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[6] [7]
limbs because SPs in the lower limbs do of the emerging nerve .
not correspond to vessels or nerves. In the upper limbs, SSP2 and SSP3 cor-
The entering points of nerves in the respond to the points of the 5th to 7th cervi-

muscles of the upper limbs were found at cal spinal nerve roots located between the
OSP1 (nerve to teres minor), OSP2 (RN), and scalenus anterior and the scalenus medius
ISP5 (AIA and AIN), a similar pattern to that muscles. This pattern was not found in the
[7]
observed with OSP4 (nerve to short head of lower limbs .
[7]
biceps femoris) in the lower limbs . All of the findings of this study parallel

Arteries were found at several points in those of Chantawang and Somana, who found
the upper limb, namely ISP1 (AA), ISP3 (BA), that CTTM SPs and BLs always relate to ana-
[7]
ISP4 (RA and UA), SSP4 (subclavian) and SSP5 tomical structures in the lower limbs .
(AA), with these points running along the
Conclusion
direction of the vessels. This was confirmed
by pressing each of the points, this leading This study revealed that upper limb SPs

to a decrease of the radial arterial pulse. A and BLs used in CTTM correspond to or are
similar effect had been noticed at ISP2 (femo- associated with various anatomical structures,
ral artery, FA), ISP3 (FA) and OSP5 (anterior especially nerves roots and nerves, blood ves-

tibial artery) in the lower limbs, with press- sels and muscles. This study focused on the
ing at these points leading to a decrease in upper limbs as therapeutic massage is fre-

the posterior tibial and dorsalis pedis arterial quently administered to these parts in a simi-
[4]
pulse, respectively . Massage at these points lar manner to the lower limbs. The results of
should be done with care in patients because this study support the practice of using

it may damage the arteries, nerves and lymph hand(s) and thumb(s) to press on these points,
[7]
nodes . SPs and BLs in CTTM. Information presented

In the upper limbs, the points of the here should be valuable in establishing stan-
artery and nerve emerged from the distal dard practice guidelines for CTTM.
border of muscles and gave branches to sup-
Acknowledgment
ply the surrounding muscles. This was found
at OSP5 (PIN and PIA emerges from the This study was funded by a grant from
muscle supinator). In the lower limbs, this Mahasarakham University Faculty of Medi-

pattern was not present because the SPs in cine in 2016. The authors thank Dr. Tim
the lower limb do not correspond to the points Cushnie for language-editing assistance.