Welcome to my latest blog post, where I'll be diving deep into the details covered in episode 5 of my podcast, "Study Acupuncture with Me." If you're gearing up for the NCCAOM board exam, you've landed in the right place. Today, we're focusing on two crucial meridians: the Pericardium and San Jiao channels. We'll cover important points, their locations, cautions, contraindications, and some valuable tips on electroacupuncture that could just make the difference in your exam results.
Pericardium Channel Overview
Let’s start with the Pericardium channel. On the NCCAOM board exam, there are three primary points you need to familiarize yourself with: Pericardium 1 (PC 1), Pericardium 3 (PC 3), and Pericardium 7 (PC 7).
Pericardium 1 (PC 1)
Located 1 cun lateral and superior to the nipple, in the fourth intercostal space, PC 1 is a point you need to be cautious with. Deep needling here could potentially result in a pneumothorax, which is definitely something we want to avoid.
Pericardium 3 (PC 3)
PC 3 is the He-Sea point and also the water point of the Pericardium channel. It's situated at the transverse cubital crease, on the ulnar side of the bicep brachii tendon. The primary caution here is the proximity to the brachial artery and vein. Precise needling is a must to avoid vascular injury.
Pericardium 7 (PC 7)
Located at the wrist joint, between the tendons of palmaris longus and flexor carpi radialis, PC 7 is both a Shu-Stream point and the Yuan-Source point. Deep needling at PC 7 can potentially harm the median nerve, but interestingly, this point combined with electroacupuncture is excellent for treating carpal tunnel syndrome. This application can come in handy both in clinic practice and for exam questions.
Electroacupuncture Insights
Electroacupuncture is a topic that comes up frequently on the NCCAOM exam, especially in relation to how different frequencies are used. Here are some basic principles to keep in mind:
- **Regular Frequencies**: Best for treating pain and spasms (muscular conditions) and draining excess conditions.
- **Alternating Quick and Slow Frequencies**: Ideal for treating paralysis and numbness (nerve conditions) and strengthening deficient conditions.
San Jiao Meridian Overview
Next, let's focus on the San Jiao meridian. The key points to master for your board exam are San Jiao 4, San Jiao 5, San Jiao 6, San Jiao 15, San Jiao 17, San Jiao 19, San Jiao 21, and San Jiao 23.
**San Jiao 4 (SJ 4)**
SJ 4 is the Yuan-Source point and is excellent for water metabolism. In clinical practice, combining SJ 4 with UB 22 (the San Jiao Shu) and UB 39 (the Lower He-Sea point) provides great results.
**San Jiao 5 (SJ 5)**
SJ 5 is located 2 cun proximal to the wrist joint on the radial side of the extensor digitorum communis tendon. As an important point for expelling wind and releasing the exterior, it's particularly noted for dispersing wind-heat. This distinction is crucial for the Bioscience segment of the exam.
**San Jiao 6 (SJ 6)**
Known as the Jing-River and Fire point, SJ 6 is located 3 cun from the wrist joint, or 1 cun from SJ 5, maintaining its position on the radial side of the extensor digitorum communis. It's famously known as the "constipation point"—pressing SJ 6 can alleviate constipation. However, combining it with different points targets different issues:
- **SJ 6 + KD 6**: Great for treating constipation.
- **SJ 6 + GB 31**: Effective for treating herpes zoster.
- **SJ 6 + GB 34**: Best for addressing hypochondriac pain.
San Jiao 15 (SJ 15)
SJ 15 is located in the suprascapular fossa, between GB 21 and SI 13. Deep needling here can result in a pneumothorax, so caution is required.
San Jiao 17 (SJ 17)
Located behind the earlobe, this point requires careful needling aimed toward the opposite ear. Incorrect angling can cause significant pain, especially when the patient talks or moves their jaw.
San Jiao 19 (SJ 19)
With SJ 19, shallow needling is advised (0.3 to 0.5 cun). Some sources contraindicate pricking to bleed at this point, so it's best to be cautious.
San Jiao 21 (SJ 21)
SJ 21 is superior to the condyloid process of the mandible and in front of the supratragic notch. An easy way to remember its location is that it's directly above SI 19 and GB 2. These points align neatly: SJ 21 (minus) SI 19 = GB 2.
San Jiao 23 (SJ 23)
Located in the depression at the end of the eyebrow, SJ 23 is contraindicated for moxibustion to avoid burning the patient's eyebrow off.
