QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) Human-type AP needles 28-32 gauge are suitable for small animals
(b) Thicker AP needles (19-25 gauge) are preferable in large animals, as the muscular twitching and spasm which frequently occurs during the needling session can twist fine needles into bizarre shapes, making them difficult to extract and destroying them for future use.
(c) Standard hypodermic needles have the advantage of being cheap and disposable but they have the disadvantage of causing more pain and they may introduce dirt or skin into the tissues because they have a lumen. They also cause more tissue damage and bleeding.
(d) In most cases, it is not necessary to attempt to sterilise the skin but each needle should be sterile
(e) Standard hypodermic needles should be inserted slowly and carefully by the push-twirl method
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) It is not possible to give an exact depth or direction for needle insertion: these vary between points (within species) and between points (between species)
(b) The direction of insertion depends on the body region being needled Over muscular areas, the needle is usually inserted at 90o to the skin, deep into the muscle. Over bony areas and on Earpoints, the needle is inserted perpendicularly until the skin is penetrated and then is advanced subcutaneously
(c) One should never needle periosteum
(d) Penetration of the human ear cartilage can cause a chronic auricular chondritis which can be very difficult to cure
(e) Penetration of the thoracic or abdominal cavities is forbidden, except in specific cases, such as aspiration of fluid or releasing gas from the viscera etc. Therefore, over the thorax and abdomen, the needles are usually inserted at 45o
3. One of the following statements is not correct. Indicate the incorrect statement:
(a) In large animals the needles can be inserted up to 100 mm deep in certain points, such as those over heavy muscles. However depths of 25-50 mm would be more usual.
(b) In small animals heavy muscle groups would be needled to depths 10-50 mm, depending on the amount of muscle.
(c) The most active AP points are never over peripheral nerves especially main nerves (trigeminal, facial, radial, median, ulnar, sciatic, spinal nerves etc).
(d) When the needle is correctly placed and stimulated, a local reflex muscle spasm grips the needle tightly, "like a fish taking the bait".
(e) De Qi in animals is indicated by shivering, local muscle twitch, vocalisation, lifting of a limb, attempts to escape, bending of the back, swishing the tail, lowering of the head and defensive reaction. The needle should be tightly gripped by the tissue, as in humans.
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) Needles are usually left in position for 10-30 minutes in conditions such as rheumatism, muscle pain, arthritic lameness etc. In some cases, for instance rhinitis, conjunctivitis, shock etc, duration of needling can be very short, 10-60 seconds.
(b) For paralysis and painful conditions (especially of the muscles) long duration of needling (up to 30 minutes) is indicated, whereas for most other conditions a quick needling is sufficient.
(c) Some Chinese sources claim that if De Qi is obtained, there is no advantage to be gained from leaving the needles in situ for 10-30 minutes, except in certain chronic conditions, such as peripheral nerve damage. Thus, a short, quick, strong needling may replace the longer, more gentle method in many diseases.
(d) If needles fall out after 10 minutes of treatment, they must be re-inserted immediately
(e) Blood needles and fire needles are used in large-animal AP in China
5. One of the following statements is not correct. Indicate the incorrect statement:
(a) In AP point injection, the choice of solution is largely a matter of personal preference
(b) Scars, especially the tender areas, can be treated, using a dental or tuberculin syringe, set to deliver 0.1-0.2 ml/point. The solution is injected intradermally at a depth of 2-5 mm, using a very fine (c. 25 gauge), short (2.5-10 mm) needle
(c) Intradermal point injection, using dental, tuberculin or Dermojet syringes is used on scars or on Ear AP points
(d) Dermojet injection is very suitable for stimulating points on the limbs of horses and cats which would not accept needling of the same points. It is also ideal for the treatment of restrained zoo animals
(e) Implantation (gold beads, orthopoedic suture wire etc) of animal AP points is not safe and is not advisable
6. One of the following statements is not correct. Indicate the incorrect statement:
(a) Moxibustion is used mainly in "Hot diseases", such as in acute cases of muscular rheumatism, arthritis; acute asthma and bronchitis; acute abdominal pain, enteritis and vomiting; acute pyometra and metritis; acute tendinitis, lymphangitis and pain.
(b) Thermostatically heated probes at 80oC have been used to heat the points. They are safe if checked regularly and not applied too strongly or too long
(c) Other methods of heating the points include ultraviolet rays, infrared rays and microwaves
(d) Moxibustion is used in 4 ways: Non-scarring method; moxa-needle; scarring method; festering method. The latter two methods are not acceptable in western-style practise
(e) Moxibustion by burning alcohol on the moistened skin is not acceptable in western vet practise
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) Cold laser (power <50 mW/cm2) in the red visible range (He-Ne lasers and ruby laser) or in the invisible range (infra-red) can be a useful means of stimulating superficial AP points.
(b) Lasers emitting <10 mW/cm2 are powerful enough to reach deep trigger points in large animals
(c) Most He-Ne and I-R lasers, even those emitting <5 mW/cm2, are effective in treating superficial disorders (cuts, bruises, granuloma, ulcers, wounds).
(d) Pulsed lasers (especially those interrupted 2000-10000 times/second (Hz) penetrate deeper than unpulsed lasers.
(e) Treatment time depends on emission power. With 30-50 mW lasers, dose time is very short, 10-60 seconds per point.
(f) The use of cold laser in conventional veterinary practice (as a therapy for tissue trauma, wounds, granuloma, myositis, tendinitis etc) is growing rapidly.