CHAPMAN REFLEX POINTS ORGAN HEENT Sinuses
Pharynx Larynx Tonsils Middle ear Eye
ANTERIOR POINT(S)
Inferior to medial clavicles
Upon C2 midway between the SP & tip of the TP st 3-4cm medial to where 1 ribs emerge Upon C2 midway between the SP & from beneath the clavicles tip of the TP 5-7cm lateral to sternocostal junction Upon C2 midway between the SP & nd upon 2 ribs tip of the TP st nd Between 1 & 2 ribs adjacent to sternum Upon C1 midway between the SP & tip of the TP Superior anterior aspect of clavicles just Posterior aspect of tips of TPs of C1 st lateral to where they cross 1 ribs Anterior aspect of humerus at level of Squamous portion of occipital bone surgical neck below the superior superior nuchal line
CARDIAC Heart
Intercostal space between 2nd & 3rd ribs at sternocostal junction RESPIRATORY Bronchi Intercostal space between 2nd & 3rd ribs at sternocostal junction Upper Lung Intercostal space between the 3rd & 4th ribs at the sternocostal junction junction Lower Lung
UPPER GI Esophagus
Stomach acidity (left) Stomach peristalsis (left) Pylorus
Duodenum
Pancreas (right) Liver/GB (right) Spleen (left)
POSTERIOR POINT(S)
Intercostal space between the 4th & 5th ribs at the sternocostal junction junction
Between T2 & T3 midway between SP & tip of TP T2 midway between SP & tip of TP Space between the TPs of T3 & T4, midway between the SP & tip of the TP Space between the TPs of T4 & T5, midway between the SP & tip of the TP
Intercostal space between the 2nd & 3rd Upon T2, midway between the SP ribs at the sternocostal junction junction & tip of the TP th Intercostal spaces between the 5 & 6th Between the TPs of T5 & T6, midway ribs, from the mid-mammillary line on the between the SPs & tips of the TPs on left to the sternum the left th th Intercostal spaces between the 6 & 7 ribs, Between the TPs of T6 & T7, midway from the mid-mammillary line on the left to between the SPs & tips of the TPs on the sternum the left Front of the sternum from the 10th rib at the costotransverse costotransverse sternomanubrial sternomanubrial junction inferiorly to the junction on the right xyphoid process Intercostal Intercos tal spaces between the 8th & 9th Space between the TPs of T8 & T9 ribs near the costochondral costochondral junctions midway between the SPs & tips of the TPs Intercostal space between the costal Between the TPs of T7 & T8, th th cartilages of the 7 & 8 ribs midway between the tips of the SPs & TPs th th Intercostal spaces between the 5 , 6 , & Between the TPs of T5, T6, & T7, th 7 ribs, from the mid-mammillary line to midway between the tips of the SPs the sternum & TPs th th Intercostal spaces between the 7 & 8 Between the TPs of T7 & T8, ribs near the costochondral costochondral junction midway between the tips of the SPs & TPs
LOWER GI Jejunum
Intercostal space between the 9th & 10th ribs near the costochondral costochondral junctions
Ileum
Intercostal space between the 10th & 11th ribs near the costochondral costochondral junctions
Appendix
Near the tip of the 12th rib on the right upon its superior edge Laterally upon the upper 1/5th of the right thigh, anteriorly on the tensor fascia lata
Cecum
Ascend. Colon
Rt Trans. Colon Lt Trans. Colon Descen. Colon Sigmoid Rectum Hemorrhoids URINARY Kidney
Bladder Urethra
Laterally upon the middle 3/5ths of the right thigh, on the anterior aspect of the IT tract Proximal to the right knee, laterally upon the anterior aspect of the IT tract Proximal to the left knee, laterally upon the anterior aspect of the IT tract Laterally upon the middle 3/5ths of the left thigh on the anterior aspect of the IT tract Laterally upon the upper 1/5th of the left thigh, anteriorly on the tensor fascia lata Proximal inner thighs over the lesser trochanters Immediately above ischial tuberosities
One inch above the umbilicus, laterally on either side of the midline Surrounding the umbilicus Superior aspect of the pubic symphysis symphysis
Space between the TPs of T9 & T10, midway between the SPs & tips of the TPs Space between the TPs of T10 & T11, midway between the SPs & tips of the TPs Space between the tips of the TPs of T11 & T12 on the right Triangular area, from the TP of L2 to the TP of L4 & extending laterally to the iliac crest Same as above
Same as above Same as above Same as above Same as above Sacrum, close to the ilium at the lower end of the SI articulation Sacrum, close to the ilium at the lower end of the SI articulation Between the TPs of T12 & L1, midway between the tips of the SPs & TPs Superior edges of the TPs of L2 Superior edges of the TPs of L3
REPRODUCTIVE Uterine tubes/ Posteriorly, midway between the Seminal acetabulum & sciatic notch vesicle Clitoris/Vagina Clitoris/Vagina Distal medial thigh, 7 to 13 cm on the upper, inner aspect of the posterior thigh
Prostate
Ovaries
Uterus
ENDOCRINE Thyroid
Adrenal
Lateral aspect of the thighs in a similar distribution to that of the colon, from the trochanter downward on the outer aspect of the femur to within 2 inches of the knee joint laterally Anterior surface of the pubic bone, from the pubic tubercle inferiorly to the origin of the adductor muscles Medial margins of the obturator foramina
Intercostal space between the 2nd & 3rd ribs, close to the sternum 5-7 cm above & 2-3 cm on either side of the umbilicus
Between the posterior superior iliac spine of the ilium & TP of L5 on the iliolumbar ligament Between the posterior superior iliac spine of the ilium & TP of L5 on the iliolumbar ligament Between the posterior superior iliac spine of the ilium & TP of L5 on the iliolumbar ligament
Intertransverse spaces between T9, T10, & T11 Between the posterior superior iliac spine of the ilium & TP of L5 on the iliolumbar ligament T2, midway between the SP & tip of the TP Intertransverse spaces between T11 & T12, midway between the tips of the SPs & TPs
Note:
Esophagus, bronchi, thyroid, & heart share the same points. Pharynx, larynx, & sinuses share same posterior points. All points are found bilaterally except where indicated differently (Stomach (Stomach & Pylorus, Appendix, Spleen, Pancreas, Gallbladder)
Sources: Nelson KE, Allgeier Allgeier J. Chapter 7: Viscerosomatic Viscerosomatic Reflexes and and Somatovisceral Somatovisceral Influences. In: In: Nelson KE, nd Glonek T, eds. Somatic Dysfunction in Osteopathic Family Medicine. 2 Ed. Baltimore, MD: Lippincott Williams & Wilkins; 2015. Fossum C, Kuchera ML, Devine WH, Wilson K. Chapter 52G: Chapman’s Approach. In: Chila A, Carreiro JE, et al, eds. Foundations eds. Foundations of Osteopathic Medicine. 3 Medicine. 3rd Ed. Baltimore, MD: Lippincott Williams & Wilkins; 2011. Beatty, DR. Chapter 12: Visceral Diagnosis and Treatment. In: Beatty DR, ed. The Pocket Manual of OMT . 2nd Ed. Philadelphia, Philadelphia, PA: Lippincott Williams & Wilkins; 2011.
