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Acupuncture Malpractice Insurance – Lung Channel Anatomy and Function

 

 

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, I am Brian Lau. I teach with sports Medicine Acupuncture, and with the Sports Medicine Acupuncture Certification program. I also teach with the three day cadaver dissection labs. And a little bit of the dissection is the impetus for why I’m gonna do the particular presentation I’m talking about today.

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First off, I wanna thank the American Acupuncture Council for having me. And we’ll go a little bit into the lung channel and the anatomy. We’ll look at some movement aspects of the channel also. So I just finished up two back-to-back five day dissections. I do this every year, the first two weeks of December with the University of Tampa with the Physician Assistance Program.

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So I had a lot of opportunity to look internally with the body. We did a lot of external dissection, but we also did evisceration and we went into the abdominal and thoracic cavity. So that’s with physician assistants. I’m not really talking much about channels in there but I’m always thinking about the channels and I’m preparing for when we do dissection for acupuncturists how to communicate some of this anatomy to acupuncturists.

So that’ll filter in a little bit to this presentation today. And then we’ll go into some application with movement. So you can give some patient exercises that will engage the channel in this case, the lung channel fully. So let’s go ahead and go to the presentation and we’ll start jumping into the anatomy.

So let’s get a start. We’re just gonna go right into the internal pathway. So let me get the setup for this. So let’s imagine we’re in a prolonged, like a five day dissection lab. We’ll go briefly layer by layer. So what we have here, . is on the slide on the left is we have skin on at one portion.

We have some subcutaneous fat in this ne netter illustration, but primarily that’s been removed and we’re down to the level of the fascia above the rectus abdominis, the fascial, the rectus sheath, and the external obliques. So we can see the rectus abdominis underneath this rectus sheath. If I were to

Look at it from the back surface. That’s what we’re seeing in the right image. So in this case, we’re looking from the back through the body visceral cavities removed, and we’re seeing the peritoneal cavity from the back but the front surface of it. So here’s the rectus abdominis. You can see a window of it.

But what I wanted to highlight from this image, first of all, you have the falciform ligament, but another interesting structure is a remnant of the . This little ligament, which is the umbilical ligament, which is a remnant from embryological development. And this whole line here is very tied in with the linear alba, which is that thick Foss structure that separates the left and the right side of the rectus abdominus.

So a nice imprint of the Ren channel or the Ren mine. So we’ll come back to that a little bit now, but I just wanted to highlight that. Let’s go to the next slide. And here in this image we have the rectus sheath removed from the rectus abdominus. So this is what we would do in dissection is we would start to come underneath this rectus abdominus, just creating a little separation from the rectus abdominus and the tissue underneath.

And we would start lifting it up. And that’s what we have in this side right here. We have the rectus abdominus starting to be removed, and you can already get a imprint. You can see the peritoneal. Membrane, the serous membrane, and you can see some of the fascia under the rectus abdominus. The reason I’m going to this detail is when you do this dissection, sometimes it’s very adhered, and as you start removing and lifting the rectus abdominus from the pub pubic bone and lifting it off, it starts to tear the peritoneum because of all the adhesions there.

And why would that be so adhered? We have to get into the next layer, which would be the first layer in the visceral cavity in the abdominal cavity. And I’m gonna go right to that here. And this is what we would see as we open slice that very thin peritoneal membrane. We have the greater momentum and we have the stomach hanging off.

The stomach is that greater momentum. And if everything’s moving well on that person before they passed, then you can just easily kinda lift the undersurface of this greater momentum. Lift it up. And what underneath it is the transverse colon. So it’s very adhere, not adhered, excuse me. It’s very tied into, connected to that greater momentum.

So it’s connected to the stomach and it’s connected to the transverse colon. So that’s a lot of anatomy. But I wanted to highlight this anatomy ’cause it gives us a really a window into the internal pathway of the lung channel. When we look at the lung channel, . We’ll look at it now with different eyes, so we’ll look at that in just a moment.

But I do wanna highlight that on many people when we’re doing dissection on many specimens, there’s a ton of adhesions because one of the things this greater momentum does is it surrounds pathogens. So if you had, perforation, like an ulcer in the colon, it would surround that. And there’s a lot of lymphatic tissue in there.

There’s lymphoid. Cells that are gonna take care of those antigens. Or if there is some kind of entry of of some pathogen into the peritoneal cavity, that greater momentum can migrate around and surround those areas. So people who’ve had a history of peritonitis, it’s gonna be extremely adhered internally so they don’t lift as well, and you can imagine that they wouldn’t be able to move as well.

Also. So one more bit of anatomy and then we’ll look at the lung channel. Is the greater momentum hangs off the stomach. Let’s move up into the thoracic cavity. Oops. Wrong direction. And here is the continuation of the stomach, the esophagus, as it passes through the diaphragm, and as I go a little higher up, I get into the trachea and bronchi and those also are very connected with each other.

