Heart meridian of hand shao yin pathway

- The heart meridian line is made up of 9 acupoints
- Similar to its name, this meridian pathway begins in the heart

Heart 1
- This is a very dangerous point due to its proximity to the axillary artery
- In order to locate this point, find the pectorals, and then go to where the arm is attached to the body. It is on the MEDIAL side of the axillary artery.
- Puncture 0.3-0.5 cun perpendicular or oblique

Indications of this point include:
- Cardiac pain
- Pain in the shoulder and arm
- Dry throat
- Constant thirst (polydipsia)
- Hypochondriac pain

Heart 2
- Draw a line between heart 1 and heart 3. This point is 3 cun above heart 3.
- It is located in the bicep groove.
- Puncture 0.5-1 cun perpendicular
- This point is NOT dangerous OR special

Indications of this point include:
- Headache
- Yellow sclera
- Pain in the shoulder and arm
- Coldness

Heart 3
- This point can be found in the midpoint between the tendon and the medial epicondyle
- IT IS A HE SE POINT and is used a lot
- Puncture 0.5-1 cun perpendicular

Indications of this point include:
- Cardiac pain
- Pain in the elbow and arm
- Pain along the heart meridian
- Pain in the head and nape

Heart 4
- This point is located 1.4 cun above the RADIAL side of the wrist
- It is a JING RIVER point
- It is dangerous due to its proximity to the ulner artery and nerve
- Puncture 0.3-0.5 cun perpendicular

Indications of this point include:
- Sudden loss of voice 
- Cardiac pain, and other usual indications of the heart meridian

Heart 5
- This point is located 1 cun above the transverse crease of the wrist
- It is a LUO point
- It is a dangerous point due to its proximity to the ulner artery and nerve
- Puncture 0.2-0.5 cun perpendicular

Indications for this point include:
- Sudden loss of voice
- Difficulty speaking (aphasia)
- Stiffness of the tongue
- Pain along the wrist and arm

Heart 6
- This point is located 0.5 cun above the transverse crease of the wrist (on the RADIAL side of the tendon)
- It is a dangerous point due to its proximity to the ulner artery and nerve
- It is a SHE CLEFT point
- Puncture 0.2-0.5 cun perpendicular

Indications of this point include:
- Nose bleeding
- Vomiting blood
- Tidal fever
- Cardiac pain
- Palpitations

Heart 7
- This point is located at the ALNER END of the TRANSVERSE crease of the wrist (on the RADIAL side of the tendon)
- This is a very important point as it is a SHU STREAM and a YUAN point
- It is a dangerous point due to its proximity to the ulner artery and nerve
- Puncture 0.2-0.5 cun perpendicular

Indications of this point include:
- Insomnia
- Vivid dreams
- Emotional problems

Heart 8
- This point is located between the 4th and 5th metacarpal bones (where the tip of the little finger rests when you bend it to your palm)
- It is a YING SPRING point
- Puncture 0.3-0.5 cun perpendicular

Indications for this point include:
- Clearing heat (heart fire)
- Palpitations
- Pain in the chest
- Dysuria
- Bed wetting
- Pain of the external genitalia
- Pain on the finger
- Urinary problems related to heat

Heart 9
- This point is located 0.1 cun posterior to the corner of the little nail (on the MEDIAL side)
- It is a JING WELL point
- Puncture 0.1 cun superficially, or prick to cause bleeding

Indications for this point include:
- Palpitations
- Cardiac pain
- Depressive manic psychosis
- Pain on the meridian
- Febrile disease
- Fainting

Diagnosis- Methods, disharmony, build

4 diagnostic methods:
- Look
- Listen and Smell
- Ask
- Touch

Short term disharmony (pathological invasion)
- Size (swelling)
- Colour
- Temperature
- Joint deformity

Long term disharmony (ex. Kidney essence: developmental issues)
- Weight
Height
Deformity

Physique based on build:

-       Robustness

o   Strong physique

o   Solid viscera, exuberant qi and blood

o   Favorable prognosis

-       Weakness

o   Feeble physique

o   Fragile viscera, insufficient qi and blood

o   Unfavorable prognosis

-       Corpulence (overweight)

o   Corpulence and good appetite- exuberant figure

o   Corpulence with poor appetite- qi deficiency

o   Corpulent and susceptible to damp- heat and stagnation

-       Emaciation

o   Emaciation and polydipsia- fire flaming in the middle jiao

o   Emaciation and small food intake- deficiency of spleen and stomach

o   Atrophy- exhaustion of qi, body fluid, and essence

o   Emaciation with feverish sensation in the five centers and night sweating- yin and blood deficiency fire

