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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: Chapmans 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.

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