resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
February, 2001, Vol. 01, Issue 02
You Know It Like the Back of Your Hand
By Neal Cross, PhD, NCTMB
While it is unfortunate that many of you may not have access to human cadavera, the amount of anatomy that may be learned and reviewed on one's own body parts is quite amazing! We often go to the books (two dimensional) first, even when we have a 3-D anatomy right in front of us.It seems to me that when we do not take advantage of reviewing anatomy on ourselves or on another living person, we are truly missing out on a wonderful opportunity.
There is a level of disconnect in going from cadaveric anatomy in the lab to that warm, pliable tissue we feel on our clients. This disconnect goes away when we study living anatomy. It also makes our hands better educated when exploring bodies. And better-educated hands make for more accurate assessments.
Let's try a simple exercise. I am sitting in a jet somewhere over New York, headed to Chicago, then to Miami. I place my left hand on my left knee, palm down. I observe that the hair pattern changes from dense to sparse as I look distally. The transverse creases on each digit indicate the underlying MCP, PIP and DIP joints. These abbreviations refer to rather cumbersome names: metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints, respectively. A nail covers each digit distally. I see the dorsal carpal venous rete and the origins of the basilic and cephalic veins medially and laterally, respectively. If I extend each digit, I clearly see its extensor tendon move just beneath the skin. I also observe that when I extend any of my fingers, its tendon and an adjacent tendon move.
All this lets me know that I have connecting tendons between the extensor tendons of digits two through five. The pattern of these intertendons varies widely from person to person. I can palpate these tendons. If I palpate carefully, I find that digits two and five each have a pair of tendons. One is from the common digital extensor (extensor communis); the other is from a muscle named for that digit. These are the extensor digit minimi and extensor indicis. I do not have the additional tendons to digits three and four, as some people do. These tendons are from the muscle extensores digiti tertii et quarti. I also note that all of these tendons "disappear" proximally under the extensor retinaculum.
If I abduct a finger against resistance, I can readily palpate a dorsal interosseous. I also know that the four dorsal interossei attach only to digits two, three and four. The third digit has two dorsal interossei, as its midline is the reference for finger movements. If I abduct the thumb and little finger against resistance, I can palpate their abductors one for digit five and two for digit one. When I hyperextend my thumb against resistance, a prominent depression appears proximally to the thumb's base. This is the anatomical snuffbox, bounded by the tendons of the short and long extensors of the thumb and the long abductor. Exploring the distal attachments of these, I can readily palpate more than one tendon associated with two of these muscles.
This is a very common phenomenon, even though it is not mentioned in many standard textbooks. I know of no significant functional consequence, other than perhaps driving a few of my medical students to some level of madness. I can readily palpate the pulse of a branch of the radila artery in the floor of the snuffbox. If I press harder and discover point tenderness, it may be indicative of a scaphoid fracture. This is arelatively common injury caused by falling backward onto a hyperextended wrist.
I can readily palpate all of my phalanges and metacarpals. I can also distinguish the major landmarks on each. If I carefully examine the range of motion of each of the joints in each digit, I note several things. In digits two through five, the range of motion is generous about one axis, but extremely limited about the other two axes. When examining the metacar-pophalgeal joint of the thumb, I notice it has generous motion about two axes and very limited motion about the third. I also discover that the ranges of motion differ if I utilize passive rather than active movements.
So, while sitting here on the plane, I have reviewed most of the salient anatomy of the dorsum of my hand. I have considered what is normal (i.e., usual) and compared my hand anatomy to "textbook" hand anatomy. In this way, I am reminded of the great wealth of variety in the human anatomy. This variation is an easily overlooked feature, yet it is so very important to understanding human form and function. As clinicians, we should strive to learn as much as we about this variation.
Some aspects of our anatomy indicate something especially unique to the individual being examined. Unique to the back of my hand are two scars. One is about two centimeters long, lying transversely at the base of the thumb. This resulted from the errant path of a knife while I was filleting a fish a few years back. The second is a very faint, perfectly rectangular scar overlying the midline of my extensor retinaculum. This was created by a burn from a popcorn popper at a Cub Scout meeting in 1958. I hadn't thought about that in decades.
So as you can see, the human hand is a marvelous instrument far more interesting than peering out the window at the top of the clouds.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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