title: [Study on angle and depth of needle insertion in acupuncture at Zusanli (ST 36)].
abstract: OBJECTIVE
  To provide an appropriate angle and depth of needle insertion in acupuncture at Zusanli (ST 36) and avoid injuring the nerve and blood vessel and exert the most effect.
  
  
  METHODS
  Eighty adult lower-limb samples were used to dissect and observe the relative layered structures and adjoining important nerves and blood vessels in needling Zusanli (ST 36) according to the national standard.
  
  
  RESULTS
  The needling depth from the skin to the interosseous membrane and from the skin to posterior border of tibialis posterior is (2.22 +/- 0.31) cm and (4.42 +/- 0.53) cm, respectively. There are flabellate branches of anterior tibial arteries and deep peroneal nerves around the needle in the superficial layer of interosseous membrane. The vessel and nerve bundles containing tibial nerve and posterior tibial vessels can be touched when the needle body past through tibialis posterior.
  
  
  CONCLUSIONS
  It is recommended that ideal average depth of acupuncture is 2.22 cm and the maximum depth is 4.42 cm for oblique needling Zusanli (ST 36). When it is injected, the needle should be perpendicularly inserted or deviated slightly to the direction of tibia and paralleled to medial surface of tibia. And the safe needling depth is generally less than 5 cm. The point of the body surface between tibialis anterior and extensor digitorum longus at 3 cun below Dubi (ST 35) is also an effectively stimulating point.
authors.affiliation: Department of Anatomy, Wenzhou Medical College, Zhejiang 325035, China. wylxf@wzmc.net
authors.forename: Xin-fa
authors.initials: XF
authors.lastname: Lou
authors.forename: Xin-dong
authors.initials: XD
authors.lastname: Yang
authors.forename: Song-he
authors.initials: SH
authors.lastname: Jiang
authors.forename: Chen-you
authors.initials: CY
authors.lastname: Sun
authors.forename: Rui-feng
authors.initials: RF
authors.lastname: Zhang
mesh_terms: D015669:Acupuncture Points; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D013977:Tibia / Q000033:anatomy & histology