To round out our study of the San Jiao meridian, it's essential to remember the function and combination points:
- **SJ 4**: Yuan-Source and helps with water metabolism.
- **SJ 5**: Disperses exterior wind-heat.
- **SJ 6**: Versatile for treating constipation, herpes zoster, and hypochondriac pain, depending on the point combination.
so in SUMMARY
I hope this detailed breakdown helps you prepare for your NCCAOM board exam. Remember, mastering these points and their nuances aren’t just about passing your exam—they’re about setting a strong foundation for your future practice. Use this blog post, re-listen to episode 5 of my podcast, and keep screenshotting crucial slides to reinforce your memory.
Feel free to share this post with your fellow acupuncture students, and remember to follow me on Facebook and Instagram for more updates and tips. Good luck with your studies, and see you in the next episode!
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If you found this post helpful, don’t forget to leave a comment below and suggest any other topics you'd like me to cover in future posts and episodes. Let’s ace that NCCAOM board exam together!
TRANSCRIPT of EPISODE
Dr. Richard Lai DPT LAc [00:00:04]:
Alright. Welcome to episode 5 of Study Acupuncture with Me. In this episode, we're gonna be going over the pericardium channel, as well as the Sanjiao channel, in terms of cautions and contraindications. Alright. So the pericardium channel, there's only 3 that really come up on the board exam. That's pericardium 1, pericardium 3, and pericardium 7. So PC 1 is actually located 1 soon, lateral, and superior to the nipple. It's in the 1, 2, 3, 4th intercostal space.
Dr. Richard Lai DPT LAc [00:00:40]:
And in this one, you just wanna be careful because deep needling can result in a pneumothorax. Next we have PC 3. PC 3 is the HSC point. It's also the water point of the pericardium channel, and it is located right at the transverse cuticle crease. It's on the ulnar side of the bicep brachii tendon. And with this one, you wanna be careful of the brachial artery and vein. And then lastly, we have PC 7. PC 7 is a shoestring point.
Dr. Richard Lai DPT LAc [00:01:17]:
It's also the urine source. And it's at the wrist joint, and it's between the tendons of, palmaris longus and also flexor carpi radialis. And with this one, deep needling could hit the median nerve. But with this point too, a good point combination for carpal tunnel syndrome with electroacupuncture, can treat the median nerve in terms of carpal tunnel syndrome. So for the board exam, you do have to know a little bit about electroacupuncture. More specifically, our first study, acupuncture gem. You have to know about frequencies. For the the primary sources from the NCCAOM, they really ask you about frequencies and specifically what the frequencies are best used to treat.
Dr. Richard Lai DPT LAc [00:02:14]:
So for example, regular frequencies are best for pain and spasm. And alternating quick and slow is good for paralysis and numbness. You know? And even going further into theory, regular frequencies would drain excess conditions, and alternating quick and slow frequencies would strengthen any deficient conditions. So regular frequencies are best for treating muscle, Whereas alternating quick and slow is best for treating paralysis and numbness, which are nerve conditions. Regular frequencies are best for treating pain and spasm, which is generally muscular conditions. And alternating quick and slow is best for paralysis and numbness, generally nerve conditions. Now really for the best clinical application of electroacupuncture, I really recommend, one of my mentors who created electroacupuncture medicine. His name is doctor Jeremy Steiner.
Dr. Richard Lai DPT LAc [00:03:24]:
He founded Electro Acupuncture Medicine, and their website is electro acupuncturomedicine.com. I'll link it below. They have online courses, which, you can go at your own pace, as well as live 2 day seminars. I mean, I've personally been to them, and they really enhance my treatments. So pop over to the website. Definitely sign up for a live seminar, and tell them that, Richard Lai sent you. So next, we're gonna go over the San Jiao Meridian. So San Jo Meridian, there's a couple more.
Dr. Richard Lai DPT LAc [00:04:00]:
San Jo 56. We have San Jo 15 as well. Then 17, 19, 21, and 23. Big tip for this, episode is to screenshot as you go. You know? I've actually received some messages saying that it's been really helpful because they screenshot it while it's on their phone, and they just look at it while they're on the train. So, definitely screenshot these, these slides. So we have San Jiao 5 as our first one. San Jiao 5 is the lower.
