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Acupuncture

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sihirlifil's version from 2018-03-20 03:13

Intro

Question Answer
2 modalities of complementary therapiesAcupuncture, chiropractic (increasing in veterinary practice)
What does acupuncture involve?Insertion of needles through skin at predetermined sites (acupuncture points)
Treatment or prevention of disease
Includes herbal therapy
History: when did acupuncture start?2000-3000 BC! During Shang & Chow dynasties
History: what was one of the 1st veterinary texts?Bai-le's Canon of Veterinary Medicine (Acupuncture & moxibustion (traditional Chinese medicine technique that involves the burning of mugwort, a small, spongy herb, to facilitate healing), emphasis on equine medicine)
History: when was the first book on equine medicine written? includes what?600-900 BC, during Tang Dynasty
Includes acupuncture chapter w/ 77 points including locations & indications
AVMA statement on acupuncture (1996)Veterinary acupuncture and acutherapy are considered valid modalities, but the potential for abuse exists. These techniques should be regarded as surgical and/or medical procedures under state practice acts. It is recommended that extensive continuing education programs be undertaken before a veterinarian is considered competent to practice acupuncture.
Scientific basisStimulation of specific predetermined points on the body to achieve therapeutic or homeostatic effect
Where are acupuncture points?Areas on the skin with high electrical conductivity, high density of neurovascular bundles (nerves, blood vv, lymphanic vv, mast cells)
What are Type I acupoints? where?67% of all points (motor points)
Located near the point where nerve enters muscle
Maximal contraction with minimal stimulation
Where are Type II acupoints?Located on superficial nerves in sagittal plane on midline dorsally & ventrally
Where are Type III acupoints?High density foci of superficial nerves & nerve plexi
Where are Type IV acupoints?Muscle-tendon junctions
What is LI-4?
What's the abaxial nerve block an example of?Acupuncture point that is on top of a peripheral nerve
What was the MERIDIAN system? Later?Originally: Acupoints with similar effects were connected by lines
Later developed into meridian philosophy = transport & communication system between organs & body surface
What are the functions of the meridian system?Transport of Qi, blood, & fluids
Coordination of organ functions
Prevention of pathogen invasion
Meridian system: where are acupuncture points?Located on a meridian's superficial branch
How does the Meridian system work?Series of interactions between nervous, endocrine & immune systems
Classic acupuncture points- associated with certain anatomic structures of the nervous system
How does Tradidional Chinese Medicine relate to the meridian system?Explained the effects for 4000 years based on empirical observations, descriptions of naturally occuring phenomena
What are the Western medical theories?Sensory receptors are stimulated (pain, thermal, pressure, touch)
Stimulate sensory afferent nerves
Signal transmitted through CNS to hypothalamic-pituitary system
Neurotransmitters & neurohormones then released
What's dry needling?Stainless steel needles, 0.25-0.75mm diameter with various lengths used
What is the physiological mechanism of dry needlingCauses microtrauma --> local inflammation with increased blood flow, WBC response --> stimulation of self-healing
What is the De-Qi response?Initial muscle/fascia contraction around needle, followed by relaxation --> feeling of cold, heat, numbing, heaviness, tingling, pain during insertion (response can be blocked by local anesthesia)
What happens with the nervous system when needling?
Needling stimulates sensory neurons, in particular touch & pain fibers (Aβ, Aδ, & C)
Stimulates sensory pathways via peripheral nervesl --> sensory tracts --> brain stem & many midbrain & forebrain areas --> cortex
Needling: some activated brain areas release which neurotransmitters/hormones?Serotonin & endogenous opioids
Enkephalins, beta-endorphins, endomorphin (via μ and δ opioid receptors)
Dynorphin (via κ opioid receptors)
What are the effects of serotonin & opioid release?Activation of descending analgesia pathways within higher CNS areas (endogenous opioids) & brain stem (serotonin) --> inhibition of incoming pain signals
Deactivation of some brain regions which modulate pain emotion (limbic system, anterior cingulate cortex)
Systemic release of endogenous opioids =Humoral response
What's a "trigger point?"Tender areas found in skeletal muscle, associated with a tight band or knot
Located in the center of a muscle in the motor endplate zone. Where nerve ends in muscle, causes contraction
Western VM vs. TCVM: perspective?Western: Control a disease. 1 underlying cause --> treat the 1 cause. Cure acute, control chronic
TCVM: Balance the body. Whole body disturbance --> treat energy flow. Restore harmony to restore self healing
Western VM vs. TCVM: clinical approach?Western: Client concern, Hx, PE, Ddx, Diagnostic tests, Dx, Tx plan
TCVM: Client concern, Hx (life), PE: where & what is the problem?, Dx, Tx plan
memorize

