Verscienta
CV22

Tiantu

Star

天突 (Tiāntū) — Celestial Chimney

Ren (Conception) channel · point 22

Not yet clinically reviewed

Window of Heaven pointMeeting point of the Ren Mai with the Yin Wei Mai

Traditionally used for

  • Nose & throat
  • Cough & breathing
  • Digestion

Cautions & contraindications

  • Avoid blood vessels

Location

On the neck, on the anterior midline, in the centre of the suprasternal fossa.

How to locate: With the patient supine with a pillow under the shoulders, or seated with the head supported, find the centre of the suprasternal fossa between the medial ends of the clavicles; the point is in this hollow above the upper border of the sternum.

Distances are in cun, a proportional unit — how to measure.

Body map, front: CV22 · Front of neck
Fig. — CV22 · Front of neck After Albinus, 1747
Body map, front: CV22 · Front of neck

CV22 · Front of neck · Albinus, Tabulae sceleti et musculorum, 1747

3D view

Approximate placement, carried over from our 2D body map onto a single adult male model (BodyParts3D) and checked against the point's location text. Shown on one side of the body. Locate the point on your patient by the location text and palpation, not by this model.

Structures highlighted
Trachea (Airway): “CV 22 tiantu, in front of the trachea” — World Health Organization, Section II §5.2 (Other points), p. 25.
Needle angle and depth
  1. Perpendicular — not drawn: WHO gives no proportional measurement for this part of the body.
  2. Perpendicular, then directed inferiorly along the posterior border of the manubrium of the sternum — not drawn: WHO gives no proportional measurement for this part of the body.
  • The lung is not drawn: the anatomical model used here does not include it as a surface. This is a limit of the model, not of the anatomy. The pneumothorax risk above still applies.

3D anatomy: BodyParts3D, © The Database Center for Life Science licensed under CC Attribution 4.0 International (licence). Subset, simplified and recoloured by Verscienta — changes and licence details.

Needling

Cited needling

  • ⚠ Pneumothorax
  • ⚠ Airway

Techniques — the source gives these as alternatives:

  1. Perpendicular insertion
    Depth 0.3–0.3 cun
    skindeeper
  2. Perpendicular insertion — then directed inferiorly along the posterior border of the manubrium of the sternum
    Depth 0.5–1 cun
    skindeeper

    With the neck extended (head pillow removed), first needle perpendicularly 0.2 to 0.3 cun, then redirect inferiorly behind the manubrium.

Reported mean safe needling depth, mm — Taiwanese adults (CT)
UnderweightNormalOverweight
Men 23.4 28.7 39.4
Women 30.1 36.9 44.6

CT-measured mean safe needling depths from Taiwanese adults, by sex and body size (Lin et al. 2013); population-specific and a guide only — adjust to the patient in front of you. Case reports: pneumothorax after needling at this point (2 cases in Wu et al. 2015).

Depths describe average adult habitus in the cited population, never a single safe number for the patient in front of you. Palpate and adjust.

Sources (4)
  1. World Health Organization. Guidelines on basic training and safety in acupuncture. Geneva: WHO; 1999. WHO/EDM/TRM/99.1 — Section II §5.2 (Other points), p. 25 Supports: airway (names this point)
  2. Lin JG, Chou PC, Chu HY. An exploration of the needling depth in acupuncture: the safe needling depth and the needling depth of clinical efficacy. Evid Based Complement Alternat Med. 2013;2013:740508 — Tables 7 (male) and 8 (female), chest acupoints Supports: safe depth (measured)
  3. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S. Systematic review of adverse effects: a further step towards modernization of acupuncture in China. Evid Based Complement Alternat Med. 2015;2015:432467 — Table 1 (Pneumothorax associated with acupuncture) Supports: pneumothorax (case report)
  4. Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. Hove: Journal of Chinese Medicine Publications; 1998 — p. 522 Supports: techniques (names this point)

Site notes · not cited

  • Avoid blood vessels
Depth: 0.2 cun perpendicular, then 0.5–1.0 cun directed inferiorly behind the sternum
Angle: Insert perpendicularly to 0.2 cun, then redirect the needle inferiorly and posteriorly, keeping it close behind the manubrium
⚠ Cautions: High-risk point. The trachea lies directly beneath and the great vessels lie deep — never angle the needle posteriorly or laterally once past the skin. Keep the shaft against the back of the sternum.

Functions

  • Descends rebellious Lung qi and relieves cough and wheezing
  • Benefits the throat and the voice
  • Dissipates phlegm nodules

Indications

Cough, asthma and wheezingsore throat and loss of voicea lump sensation in the throat (plum-pit qi)goitrehiccupdifficulty swallowing

Clinical Notes

The primary point for acute asthma and for plum-pit qi. The two-stage insertion angle is not optional; a perpendicular deep needle here can enter the trachea.

Similar Points

Tianding how are these connected? (Tianding)

Sources

  • World Health Organization. WHO Standard Acupuncture Point Locations in the Western Pacific Region. Manila: WHO Regional Office for the Western Pacific, 2008. (Location.)
  • Focks C, ed. Atlas of Acupuncture. Edinburgh: Churchill Livingstone Elsevier, 2008. (Locating method and actions.)

📝 Notes

Public notes from the community and your own private notes on CV22 Tiantu.

No notes yet.

Log in or register to add your own notes.

Back to Points