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Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
July, 2003, Vol. 03, Issue 07
By Neal Cross, PhD, NCTMB
In 1964, Davis published a wonderful monograph describing the functional anatomy of the Giant Panda,1 including a detailed description of the panda's "thumb." Although not a real thumb, this connective tissue pad and underlying bony anatomy functions as a thumb in helping to grasp bamboo: the mainstay of the panda's diet.
Stephen J.Gould's 1980 volume, discusses various functional anatomical adaptations that have occurred in many different taxa over evolutionary time; chapter one discusses the panda's thumb specifically. As functional as this tissue is, it is a far cry from our opposable thumbs. One could, in fact, make the argument that our thumbs are one hallmark of being human - certainly our hands are the mainstay of the massage profession.
The thumb, or first digit, is made up of two phalanges and associated soft tissue. It is attached to the wrist at the first carpometacarpal (CMC) joint. This is a classic saddle joint where the base of the proximal first phalanx and the distal surface of the trapezium are reciprocally saddle-shaped. This allows for considerably more degree of motion than found with any of the other four digits.
The motions allowed at this joint are flexion/extension; abduction/adduction; opposition/apposition/reposition; and circumduction:
The ligaments surrounding the first CMC are very important to the integrity and function of this joint. There have been five ligaments described.4 These ligaments generally allow considerable motion, thus they are not as commonly injured as the metacarpophalangeal (MP) joint; however, the CMC is commonly affected by osteoarthritis. 5 The ulnar ligament of the thumb's MP is frequently stretched or torn. This has been referred to as "gamekeeper's" thumb (early gamekeepers used to dispose of farmyard fowl by placing the bird's neck between the thumb and forefinger and snapping the neck) or "bowler's" thumb.
Currently, the most common injury here is related to ski pole usage. At any rate, the injury is the result of a traumatic event that tears the ulnar collateral ligament when the thumb is forced into hyperabduction/extension. By gapping the MP joint using a valgus force, one sees a dramatic gap on the ulnar side of the joint. Splinting is indicated for a stretched ligament, and surgery for a torn ligament.5
Another common problem of the thumb is de Quervain's tenosynovitis.5 This involves inflammation of the abductor pollicis longus and extensor pollicis brevis tendons within their tendon sheaths at the lateral (anterior) border of the anatomical snuffbox. Remember, the anatomical "snuffbox" is that region bounded by the tendons of the abductor pollicis longus and extensor pollicis brevis, laterally (anteriorly); and the extensor pollicis longus, medially (posteriorly). The radial artery runs along its floor; here, the artery's pulse can be palpated. Treatments of de Quervain's tenosynovitis include immobilization, steroid injections and surgery.
Back to the panda's thumb: Where did it come from? It seems to be a modification of the connective tissue overlying a modified sesamoid bone. We have two sesamoid bones associated with our first metacarpophalangeal joint. These bones serve as attachments of thenar muscles. The abductor pollicis brevis and flexor pollicis brevis attach to the lateral sesamoid and the proximal phalanx, while the two heads of the adductor pollicis attach to the medial sesamoid and the proximal phalanx. Both of these attachments continue on to the extensor hood, as well. It seems that over evolutionary time, some carnivore taxa had a more developed lateral sesamoid bone. This developed into a large sesamoid bone, as seen today in the Giant Pandas. Other mammals, like the raccoon, have sophisticated grasping function, but not nearly as sophisticated as ours.
Take good care of your thumbs. They serve you well.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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