You could dissect them away, but it’ll take a lot of work. They almost are one unit. So now we have a lot of anatomy to go and look at that internal pathway of the lung channel. So let’s look at that. Here it is. So we see these, we study these internal pathways but it’s sometimes not always clear what the anatomy is when we learn ’em.

So we can now see that yes, we do have these bronchi break branching off the trachea. We could follow down the esophagus. We’ve learned when we learned the internal pathway that the internal lung path channel pathway connects to the stomach, it loops down and connects to the large intestine.

And that’s exactly what the greater momentum does. So what I’m proposing for this internal pathway is we have the trachea and bronchi, the esophagus, the stomach, the greater momentum linking with the large intestine at the transverse colon. So structures match. It matches the description of the internal pathway, but reminding ourselves again, that greater momentum has an immune function, that it has lymphoid cells in there, cells that migrate and take care of pathogens, also links with the actual function of the lungs because they do have a lot to do with wayI, wayI and the surface of the body.

This is at the surface of the internal . Abdominal cavity, but still taking some account of the immune response or the wayI response. So function and form, both match. I think it’s a really good a really good model for understanding the internal anatomy of that internal portion of the lung channel.

So let’s branch out now to the actual main channel. . But we’re gonna primarily talk about the sinus involved with it, because we’re gonna look at some movement aspects that, that we’re gonna, I’m gonna introduce that can help stretch and open and engage that outer channel, but also engage that inner inner branch of the channel.

So this is what I have as a model and what we teach in sports medicine, acupuncture. For the lung sinu channel, we have the pectoralis minor biceps, brachii, short head and long head. This bicipital a neurosis, which is an extension of that links in with the flexor carpi radialis, and then into the thenar muscles.

That’s the superficial branch. There’s also a deep branch of the sinu channel, which is the flexor lysis, longus, flexes. The big thumb, the brachialis, which lies deep to the biceps a little bit shorter. It doesn’t cross the shoulder joint, just crosses the elbow joint. And then that links up with the anterior deltoids and the clavicular head of the pectoralis major.

So we also have the scalings in there, especially the anterior scalings. I don’t have that listed in my list. But the, there’s that superficial branch all the way up into the thumb, to the pec miner and the deeper branch that lies underneath that. The main channel would follow the course, the little spaces between a lot of these mussel.

So these could be almost like the river banks. With all the river being the communication that happens in those fossils spaces. A lot of the organisms and such in the river. You could study a river, but you need to understand the river banks, the structures that make up that river, that form that river.

And that’s what the sinu channel’s kinda so for the rest of this webinar, I would like to look at a movement, a Qigong exercise that I give to patients. I also teach in Qigong classes. And this will exercise that external portion. It’ll engage those sinews, but I also wanna show how that’s gonna gently mobilize and move and massage the internal portion, the esophagus, the bronchi, the greater momentum, the stomach.

So I think if you wanna fully exercise the lung channel, it needs to have all of those components there. And this exercise does that nicely. There’s plenty of other good exercises, but I like this one particularly. sO this exercise I have on my YouTube channel, I did it a little bit differently when I filmed it originally.

I focused a little bit more on the stretching aspect. I’m gonna put up another video, same exercise, but I’m gonna do it the way I’m showing in this particular webinar. So that should be up soon. But either way you can check out the video on my YouTube channel if you wanna get a reminder of it.

Or this recording will be available afterwards too, if you wanna have a reminder for it. So if you used it yourself, great, you have some nice memory aids, but also if you give it to patients, it’ll be something you can refer back to. All right, so let’s set it up. So this is gonna be the exercise. It’s a very simple exercise.

Anything, anytime we engage these this lung channel, we wanna engage the sinus, of course, but we al engaging the sinus will open and close the chest, but we also wanna mobilize that internal pathway of the channel. We’ll look at that kind of point by pint. This is gonna be engaging the lung channel, but really when you’re engaging channels, you tend to do ’em in networks.

So this will be really the Y Ming and tie-in channels as a whole. So that’ll be the lung and spleen channel, the large intestine and the stomach channels. But the primary focus for this one is the lung channel. So we’ll come back and look at this video afterwards and highlight some features of it.

But let’s move on to the next slide.

So this is the starting position. This video will loop and you can see it as I’m talking about it. So I’m gonna start by bringing the hands up. I’m standing shoulder width stance. My arms are gonna cross in front of the body. The forearms are supinated, which means basically the palms are facing me.

Our palms are facing the chest. The hands are a little ways away from the body, so the shoulder blades are slightly pronated and the elbows are slightly lateral to the body. So that’s our starting position. I did mention in there that you’re standing at shoulder width. This exercise works perfectly well seated.

If you’re working with a patient or yourself and you have mobility issues and aren’t able to stand even somebody in a wheelchair. I, when I work with people seated, I have them slide forward sitting on their sit bones, sitting upright, so they’re away from the seat and, their sit bones basically serve as their feet then so that they’re able to have an upright posture in the same way that I have an upright posture in the standing version.

Okay, so I’m gonna start by opening the chest, which really means that I’m starting to retract the scapula. So the scapula are starting to pull together in the back. You might be able to see that in the mirror that I have behind me. That I’m starting to retract, bring the shoulder blades closer to the spine.

