[Anatomic structure of "Shaoze" (SI 1), "Qiangu" (SI 2), "Houxi" (SI 3), "Yanggu" (SI 5) and Xiaohai" (SI 8) regions of Hand-Taiyang Meridian in the rabbit's forelimb].

OBJECTIVE: To observe the anatomic structure of the Five Shu-acupoints: "Shaoze" (SI 1) ,"Qiangu" (SI 2), "Houxi" (SI 3),"Yanggu" (SI 5) and "Xiaohai" (SI 8) regions of the Taiyang Meridian in the rabbit's forelimb. METHODS: Thirty rabbits (half male and half female) were used in the present study. The Five Shu-acupoints regions were located first based on the atlas of rabbits, stimulated by needling and confirmed later by using an electronic acupoint detector. Under anesthesia, the rabbit was perfused with warm normal saline via the common carotid artery and the internal jugular vein, followed by arterial perfusion of dental base acrylic resin powder(30 g), dibutylphthalate(6 mL), red couring agent liquid for denture acrylic and acetoacetate (2 mL), respectively; and venous perfusion of 30% gelatin (filtered) and black ink (filtered) and formaldehyde (8%). After fixing in 8% formaldehyde for 10 days, the rabbit's forelimb containing the aforementioned Five Shu-acupoints were carefully dissected layer by layer, followed by observing the local anatomic structure under microscope. RESULTS: The superficial layers of these acupoint regions mainly contained the basilic vein and its branches, and the superficial branch of the ulnar nerve. The deep layers chiefly comprised of the ulnar artery, the ulnar vein and their branches, and the ulnar nerve. CONCLUSION: In "Shaoze"(SI 1 ), "Qiangu" (SI 2), "Houxi" (SI 3), "Yanggu" (SI 5) and "Xiaohai" (SI 8) acupoint regions, the ulnar artery, basilic vein, ulnar vein and their branches, the ulnar nerve and its superficial branches are found, which constitute the morphological basis of the five acupoints of the Hand-Taiyang Meridian for treating some related clinical disorders.

A review of compressive ulnar neuropathy at the elbow.

OBJECTIVE: To review the anatomy, etiology, and symptoms associated with compressive ulnar neuropathy at the elbow and to discuss the diagnosis and treatment of this condition. DATA SOURCE: The following were searched for information relevant to cubital tunnel syndrome: MEDLINE, WorldCat, and Index to Chiropractic Literature. RESULTS: Cubital tunnel syndrome is the second most common nerve compression syndrome of the upper extremity. Clinical features of this syndrome are described along with electrodiagnostic techniques that can be used to provide evidence concerning the probable location, character, and severity of the lesion affecting the ulnar nerve. Conservative treatment of cubital tunnel syndrome is recommended for patients with intermittent symptoms and without changes in cutaneous sensation or muscle atrophy. CONCLUSION: A definitive diagnosis can best be made using clinical tests along with nerve conduction studies and electromyography, conservative treatment can be effective in treating this neuropathy in mild cases; in moderate or severe cases, surgery may be necessary.

Median "pseudoneurapraxia" at the wrist: reassessment of palmar stimulation of the recurrent median nerve.

OBJECTIVE: To determine the occurrence and effect of incidental deep ulnar nerve (DUN) costimulation during palmar stimulation of the recurrent median nerve (RMN). DESIGN: Observational. SETTING: Electromyography laboratory. PARTICIPANTS: Seventeen asymptomatic adult volunteers (34 hands) and 4 fresh cadaver hands. MAIN OUTCOME MEASURES: Median nerve stimulation at the wrist and careful incremental surface and subcutaneous (needle) palmar stimulation were performed while recording thenar and first dorsal interosseous manus compound muscle action potentials. Thenar palm-to-wrist amplitude difference (P -- W Delta) and palm-to-wrist amplitude ratio (P/W) were compared with published values. Correlation of DUN costimulation with falsely elevated P -- W Delta and P/W values was assessed. Multiplanar magnetic resonance imaging (MRI) and subsequent dissection of 4 fresh cadaver hands was done to measure the distance between the RMN and DUN at the palmar stimulation site. RESULTS: Two groups emerged: Group I (63%), with DUN stimulation, and II (37%), with no DUN stimulation. When DUN costimulation occurred (Group I), there was a statistically significant increase in P -- W Delta (p =.002 percutaneous, p =.02 subcutaneous) and P/W (p =.004 percutaneous, p =.007 subcutaneous) when compared with previously published data. Combining all trials on all hands, 53% and 25% had P -- W Delta values and P/W values that exceeded previously published normative data, respectively. The mean distance between the DUN and RMN at the palmar stimulation site was determined by dissection (1.2cm) and MRI (1.5cm). CONCLUSIONS: Close proximity of the DUN to the RMN causes frequent and often unavoidable DUN activation during palmar stimulation of the RMN. This inadvertent stimulation may cause a false diagnosis of median neurapraxia at the wrist.

Vasomotor innervation of the skin of the hand: a contribution to the study of human anatomy.

The sympathetic vasomotor innervation of the skin of the human hand was studied in 47 subjects who underwent local anaesthetic block of ulnar, median or radial nerves at elbow or wrist levels. Areas of cutaneous anaesthesia were compared with cutaneous territories of paralytic vasodilatation delineated by infrared telethermography. It was found that: (1) during ulnar nerve block the area of vasodilatation matched the area of anaesthesia in all 15 cases; (2) median nerve block induced paralytic vasodilatation which, in 14 of 15 cases, matched the area of cutaneous anaesthesia in median territory, but also extended to the unanaesthetised lateral part of the dorsum of the hand; (3) no vasodilatation developed during radial nerve block in 17 of 18 cases, whereas areas of sympathetic sudomotor paralysis matched the area of radial sensory loss in all 5 subjects in whom sweating function was studied. It is concluded that: (1) the ulnar nerve supplies vasomotor fibres to its cutaneous sensory territory, no less and no more; (2) the median nerve normally provides supplementary vasomotor innervation to the skin of the radial aspect of the dorsum of the hand; (3) the radial nerve supplies sudomotor innervation for the lateral aspect of the dorsum of the hand, but (4) does not normally contribute vasomotor sympathetic fibres to the skin of the hand.

A martial arts exploration of elbow anatomy: Ikkyo (Aikido's first teaching).

The Martial Art of Aikido, based on several effective anatomical principles, is used to subdue a training partner. One of these methods is Ikkyo (First Teaching). According to Saotome, the original intent of Ikkyo was to "break the elbow joint" of an enemy. Nowadays the intent is to secure or pin a training partner to the mat. This investigation focused on examining Ikkyo with the purpose of describing the nerves, bones, and muscles involved in receiving this technique. Particular focus was placed on the locations and sources of the reported pain.

Acupuncture points of the brachial plexus.

This publication is the third of a total of six papers intended to name acupuncture points following the anatomic nomenclatures. In the first publication, acupuncture points in the head are named using terminal branches of the trigeminal nerve and the muscles of facial expression. In the second publication, acupuncture points in the neck are named using the cutaneous nerves of the cervical plexus and neuromuscular attachments formed by the spinal accessory nerve on the trapezius muscle. In this third publication, acupuncture points existing on the upper limbs are described following the terminal branches of the brachial plexus.