M & A: Meridians and Collaterals

Meridians: 
- Run deeper than collaterals
- 12 regular
- 12 divergent
- 12 muscular
- 12 cutaneous
- 8 extra
- Functions of meridians include: transporting qi and blood, regulating yin and yang, resisting pathogens, transmitting needle sensations, reflection of signs and symptoms

Hand yin meridians:
- Lung meridian of hand tai yin
- Pericardium meridian of hand jue yin
- Heart meridian of hand shao yin

Hand yang meridians: 
- Large intestine meridian of hand yang ming
- San jiao meridian of hand shao yang
- Small intestine meridian of hand tai yang

Foot yang meridians: 
- Stomach meridian of foot yang ming
- Gallbladder meridian of foot shao yang
- Bladder meridian of foot tai yang

Foot yin meridians: 
- Spleen meridian of foot tai yin
- Liver meridian of foot jue yin
- Kidney meridian of foot shao yin

Anatomy- Liver/Gallbladder

Liver
- Located in upper abdominal (beneath diaphragm)
- Second largest organ in the human body (second only to skin)
- Heaviest gland of the body (3lbs)
- Has a larger right lobe, smaller left lobe
- Only place in the body that has two sources of blood (hepatic artery/hepatic portal vein)
- Filters bacteria and toxins from the body
- Manufactures bile

- Made up of approximately 10,000 lobules 

- Contain kupffer cells which destroy worn out white/red blood cells, bacteria, and other foreign matters

- Common hepatic duct joins the cystic duct from the gallbladder to form the common bile duct

Contains:
- Hepatic artery: brings fresh blood from heart (oxygenated)
- Portal vein:
- Hepatic vein: purified blood leaves through here
- Hepatic bile duct:


Gallbladder
- 7-10cm long and hangs from anterior inferior margin of the liver
- Produces 800-1000 mL of bile/day 
- Bile contains: water, bile salts, cholesterol, lecithin, bile pigments, several ions
- The bile salts helps to break down lipids.
- Bilirubin is the principal bile pigment, which is secreted into the bile and broken down in the intestine

Anatomy- Pancreas

The pancreas is located in the upper abdominal cavity, and is approximately 12-15cm long and 2.5cm thick.

Function:
- Completes the job of breaking down food
- Secretes hormones that affect sugar level (Glucagon- increases blood sugar, Insulin- stimulates cells to use glucose, Somatostatin- regulates the secretion of above)

Macrostructure
- Consists of a head, body, tail
- Contain the spinster of oddi.

Microstructure
- Exocrine: Acini (99% of clusters). Produces digestive enzymes/pancreatic juice. The juice is slightly alkaline.
- Endocrine: Islets of Langerhans (1%)
Amyylose is produced by the pancreas for sugar digestion. This can also be found in the saliva 

Pancreatic juice
- We produce 1200-1500mL per day
- It is made up of water, salts (including bicarbonate), digestive enzymes, and mucus.
- Digestive enzymes include: Pancreatic amylase (carbs), Trypsin (protein), Pancreatic lipase (fats).

Anatomy- Peripheral Nervous System

Central nervous system 
-The central nervous system contains the brain and spinal cord

Peripheral nervous system 
- The peripheral nervous system contains all nervous tissue outside of the CNS. It can be broken down into the Somatic nervous system (control skeletal muscles) and the Autonomic nervous system (regulates glands, blood vessels, and internal organs).
- It keeps the body in adjustment with the outside world.

Autonomic nervous system
- Maintains internal balance
- Regulates glands, blood vessels, and internal organs
- Maintains steady state within body automatically (ex. constant body temperature, regulates heart beat)

Sympathetic nervous system
- Prepares body for action
- Most active during stressful situations

Parasympathetic nervous system
- Helps return body to resting conditions
- Most active during periods of calm and physical rest

Cranial nerves
- There are 12 pairs, which all emerge from the brain.
- They transmit information from sensory receptors to the brain, and then transmit orders from the CNS to the muscles and glands.
- They are usually mixed nerves (a combination of afferent (sensory) and efferent (motor) nerurons).

1- Olfactory (sensory)- for smelling
2- Optic (sensory)- for vision
3- Oculomotor (motor)- eye movement
4- Trochlear (motor)- eye movement
5- Trigeminal:
     - Opthalmic (sensory)- face and scalp sensation
     - Maxillary (sensory)- mouth and nose sensation
     - Mandibular (mixed)- chewing
6- Abducens (motor)- eye movement
7- Facial (mixed)- face and scalp movement, tongue taste sensation, ear pain and temperature
8-Vestibulocochear (sensory)- hearing and equilibrium
9- Glossopharyngeal (mixed)- ear pain and temperature, tongue and throat sensations, throat movement
10- Vagus (mixed)- sensations in the throat, voice box, chest, abs. Movement in the voice box, throat, chest, abdominal viscera.
11- Accessory (motor)- neck and back movement
12- Hypoglossal (motor)- tongue movement

