3.Renying（ST 9）

【Location】In the anterior region of neck，at the level of the thyroid cartilage，on the anterior border of the sternocleidomastoid m..

【Manipulation Method】Avoid the carotid a.，puncture perpendicularly 0.3-0.8 cun.

【Indications】Sore throat，fullness in the chest，scrofula，goiter，headache，dizziness.

【Stratified anatomy】（Fig.2-3）

（1）Skin The skin is distributed by transverse cervical n..

（2）Subcutaneous tissue There are the branches of transverse cervical n.and platysma.

（3）Superficial layer of cervical fascia The deep fascia surrounding stemocleidomastoid and trapezius.

（4）Constrictor m.of pharynx The constrictor m.of pharynx mainly attaches to the thyroid cartilage，and it is the component of composing the muscular layer of the posterior pharyngeal wall.

【Adjacent structures】

（1）Sternocleidomastoid and superior belly of omohyoid The sternocleidomastoid and superior belly of omohyoid are respectively located in the posterior-lateral and anteriormedial position of needling.

（2）Carotid sheath The carotid sheath is the deep fascia sheath surrounding the common carotid a.，the internal carotid a.，the internal jugular v.and the vagus n..It is located in the posterior-lateral position of needling and covered by the sternocleidomastoid rightly.

（3）Deep structures of the carotid sheath The deep structures of carotid sheath include the sympathetic trunk，the deep neck muscle，the vertebral a.，the fourth cervical vertebra and so on.

【Cautions】If the needling direction is more lateral，the common carotid a.can be needleinserted and the needle point can be touched with the obvious pulsation.At this moment，the needle shall be removed.If the needling direction is extremely lateral，the internal jugular v.can be needle-inserted and then so does the vagus n..If there are the excessive manipulating methods of lifting，thrusting，twirling and rotating or the larger electrical current flow and faster frequency of electrical needling，the patients can have the vagus n.reactions such as palpitation，stuffy chest and pale complexion.The needle shall be removed immediately at this moment.Otherwise，there is a serious consequence even death.Hence，the needling direction shall not be more outward while the more deep insertion and excessive manipulating methods shall be avoided. o1gvSPjrW2B1G22G15XB4Ds2Or+P8Dut2nwQST3XjjuCL5ov2DEc/qu1LBFG1kQU