H2 Great Auricular Cutaneous

Forward Head Posture Fix

Forward Head Posture Fix

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The great auricular nerve is the site of one of the most important ARPs in the human body. Its location is crucial for the balance of head weight and therefore to the balance of the entire head. The importance of this nerve can be understood from its relation to the homeostasis of both mechanical posture and systemic physiology. However, the vas-culature related to this point challenges clinicians because of safety concerns.

This point is located just behind the earlobe and on the anterior border of the sternocleidomastoid muscle. It is one of the four branches of the cervical nerve plexus. Four cutaneous branches from the cervical plexus emerge around the middle of the posterior border of the sternocleidomastoid muscle (Fig. 8-14).

The greater auricular nerve curves over and ascends obliquely toward the earlobe and the angle of the mandible. This nerve bundle surfaces through the investing fascia just below the earlobe and divides into branches to supply the skin on the inferior part of the ear and the area extending from the mandible to the mastoid process.

The H2 greater auricular ARP is sensitive in almost every patient. However, needling this point often causes bleeding because the external jugular vein descends just beside the greater auricular nerve. If the external jugular vein is prominent throughout its course, this is a sign that venous pressure is elevated owing to heart problems; in such cases, to avoid an accident such as a venous air embolism, this point should not be needled. A fine needle of gauge 36 or 38 (0.20- or 0.18-mm diameter) may be used to needle this point, with a needling depth of about 5 to 8 mm.

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