TCVM Assessment

Question Answer
How do you begin the TCVM assessment?Hx: Signalment, personality, use, diet, preferences, activities, interactions, previous diseases, tx, presenting complaint
Inspection: movement, posture, skin, hair, BCS, tongue, eyes, ears, nose
Sensing (hearing & smelling): breathing, cough, voice, odor, feces, urine
Palpation: Ears, nose, lips, body surface, limbs, pulse, diagnostic scan
How is the natural world divided? (aka WHERE is the problem?)5 categories (elements) based on seasons
What are the 5 seasons?Spring = Wood
Summer = Fire
Late summer = Earth
Autumn = Metal
Winter = Water
In medicine, the 5 elements describeOrgan systems, their relationship with the body, and the external world = internal & external balance
WOOD: General characteristics
WOOD: Physical characteristics
WOOD: Pathology
FIRE: General characteristics
FIRE: Physical characteristics
FIRE: Pathology
EARTH: General characteristics
EARTH: Physical characteristics
EARTH: Pathology
METAL: General characteristics
METAL: Physical characteristics
METAL: Pathology
WATER: General characteristics
WATER: Physical characteristics
WATER: Pathology
All concepts of the universe are composed of...The 2 opposing, yet complementary aspects Yin & Yang
How are Yin & Yang related?Control, create, and are contained in each other
Yang =Summer
Heat
Day
Male
Yin =Winter
Cold
Night
Female
Yin & Yang imbalance: Excess Yang =Heat
Yin & Yang imbalance: Deficient Yin =Heat
Yin & Yang imbalance: Excess Yin =Cold
Yin & Yang imbalance: Deficient Yang =Cold
What do the "5 treasures" do?Keep the 5 elements alive, help maintain balance (=healthy organs)
5 treasure: Jing ="Essence" of life at birth
Stored in kidney
Depletion leads to death
5 treasure: Jing imbalance =Deficiency
5 treasure: Qi =Circulating essence = lifeforce
Initiates all organ functions (Yin & Yang)
Nourishes & defends the body
5 treasure: Qi imbalance =Deficiency
Stagnation = pain
5 treasure: Blood =Contains & circulates Qi
Nourishes & moistens body
5 treasure: Blood imbalance =Deficiency
Stagnation = pain
5 treasure: Shen =Mind
Controls all mental activities, sleep, memory, behavior, inner peace
5 treasure: Shen imbalance =Disturbance
5 treasure: Fluids =Enable organ functions, moisten body parts (joint, GI, urine, sweat, saliva)
5 treasure: Fluid imbalance =Disharmony
(imbalance flowchart)
Invasion of pathogens: 1ryWind, cold, heat, damp, dryness, summer heat
Invasion of pathogens: 2ryStagnation, phlegm, stones, food stasis
The "scan" is based onSensitivity to acupoints that correspond to specific conditions
"Scan:" may points found where?Bladder meridian (lateral to dorsal midline)
HL lameness related to stifle or hock; 1ry back problem
"Scan:" Diagnostic points can be?Trigger points (knots or tight bands in muscle)
If a horse was reactive at the blue points, what localization are you thinking?
Foot! (LI-18, PC-1, BL-13,14,15)
If a horse was reactive at the orange points, what localization are you thinking?
Stomach (ST-7, CV-12, BL-20,21)
Treatment strategy based on?Underlying disease pattern (=imbalance)
Local treatment of stagnation (=pain)
What different treatments are there?Dry needle acupuncture
Electro acupuncture
Haemo A.
Aqua A.
Moxa
What exactly does treatment accomplish?Tonify deficiencies (Qi, Blood, Yin, Yang)
Clear excess (Heat, Wind, Cold, Damp, Dryness)
Clear stagnation (Pain)
Balance immune system
Aquapuncture =Injection of fluid into acupuncture point (e.g. Vit B12)
Hemoacupuncture =Injection of blood into an acupuncture point
Electrostimulation =Attaching electrodes to acupuncture needles & applying electrical current
Pneumoacupuncture =Injection of air into an area
Moxibustion =Burning of a herb on an acupuncture point (direct) or over the skin at an acupuncture point (indirect)
What's this?
Electrostimulation: often used for non-responsive pain e.g. lumbar area
What's this?
Moxibustion using a burning moxa stick 0.5-1 inch above the acupuncture point
What's this?
Aquapuncture with Vitamin B12
memorize

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