I’m opening the elbows while keeping them down. Pronating the forearms. So the pronation will start to stretch the biceps, and at the end of the opening, I’m gonna push the hands away from the body so the elbows will be extended. Also stretching the biceps. So generally . There’s a problem that I see when I give this exercise to people, and I wanna highlight what I wanna do before I highlight the problem.

You’ll notice as I’m doing this in the looped kind of version here, is that my hands start narrow or start medial to the elbows, but then they get ahead of the elbows. So that’s what I wanna do. I wanna keep the elbows down and I want the hands to go wide to the elbows. There’s a nice midpoint.

That you can notice where the hands line up right there, they line up with the elbows just on the side of the body. I’m gonna put my cursor over it. So right here. So there’s a point in time where the hands, elbows line up, the hands are facing out. This keeps my elbows from going wide. The point is a lot of people are internally rotated in the shoulder.

And if they keep their elbows wide, then the the arms stay and internal rotation. And I want my arms to externally rotate so that the whole structure opens up. So that’s a little landmark you can look for when you’re doing it yourself or when you’re giving it to patients, is that lining up right lateral to the body and then the hands continue out?

So this is the expansive phase. I’m starting to stretch the biceps. I’m opening the chest by retracting the shoulders in the back, which creates more space in my chest. Creates more volume in that whole thoracic cavity. So let’s look at the compressive phase of the movement. So once I’m fully open, I’m gonna start, you’ll see a little gentle contraction in the abdominals, which starts to compress the torso as I fully push out.

And that’ll take me into a further pronation of the forearms and a winding type motion in the forearm. So let’s look at that. So hands push, out turn. So you might be able to see a little better in the mirror is that the torso bows slightly. My abdomen bows my spine bows look at that a couple more times.

So this is where I can start to engage in the front and gently massage that greater momentum. There’s a little bit of shortening along the whole front line during the compressive phase, which then when I continue this movement and go into the expansive phase, I’m stretching, compressing, stretching, compressing.

So as I turn the forearms, then I’m gonna start to reach the arms back. So that’s the compressive phase of the movement, and then it returns back to the same position.

I leading with the fingertips.

So fingers come forward, I cross my hands, return my chest lifts, and that bow that was in the torso, un bow straightened. So I get a nice gentle stretching and mobilization of the inner part of the channel.

All right, I’m gonna go back a couple slides and I wanna look at the full exercise.

So hands come up, cross slightly away from the body, open the hands, expand the chest, push out slightly, compress hands back. Return back to the starting position.

Hands out, push, compress, hands back, return to the starting position.

All right,

so I’m gonna end the PowerPoint.

Yeah, very simple exercise. I would highly encourage you to practice it. Like I said, I’ll put up a video on my YouTube channel, but this video, I think it has the a little snippet of it so you can get the idea of it. But the goal is to open the chest, create more volume in the lungs, but then as I start to compress everything, bows.

Then I go back to the expansive phase, so there’s movement inside so that I can gently mobilize that greater momentum. I can gently mobilize the stomach, I can gently mobilize the trachea and the esophagus in combination with what I’m doing on the external portion of the lung channel. So the whole channel is active and the whole channel is engaged.

So I use this for a lot of different things. You could use it really for anything where you wanted to improve the health of the lung channel. So that could just be preventative, of course. Respiratory issues would be a key component. Of course, if you’re working with people with respiratory issues, you want ’em to have that full volume in the chest.

shOulder problems is one that I give this exercise to quite frequently. You have to make sure that there’s no pain with doing it. So one component is that turning internal rotation, once I’ve stretched out, is I want that to come as much from the body as opposed to all my arm where I’m cranking my shoulder forward.

That can create a lot of pain for people who have shoulder problems, so I have to be very gentle. I’m starting from the distal portion, winding my arm, compressing my torso slightly. So it should be very comfortable for people. There shouldn’t be any sharp pain with this exercise. But that’s one where I give this to is shoulder issues.

Neck issues of course, because that shoulder girdle health is very tied to neck neck pain. It’s really versatile exercise. It’s pretty simple. Patients can catch onto it very quickly. They tend to like it ’cause they’re sitting so much during the day if they work at a desk or driving, or so many instances where we’re compressed there.

So it feels really nice to be able to open and stretch the chest and stretch that whole fossil. Line throughout the arms, but also you get that nice gentle engagement in the inside. So give it a try see what you think of it. But you can always reference the video and highlight it.

And if I have a YouTube video up on it, you can give some questions and comments if you want further clarification. I think that concludes the information I wanted to give today. It’s short and sweet. I’m gonna put this information together into a longer class that I’ll put on net of knowledge that’ll be available through lasa and a couple other partners overseas.

But that should be coming out fairly soon. I’m gonna put a little self massage in there and some some other details for treatment, maybe some needling also. This was just an introduction. Got the ball rolling for that. I was very happy to. . To be able to introduce this to you, and again, thanks to American Acupuncture Council for having me on.

 

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