1.Anatomical consideration of the acupuncture into the stellate ganglion.
Tomohumi OZAKI ; Seiichiro KITAMURA ; Shungo MORI ; Ikiko TAKESITA ; Yukie UESHIMA ; Akira SAKAI
Journal of the Japan Society of Acupuncture and Moxibustion 1987;37(4):268-278
The anatomical structures penetrated by a needle which was inserted in an acupuncture point into the stellate gaglion, 1.5cm lateral to and 2.5cm above the point Tentotsu, were studied bilaterally with dissection of 19 cadavers. Furthermore, the size of the dissected stellate ganglion, its anatomical position, and its positional relation to structures located near it were measured or observed.
Though 8 out of 38 inserted needles pricked the medial margin of the ganglion, the remaining 30 needles all missed medially from the ganglion. In the cases pricking the ganglion, all of 8 needles penetrated either the vertebral or the subclavian artery before reaching the ganglion, and 7 of these did also the dome of the pleura in addition to the artery. In the cases missing from the ganglion, however, a frequency of penetrating the above structures were considerably lower.
The dissected stellate ganglion almost lay on beteen the mid-level of the vertebral body of the 7th cervical vertebra and the upper level of body of the second thoracic vertebra, with their mean size 27.1, 7.7 and 2.8mm in length, width and thickness, respectively. All of the ganglions were located dorsal to the vertebral and subclavian arteries and the dom of the pleura the distances from the median line to their upper and lower extremity being 21.9 and 22.7mm in average, respectively.
The pricked point for directly aiming at the stellate ganglion from the body surface is within a range 20 to 30mm lateral to and 10 to 40mm above the point tentotsu on the right, and on the left it is within a range 15 to 25mm lateral and 10 to 35mm above; the depth from the point is about 4.0 and 3.8cm on the right and left, respectively. But when directly aiming at the ganglion, the possibility of injuring the vertebral or subclavian artery and the dome of the pleura was suggested to increase considerably owing to their location ventral to the ganglion.
2.Anatomical consideration to an acupuncture near the middle cervical or the vertebral ganglia.
Tomohumi OZAKI ; Seiichiro KITAMURA ; Shungo MORI ; Ikiko TAKESITA ; Yasukiyo NISHIZAKI ; Yukie UESHIMA ; Tetuo TATUMI ; Mituo GOUDA ; Akira SAKAI
Journal of the Japan Society of Acupuncture and Moxibustion 1989;39(2):185-194
The incidences of the middle cervical and the vertebral ganglia and their sizes were investigated bilaterally during dissection of 18 cadavers. Furthermore, the positional relations of each ganglion to the vertebral column, the point Tentotsu, the anterior tubercle of the sixth cervical (C6) vertebra, and the cricoid cartilage were investigated along with the relations of the anterior tubercle of the C6 vertebra to the point Tentotsu and the cricoid cartilage. The middle cervical ganglion was 14, 4 and 2mm in average length, width and thickness, respectively, on the right, and on the left these values were 14, 5 and 2mm. The ganglion was found in about half the cases, and it was located at about the level of the cricoid cartilage and close laterally and above to the anterior tubercle of the C6 vertebra. In the cases lacking the middle cervical ganglion, the sympathetic trunk passed immediately medial to the tubercle. The vertebral ganglion was found in almost all cases, with its mean size 8, 5 and 3mm on the right and 9, 5 and 2mm on the left in lenght, width and thickness, respectively. The ganglion was included in many cases within a range 15 to 30mm lateral and 20 (the left) or 25 (the right) to 45mm above the point Tentotsu, and it lay at the level of the C7 vertebra. The anterior tubercle of the C6 vertebra was within a range 20 to 30mm lateral to that point, and in the upper to lower direction, it lay at the level slightly upper than the cricoid cartilage in the male and at about the level of the cartilage in the female.