Dr. Mehdi Hashemi
|Posted on Tuesday, December 08, 2009 - 11:45: |
Is it true to locate DU4 to be in front of umbilicus(L2) at back (and then locate BL23 easily accordingly) ?
Or it is better to locate DU4 and BL23 according to iliac crest (L4)
|Posted on Tuesday, December 08, 2009 - 13:08: |
Both methods are correct. However, these are valid guidelines when your patient has a reasonable body build. Quite often, you encounter fat people with bulging abdomen or twisted vertebral column, facts that make this point location techniques invalid. Most experienced practitioners usually need a mere glance in order to pinpoint B-23. Until you acquire this skill, what I suggest is that you locate Du-3, very easily found one depression proximal to the last vertebral depression before the sacrum. This is even easier to locate when you push a pillow beneath your patient's abdomen in order to lift the spine a bit and make the vertebrae protrude a little. When you have located Du-3, simply count two depressions proximally and you land at Du-4. I find this technique superior to those that you have mentioned.