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Chapman Points Table


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CHAPMAN REFLEX POINTS


ORGAN ANTERIOR POINT(S) POSTERIOR POINT(S)
HEENT
Sinuses Inferior to medial clavicles Upon C2 midway between t
tip of the TP
Pharynx 3-4cm medial to where 1st ribs emerge Upon C2 midway between t
from beneath the clavicles tip of the TP
Larynx 5-7cm lateral to sternocostal junction Upon C2 midway between t
upon 2nd ribs tip of the TP
Tonsils Between 1st & 2nd ribs adjacent to sternum Upon C1 midway between t
tip of the TP
Middle ear Superior anterior aspect of clavicles just Posterior aspect of tips of T
st

Eye lateral
Anteriorto aspect
where of
they cross 1atribs
humerus level of Squamous portion of occipit
surgical neck below the superior nuchal li
CARDIAC
Heart Intercostal space between 2nd & 3rd ribs at Between T2 & T3 midway b
sternocostal junction SP & tip of TP
RESPIRATORY
Bronchi Intercostal space between 2nd & 3rd ribs at T2 midway between SP & ti
sternocostal junction
Upper Lung Intercostal space between the 3rd & 4th Space between the TPs of T
ribs at the sternocostal junction midway between the SP & t
TP
Lower Lung Intercostal space between the 4th & 5th Space between the TPs of T
ribs at the sternocostal junction midway between the SP & t
TP
UPPER GI
Esophagus Intercostal space between the 2nd & 3rd Upon T2, midway between
ribs at the sternocostal junction & tip of the TP
Stomach Intercostal spaces between the 5 th & 6th Between the TPs of T5 & T6,
acidity ribs, from the mid-mammillary line on the between the SPs & tips of the
(left) left to the sternum the left
Stomach Intercostal spaces between the 6 th & 7th ribs, Between the TPs of T6 & T7,
peristalsis from the mid-mammillary line on the left to between the SPs & tips of the
(left) the sternum the left
Pylorus Front of the sternum from the 10th rib at the costotransvers
sternomanubrial junction inferiorly to the junction on the right
xyphoid process
Duodenum Intercostal spaces between the 8th & 9th Space between the TPs of T
ribs near the costochondral junctions midway between the SPs &
the TPs
Pancreas Intercostal space between the costal Between the TPs of T7 & T
(right) cartilages of the 7th & 8th ribs midway between the tips of
& TPs
Liver/GB Intercostal spaces between the 5th, 6th, & Between the TPs of T5, T6,
(right) 7th ribs, from the mid-mammillary line to midway between the tips of
the sternum & TPs
Spleen (left) Intercostal spaces between the 7th & 8th Between the TPs of T7 & T
ribs near the costochondral junction midway between the tips of
& TPs

LOWER GI
Jejunum Intercostal space between the 9th & 10th Space between the TPs of T
ribs near the costochondral junctions T10, midway between the S
tips of the TPs
Ileum Intercostal space between the 10th & 11th Space between the TPs of T
ribs near the costochondral junctions T11, midway between the S
tips of the TPs
Appendix Near the tip of the 12th rib on the right Space between the tips of th
upon its superior edge T11 & T12 on the right
Cecum Laterally upon the upper 1/5th of the right Triangular area, from the TP
thigh, anteriorly on the tensor fascia lata to the TP of L4 & extending
laterally to the iliac crest
Ascend. Colon Laterally upon the middle 3/5ths of the Same as above
right thigh, on the anterior aspect of the
IT tract
Rt Trans. Proximal to the right knee, laterally upon Same as above
Colon the anterior aspect of the IT tract

Lt Trans.
Colon Proximal to aspect
the anterior the leftof
knee, laterally
the IT tract upon Same as above
Descen. Colon Laterally upon the middle 3/5ths of the left Same as above
thigh on the anterior aspect of the IT tract
Sigmoid Laterally upon the upper 1/5th of the left Same as above
thigh, anteriorly on the tensor fascia lata
Rectum Proximal inner thighs over the lesser Sacrum, close to the ilium a
trochanters lower end of the SI articulat
Hemorrhoids Immediately above ischial tuberosities Sacrum, close to the ilium a
lower end of the SI articulat
URINARY
Kidney One inch above the umbilicus, laterally Between the TPs of T12 & L
on either side of the midline midway between the tips of
& TPs
Bladder Surrounding the umbilicus Superior edges of the TPs o
Urethra Superior aspect of the pubic symphysis Superior edges of the TPs o

REPRODUCTIVE
Uterine tubes/ Posteriorly, midway between the Between the posterior superio
Seminal acetabulum & sciatic notch spine of the ilium & TP of L5
vesicle iliolumbar ligament
Clitoris/Vagina Distal medial thigh, 7 to 13 cm on the Between the posterior superio
upper, inner aspect of the posterior thigh spine of the ilium & TP of L5
iliolumbar ligament
Prostate Lateral aspect of the thighs in a similar Between the posterior superio
distribution to that of the colon, from the spine of the ilium & TP of L5
trochanter downward on the outer aspect iliolumbar ligament
of the femur to within 2 inches of the
knee joint laterally
Ovaries Anterior surface of the pubic bone, from Intertransverse spaces betwee
the pubic tubercle inferiorly to the origin T10, & T11
of the adductor muscles
Uterus Medial margins of the obturator foramina Between the posterior superio
spine of the ilium & TP of L5
iliolumbar ligament
ENDOCRINE
Thyroid Intercostal space between the 2nd & 3rd T2, midway between the SP &
ribs, close to the sternum the TP
Adrenal 5-7 cm above & 2-3 cm on either side of Intertransverse spaces betwee
the umbilicus & T12, midway between the t
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
Spleen, Pancreas, Gallbladder)

Sources:
Nelson KE, Allgeier J. Chapter 7: Viscerosomatic Reflexes and Somatovisceral Influences. In
Glonek T, eds. Somatic Dysfunction in Osteopathic Family Medicine. 2nd Ed. Baltimo
Lippincott Williams & Wilkins; 2015.
Fossum C, Kuchera ML, Devine WH, Wilson K. Chapter 52G: Chapman’s Approach. In: Chi
JE, et al, eds. Foundations of Osteopathic Medicine. 3rd Ed. Baltimore, MD: Lippinco
Wilkins; 2011.
Beatty, DR. Chapter 12: Visceral Diagnosis and Treatment. In: Beatty DR, ed. The Pocket Ma
2nd Ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011.
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