Practical Acupuncture Clinical Handbook

Author: China Medical Science Press
Publisher:
Publish Date: 1999-05-01
Features: Head needling therapy is characterized by simple operation, effective results, and wide application, making it highly popular among acupuncture practitioners. This book is compiled by Professor Feng Chunxiang and his team, summarizing their over ten years of clinical and teaching experience in head needling, and incorporating the features of various head needling schools in China. The book is divided into two parts: the first part introduces the basic knowledge of head needling, focusing on the characteristics of different head needling schools and treatment methods. The second part discusses the clinical application of head needling, covering internal, external, gynecological, pediatric, and ophthalmological departments, providing detailed descriptions of the selection of points, needling techniques, and auxiliary therapies for 100 common clinical conditions. The book is written in simple and accessible language, suitable for acupuncture practitioners, especially those interested in head needling.
Excerpt: Also known as subcutaneous tissue, it is composed of dense connective tissue and contains fat, the amount of which varies regardless of a person's weight. The connective tissue divides the fat into numerous small compartments, which, in addition to fat, also contain nerves and blood vessels. Therefore, when inflamed, exudates are not easily diffused or spread, and redness and swelling are usually localized. However, due to the compression of nerve endings, headache can be felt in the early stages of inflammation. Blood vessels in this layer adhere to the connective tissue, making them difficult to contract during trauma, resulting in significant bleeding. To stop bleeding, the method of compressing both blood vessels and connective tissue is required. The blood vessels and nerves at the top of the skull run from the base to the top of the skull within the superficial muscles.
1. Arteries and Nerves: The arteries and nerves at the top of the skull are divided into three groups (Figure 2-2):
1) Anterior Group:
1) Anterior Medial Group: 2.0 cm from the midline, with the frontal artery and supratrochlear nerve.
2) Anterior Lateral Group: 2.5 cm from the midline, with the supraorbital artery and supraorbital nerve.
2) Lateral Group:
1) Preauricular Group: The superficial temporal artery and auriculotemporal nerve run together.
2) Postauricular Group: The posterior auricular artery, posterior auricular branch of the facial nerve, posterior auricular branch of the cervical plexus, and lesser occipital nerve. The posterior auricular branch supplies the muscles above the ear, while the greater and lesser occipital nerves supply the skin.
3) Posterior Group: The occipital artery and greater occipital nerve supply the occipital region and extend to the top of the skull, with the artery running lateral to the nerve. The arteries at the top of the skull have extensive anastomoses, not only between the left and right sides but also between the internal and external carotid artery systems. The nerves at the top of the skull run within the subcutaneous tissue and are distributed in overlapping layers.
2. Veins: The veins at the top of the skull are located in the subcutaneous tissue, forming a venous network through extensive anastomoses. The main veins run alongside their corresponding arteries.
(III) Skull Top Muscles and Galea Aponeurotica
The muscles at the top of the skull include the frontalis muscle in the front and the occipitalis muscle in the back, which are connected by the galea aponeurotica. The frontalis muscle originates from the skin and subcutaneous tissue at the eyebrows and root of the nose, and is connected to the orbicularis oculi muscle. The occipitalis muscle originates from the external occipital protuberance and superior nuchal line. These two muscles are cutaneous muscles. The galea aponeurotica is tough and thick but becomes thinner in the temporal region, transforming into the temporal fascia.
(IV) Subgaleal Loose Connective Tissue
The subgaleal loose connective tissue is a potential loose tissue space between the galea aponeurotica and the periosteum of the skull. It contains a small amount of loose connective tissue and is also known as the subgaleal space. This space is extensive at the top of the skull, extending forward to the supraorbital margin and backward to the superior nuchal line. Due to its loose connection with the scalp and periosteum, it has high mobility. During craniotomy, the skin flap can be freed and lifted through this space. Scalp avulsion injuries often occur in this layer. When bleeding occurs in the subgaleal space, it tends to spread widely, often forming large hematomas, with bruises appearing even under the eyelids. This space contains several drainage veins, which connect to the diploic veins of the skull and the dural sinuses within the cranial cavity. If infection occurs, it can lead to cranial osteomyelitis or spread intracranially. Therefore, the subgaleal space is known as the "danger zone" of the top of the skull.
(V) Periosteum of the Skull
The periosteum of the skull is composed of dense connective tissue and is connected to the surface of the skull by a small amount of connective tissue, making it easily separable. In severe scalp avulsion injuries, the scalp may be torn off along with part of the periosteum. The periosteum adheres tightly to the skull sutures and is continuous with the outer layer of the dura mater (periosteal layer). Therefore, when a subperiosteal hematoma occurs, it is usually limited to a specific part of the skull and does not spread outward. When there is a defect in the dura mater, the periosteum can also be used to repair it.