CHAPMAN REFLEX POINTS

ORGAN ANTERIOR POINT(S) POSTERIOR POINT(S)

HEENT
Sinuses Inferior to medial clavicles Upon C2 midway between the SP &
tip of the TP
Pharynx 3-4cm medial to where 1st ribs emerge Upon C2 midway between the SP &
from beneath the clavicles tip of the TP
Larynx 5-7cm lateral to sternocostal junction Upon C2 midway between the SP &
upon 2nd ribs tip of the TP
st nd
Tonsils Between 1 & 2 ribs adjacent to sternum Upon C1 midway between the SP &
tip of the TP
Middle ear Superior anterior aspect of clavicles just Posterior aspect of tips of TPs of C1
st
lateral to where they cross 1 ribs
Eye 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 Between T2 & T3 midway between
sternocostal junction SP & tip of TP
RESPIRATORY
Bronchi Intercostal space between 2nd & 3rd ribs at T2 midway between SP & tip of TP
sternocostal junction
Upper Lung Intercostal space between the 3rd & 4th Space between the TPs of T3 & T4,
ribs at the sternocostal junction midway between the SP & tip of the
TP
Lower Lung Intercostal space between the 4th & 5th Space between the TPs of T4 & T5,
ribs at the sternocostal junction midway between the SP & tip of the
TP
UPPER GI
Esophagus Intercostal space between the 2nd & 3rd Upon T2, midway between the SP
ribs at the sternocostal junction & tip of the TP
Stomach Intercostal spaces between the 5th & 6th Between the TPs of T5 & T6, midway
acidity ribs, from the mid-mammillary line on the between the SPs & tips of the TPs on
(left) left to the sternum the left
Stomach Intercostal spaces between the 6th & 7th ribs, Between the TPs of T6 & T7, midway
peristalsis from the mid-mammillary line on the left to between the SPs & tips of the TPs on
(left) the sternum the left
Pylorus Front of the sternum from the 10th rib at the costotransverse
sternomanubrial junction inferiorly to the junction on the right
xyphoid process
Duodenum Intercostal spaces between the 8th & 9th Space between the TPs of T8 & T9
ribs near the costochondral junctions midway between the SPs & tips of
the TPs
Pancreas Intercostal space between the costal Between the TPs of T7 & T8,
(right) cartilages of the 7th & 8th ribs midway between the tips of the SPs
& TPs
Liver/GB Intercostal spaces between the 5th, 6th, & Between the TPs of T5, T6, & T7,
(right) 7th ribs, from the mid-mammillary line to midway between the tips of the SPs
the sternum & TPs
Spleen (left) Intercostal spaces between the 7th & 8th Between the TPs of T7 & T8,
ribs near the costochondral junction 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
Cecum Laterally upon the upper 1/5th of the right
thigh, anteriorly on the tensor fascia lata
Ascend. Colon Laterally upon the middle 3/5ths of the
right thigh, on the anterior aspect of the
IT tract
Rt Trans. Proximal to the right knee, laterally upon
Colon the anterior aspect of the IT tract
Lt Trans. Proximal to the left knee, laterally upon
Colon the anterior aspect of the IT tract
Descen. Colon Laterally upon the middle 3/5ths of the left
thigh on the anterior aspect of the IT tract
Sigmoid Laterally upon the upper 1/5th of the left
thigh, anteriorly on the tensor fascia lata
Rectum Proximal inner thighs over the lesser
trochanters
Hemorrhoids Immediately above ischial tuberosities
URINARY
Kidney One inch above the umbilicus, laterally
on either side of the midline
Bladder Surrounding the umbilicus
Urethra 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 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
Ovaries Anterior surface of the pubic bone, from
the pubic tubercle inferiorly to the origin
of the adductor muscles
Uterus Medial margins of the obturator foramina
ENDOCRINE
Thyroid Intercostal space between the 2nd & 3rd
ribs, close to the sternum
Adrenal 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.