal on the dorsum of the hand. Feel for a depression and a tender spot.

2. HT7

On the wrist crease (palmar aspect) located between the ulnar styloid process and the pisiform bone, lateral to (on the radial side) of the flexor carpi ulnaris tendon.

Question 2

LI4 location and needling technique

• Location
• Insertion
• Depth

Answer 2

LI4 Needling technique

Location: At the level of the midpoint of the second metacarpal, between the first and second metacarpal on the dorsum of the hand. Feel for a depression and a tender spot

Insertion: perpendicular

Depth: 0.5 cun

Question 3

LI4 anatomy

• Muscles
• Nerves (superficial, intermediate, deep) + influences
• Vessels

Answer 3

Muscles:

1. adductor pollicis
2. first dorsal interosseus
3. thenar muscles
   a. opponens pollicis
   b. flexor pollicis brevis
   c. abductor pollicis brevis

Nerves:

superficial level: superficial branch of the radial nerve (innervating the skin)

intermediate level: ulnar nerve

deep: median nerve

influences C5-T1 nerve roots

Vessels:

1. radial arterydeep
2. palmar arch

Question 4

List 4 neuroanatomical indications for LI4

Answer 4

LI4 indications

1. Osteoarthritis hand and wrist
2. De Quervain’s tenosynovitis
3. Headache, neck pain, pain in the upper extremity
4. Carpal tunnel syndrome

Nb. Sympathetic switch

Question 5

HT7 needling technique

• Location
• Insertion
• Depth

Answer 5

HT7 needling technique

Location

On the wrist crease (palmar aspect) located between the ulnar styloid process and the pisiform bone, lateral to (on the radial side) of the flexor carpi ulnaris tendon.

Insertion

Perpindicular

Depth

0.25-0.5 cun

Question 6

Describe relevant HT7 anatomy

• Nerves (2)
• Muscles (1)
• Vessels (2)

Answer 6

HT7 anatomy

Nerves:

1. medial cutaneous nerve of the forearm in the skin
2. deeper - ulnar (C5 –T1)

Muscles:

1. flexor carpi ulnaris

Vessels

1. ulnar artery
2. ulnar vein

Question 7

List 4 neuroanatomical indications for HT7

Answer 7

HT7 indications

1. Heart dysfunction (parasympathetic switch)
2. wrist joint osteoarthritis or rheumatoid arthritis
3. ulnar collateral ligament sprain
4. flexor carpi ulnaris sprain/strain

Nb. parasympathetic switch