Atlas of Acupuncture

3 Anatomical Orientation

3.4 Spine and Sacroiliac Region

The spinous processes of the vertebrae are in most cases good

markers for anatomical orientation. The correct positioning of

the patient is important in order to facilitate palpation of the

spinous processes and the intervertebral spaces.

For palpation, the practitioner places his/her index and middle

finger to the left and right of a previously identified vertebra,

gliding smoothly with both fingers from one intervertebral space

to the next. Palpating the depressions between the vertebrae

allows for orientation along the spine even in heavy or obese

patients whose spinous processes might not be palpable.

Note regarding the inner branch of the Bladder channel:in

clinical practice the points on the inner branch of the Bladder

channel are not on all sections of the spine measured at a 1.5 cun

distance from the midline. Rather they are located on the highest

point of the paraspinal musculature, so that the distance to the

midline tends to be greater at the level of the lower thoracic and

the upper lumbar spine.

Note regarding position of the patient:The position of the

patient can significantly influence the level of the vertebrae in rela-

tion to other anatomical structures, such as the scapula or the pelvis

(
for more detail see sections on the thoracic and lumbar spine).

3.4.1 Cervical Spine

For orientation on the cervical spine the patient should best be

seated (or standing). The head should be in a neutral position.

Spinous process of the 2nd cervical vertebra

(C2, axis) (
Figs 3.66, 3.67)

The 1st cervical vertebra (atlas) has no spinous process, so that

when palpating down the posterior midline from the occiput the

2nd cervical vertebra (axis) has the first palpable spinous

process. 
Du-15is located slightly superior to this.

The spinous processes of C3, C4 and C5 are often only indistinct

or not at all palpable, while C6 can on the other hand be clearly

felt (
identification of C6 and C7).

Midline

Trapezius,

superior

fibres

G.B.-20

BL-10

Du-15

1st palpable

spinous process

(C2 axis)

Atlas

Fig. 3.66