Tuesday, December 14, 2021

Anatomy, Dissection, and the Chong Mai

 
I just finished leading two 5-day dissection classes for the University of Tampa Physician Assistant program. While I was teaching ‘standard’ Western anatomy and guiding the student teams through the full body dissection, the Chinese medical channel system was never too far from my mind. I did occasionally share some of this information to the PA students, but it is obviously not the anatomy that they are studying, and I was sparing with this information. Below is one aspect I shared, and something that I got an even better appreciation of: the anatomy associated with the chong mai, or penetrating vessel.

Inferior epigastric artery and vein connecting
into iliac artery and vein.
One of the tables (there were teams of 5 people working on each donor) produced a very similar view to this image on the left. This is created by slowly resecting the obliques, then cutting the rectus abdominis from the pubic bone and resecting it superior. Underneath the rectus abdominis are these vascular structures which are the epigastric artery and vein. There is some complicated anatomy associated with the fascial layers inferior to the umbilicus (look up the arcuate line if you want more information), but suffice it to say that these vascular structures run deep to the rectus abdominis, and that the fascial plane that they run in dives a bit deeper as these blood vessels connect with the iliac artery and vein.

Epigastric artery and vein running
deep to the rectus abdominis

This fascial plane is what I associate with the Spleen sinew channel; it is the fascial plane that runs deep to the rectus abdominis, connects with the anterior diaphragm and then follows the diaphragm around to the crura (attachments on the lumbar spine) of the diaphragm. However, this fascial plane also houses these epigastric arteries and veins. These vascular structures change names as they reach the thoracic cavity, becoming the internal thoracic artery and vein (also called the internal mammary artery and vein), and running along the deep surface of the sternum and anterior ribcage. During dissection, we cut a window through the sternum and ribcage to access the thoracic cavity; when we remove this window and look at the undersurface, these vascular structures are apparent.

Internal thoracic artery and vein
running just posterior to the
anterior ribcage

Traveling superior, these arteries and veins join with the subclavian artery and brachiocephalic vein. It is not necessary for this discussion to get too detailed about this anatomy, but there is a relationship between these vessels coming from the thoracic cavity and similar vessels in the neck which supply the neck and face.

Collectively, these vessels supply the skin, muscles, and bone on the anterior region of the body, umbilical region, diaphragm, pleura, pericardium, thymus, and important structures of the neck.

Finally, in the thoracic cavity, these blood vessels branch into the intercostal arteries and veins; they drain into the thoracic aorta and a venous structure called the azygos vein, all in the posterior portion of the thoracic cavity and consistent with the posterior branch of the chong mai. Clinically, these vessels act as a collateral circulation for blood movement from and to the heart. If there is obstruction in the aorta, blood will take this collateral circulation route. If the blood is abundant, these vessels can be filled, so they act as a bit of a reservoir.

Go back and review the chong mai with this anatomy in mind and you will see it in an entirely different light. These structures are in the myofascial plane of the Spleen sinew channel, regulated by a Spleen channel point, SP 4, and they clinically match the description and topography of the chong mai.

Tuesday, May 25, 2021

Pelvic Rotation in Taiji and Qigong

This month we will be focusing on rotation, specifically how this movement involves the innominate bones and the sacrum. I frequently find that, when demonstrating rotation, students often think of the pelvic structure as a block that rotates as a unit. However, the pelvis is quite dynamic and there can be much movement between the two innominate bones which allows sacral rotation to occur. This is seen also with walking or running. The back leg in gait pulls the innominate bone on that side into an anterior tilt, while the forward leg pulls the other innominate bone into a posterior tilt. The entire pelvis is 'twisted' or moves into torsion. 


When the practitioner is in a horse stance or in a neutral stance hip width apart and performs pelvic rotation, this same dynamic occurs, or at least the potential is there for it to occur. This movement will create a rotation all of the way from the feet and potentially upward throughout the body to the head, a movement that takes the joints through their full range of motion in the transverse plane.

We will be exploring this rotation in the Eight Pieces of Brocade, Taiji, Taiji Ball, and even the Core classes this month. Check out the schedule below.

May Taiji and Qigong Schedule

Monday

Tue

Wednesday

Thur

Friday

Saturday

Sun

Eight Pieces of Brocade

9:30-10:15am est

Eight Pieces of Brocade

9:30-10:15am est

Core (No Floor)

Strengthening for

Qigong
9:00-9:30am est

Taiji Ball

10:00-10:30 am est

Core (Floor) Strengthening for Qigong

10:30-11:15 am est

Five Animal Sports 

10:30-11:15am est

Eight Pieces of Brocade

9:30-10:15am est

Five Animal Sports Practice

10:30-11:30 am est

Taiji (Tai Chi)

6:00-6:45pm est

 

Taiji (Tai Chi)

6:00-6:45pm est