Spinal nerves
- These are all mixed nerves, and there are 31 pairs.
- 8 pairs of cervical spinal nerves (c1-c8)
- 12 pairs of thoracic spinal nerves (t1-t12)
- 5 pairs of lumbar (L1-L5)
- 5 pairs of sacral spinal nerves (s1-s5)
- 1 pair of cocygeal spinal nerves

Plexus 

- Cervical plexus: receives sensory information from the back of hear, neck, shoulders and upper chest
- Sends impulses to muscles of neck and shoulders
- Phrenic nerve arises from the cervical plexus and sends impulses to diagram

- Brachial Plexus: Supplies shoulder, arm, and hand.
- Ulnar and radial nerves emerge from here

- Lumbar Plexus: Supplies lower abdominal wall, buttocks, thigh, and genitals.
- Femoral nerve arises from here

-Sacral plexus: Supplies the thigh, leg, and foot
- Contains the sciatic nerve (largest nerve in the body)

Anatomy- Skin

Above is our "line of defence" in our body.

The structure of skin can be divided into 5 categories:
1- Epidermis, dermis, subcutaneous layer
2- Sweat glands
3- Oil glands (sebaceous glands)
4- Hair and nails
5- Melanin

Epidermis
- This is the outer layer of our skin (what we see), and it is made up of stratified squamous epithelial tissue.
- Our skin cells are constantly flaking off, so new epidermal cells are produced in the deepest sublayer of the epidermis, and then pushed towards the outer surface as they mature.
- The epidermis cells contain a structural matrix of Keratin. This is a protein which is essentially waterproof, and which aids in the flexibility and elasticity of the skin.
- The epidermis is NON VASCULAR. This means that there are no blood vessels.
- The epidermis contains melanin, which provides the pigment in our skin

Dermis
- This is a thick layer below the epidermis.
- Consists of connective tissue which is made up of collagen fibres. Collagen is responsible for the strength and stretching of the skin.
- The dermis is VASCULAR. This means that are are blood vessels and nervous found throughout the layer.
- The upper portion of the dermis has "dermal papillae" that project into epidermal tissue. These papillae delivery oxygen and nutrients to the cells of the epidermis and help with temperature regulation.

Subcutaneous layer 
- This layer is also known as the "superficial fascia."
- It contains loose connective tissue, as well as lots of fat (adipose) tissue.
- The function of this layer is to attach the skin to the muscles and tissues beneath.
- It also helps protect the underlying organs from mechanical shock.
- Distribution of fat in this layer is responsible for male and female body shapes.
                                                                                                                                                                        

Sweat glands
- Sweat glands are tiny coiled tubes in the dermis or subcutaneous tissue. They have a duct which extends up through the skin and opens onto the surface.
- There are over 3 million in skin
- Their functions include regulating temperature and eliminating waste.
- We sweat approximately 1 quart/day 

Sebaceous glands
- These are also known as oil glands.
- They are generally attached to hair follicles, so are mostly present on the face and the scalp.
- They secrete sebum (an oily substance) which helps lubricate the surface and prevent water loss.
- They have an anti fungal property, as well as inhibit the growth of bacteria.
- An accumulation of sebaceous glands cause blackheads.
- They are relatively inactive in childhood, but are active during and after puberty.

Hair
- Hair is found everywhere on our body except for our palms and soles.
- It has a protective function.
- The part of the hair that we see is called the shaft, the root lies below the surface.
- At the bottom of the hair follicle, a bundle of connective tissue can be found which delivers nutrients to the follicle.
- Hair is formed from Keratin.

Nails
- Nails are mainly for protection.
- They are developed from epidermal cells, and contain compressed keratin.
- Nails appear pink due to underlying capillaries

Melanin
- Melanin is responsible for pigment in our skin.
- These cells are scattered throughout the lowest layer of the epidermis.
- Albino's cannot produce melanin, and therefore are extremely pale.
- When melanin cannot absorb all of the ultraviolet rays due to sun exposure, we get a sunburn.

Random facts about skin
- Total skin on our body is approximately 20 sq feet.
- Skin helps maintain homeostasis (internal balance).
- Skin helps protect us. It is part of the first line of defence.
- In order to determine how much water we have in our body, we must multiply our body weight (kg) by 0.6.
- For example: If we weight 60kg, we will have 36 L of water in our body. Out of this 36L, intercellular fluid accounts for 24L, while extracellular fluid accounts for 12L. If we further break down the extracellular fluid, 9L will be for interstitial fluid, and 3L will be comprised of plasma.