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 3-4cm medial to where 1st 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 & upon 2nd 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 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 Lower Lung UPPER GI Esophagus Stomach acidity (left) Stomach peristalsis (left) Pylorus Duodenum Intercostal space between the 4th & 5th ribs at the sternocostal junction Intercostal space between the 2nd & 3rd ribs at the sternocostal junction Intercostal spaces between the 5th & 6th ribs, from the mid-mammillary line on the left to the sternum Intercostal spaces between the 6th & 7th ribs, from the mid-mammillary line on the left to the sternum Front of the sternum from the sternomanubrial junction inferiorly to the xyphoid process Intercostal spaces between the 8th & 9th ribs near the costochondral junctions Pancreas (right) Intercostal space between the costal cartilages of the 7th & 8th ribs Liver/GB (right) Intercostal spaces between the 5th, 6th, & 7th ribs, from the mid-mammillary line to the sternum Intercostal spaces between the 7th & 8th ribs near the costochondral junction Spleen (left) POSTERIOR POINT(S) 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 Upon T2, midway between the SP & tip of the TP Between the TPs of T5 & T6, midway between the SPs & tips of the TPs on the left Between the TPs of T6 & T7, midway between the SPs & tips of the TPs on the left 10th rib at the costotransverse junction on the right Space between the TPs of T8 & T9 midway between the SPs & tips of the TPs Between the TPs of T7 & T8, midway between the tips of the SPs & TPs Between the TPs of T5, T6, & T7, midway between the tips of the SPs & TPs Between the TPs of T7 & T8, midway between the tips of the SPs & TPs LOWER GI Jejunum Intercostal space between the 9th & 10th ribs near the costochondral junctions Ileum Intercostal space between the 10th & 11th ribs near the 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 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 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 & Pylorus, Appendix, Spleen, Pancreas, Gallbladder) Sources: Nelson KE, Allgeier J. Chapter 7: Viscerosomatic Reflexes and Somatovisceral Influences. In: Nelson KE, Glonek T, eds. Somatic Dysfunction in Osteopathic Family Medicine. 2nd 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 of Osteopathic 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, PA: Lippincott Williams & Wilkins; 2011.
