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.
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| Inferior epigastric artery and vein connecting into iliac artery and vein. |
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| 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.
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| 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.
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