Dr. Richard Lai DPT LAc [00:04:35]:
Right? It's too soon. Right? Proximal to the wrist joints, which is where Sanjal 4 is. It's on the radial side of the extensor digitorum communicus tendons, which is highlighted in blue here. Next one to learn in conjunction is Sanjiao 6. Right? This is the Jing River point. It's a fire point. And this one is just 1 Sun above. It's 3 Sun from the wrist joint.
Dr. Richard Lai DPT LAc [00:05:11]:
It's 3 cun from Sanjiao 4, or 1 cun from Sanjiao 5. And again, it's on the radial side of extensor digitorum communicus. In this one, when you're needling it, you just want to make sure you tell the patient, you know, not to move too much because they're moving a lot. It can result in a bent needle. Alright. So next, we have Sanjiao 15. Sanjiao 15. It's called Heavenly Crevice.
Dr. Richard Lai DPT LAc [00:05:42]:
It's in this Superscapular Fossa. It is between this point here, which is gallbladder 21, and this point here, which is SI13. Right? This is the medial end of the suprascapular fossa. And with this one you want to be careful, because with deep needling, you could hit the lung, which would result in a pneumothorax. Alright. Next, we have Sanjiao 17 right over here. This one's called, windscreen, And you wanna when you needle this one, you want to aim towards the opposite ear, and you wanna be careful if you go too far anteriorly or too far posteriorly. It can cause a lot of pain, because if the patient talks, the patient does anything opening, closing the mouth, it can cause a lot of pain.
Dr. Richard Lai DPT LAc [00:06:43]:
Next, we have Sanjo 19. Sanjo 19, you I mean, with this one, it's a very shallow needling. It's like 0.3 to 0.5 soon. But this one is, in some sources, does say that it's contraindicated to prick to bleed this point. Next we have Sanjiao 21. Sanjiao 21 is a fun one to remember because it's right in front of the supertragic notch, and it's superior to the condyloid process of the mandible here, where TMJ problems occur. And right below it, right, Sanjiao 21, you remember that small intestine 19 is right below it, and then gallbladder 2 is right below that. So easy way to remember that one is that 21 minus 19 is equal to 2.
Dr. Richard Lai DPT LAc [00:07:43]:
Right? And then if you remember the words 2, jib, you would remember Sanjiao 21 minus SI 19 equals gallbladder 2. And then last one we have is just Sanjal 23, which I'm I'm not gonna put as a picture here, but it's just at the in the depression, at the end of the eyebrow. And with this one, you just don't wanna do moxa because you don't wanna be burning anybody's eyebrows off. Alright. Lastly, we have our last study acupuncture gem of this episode, which is just a quick screenshot. My notes from when I was studying, and I remember these were on my board exam. So Sanjiao 4, it is a urine source, and it's good for water metabolism. And this was a point combination that did come up a lot, and it's actually very useful in, daily application as well in treatments.
Dr. Richard Lai DPT LAc [00:08:45]:
Sanjiao 4 being the source, UB 22, which is the Sanjiao Shu, and UB 39, which is the lower HOC point. We also have San Jo 5. San Jo 5, according to Dedman, it expels wind and releases the exterior. For the Bioscience board exam, it's very important to note that it disperses exterior wind heat specifically. And then San gel 6, we know is the constipation point. Right? If you're constipated, you're sitting on the toilet, nothing's coming, just start doing pressure on Sangel 6. Now, for the board exam and for application purposes in your clinic, Sangel 6, when you add it with a certain point, it may treat different things. So although Sangel 6 stays the same, when you add it with a different point, it will it it indicate for something different.
Dr. Richard Lai DPT LAc [00:09:35]:
So Sanjiao 6 with kidney 6 is great for constipation. Sanjiao 6 with gallbladder 31 is great for herpes zoster. And then Sanjiao 6 with Gallbladder 34 is great for hypochondriac pain. Alright, and that's the end of episode 5. Really hope that you enjoyed the content. Go back, screenshot any of those lines. Feel free to share it on social media. Definitely go check out electroacupuncture medicine as well if you're interested in learning about really high level, clinical applications of electro acupuncture.
Dr. Richard Lai DPT LAc [00:10:14]:
And then check with us every single Wednesday for new videos and find us on Facebook as well as Instagram and comment below if you have any certain topics that you really want us to go over. Alright. I'll see you next time.
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