Chapman reflex points: the anterior map, made memorable

4 min read. Updated October 9, 2026.

Chapman reflex points are small, firm, tender nodules described in the deep fascia at recurring spots on the body wall, each linked to a particular organ. They are traditionally described as "gangliform": smooth, firm and only a few millimeters across. Most of what boards ask is on the front of the body, so this guide starts there.

The chest map

Anterior Chapman points by intercostal spacePatient's right, space 2: heart, thyroid, esophagus, bronchi; space 3: upper lung; space 4: lower lung; space 5: liver; space 6: liver, gallbladder; space 7: pancreas. Patient's left, space 2: heart, thyroid, esophagus, bronchi; space 3: upper lung; space 4: lower lung; space 5: stomach acidity; space 6: stomach peristalsis; space 7: spleen.Patient's rightPatient's left1234567Heart, thyroid, esophagus, bronchiUpper lungLower lungLiverLiver, gallbladderPancreasHeart, thyroid, esophagus, bronchiUpper lungLower lungStomach acidityStomach peristalsisSpleenNumbers on the sternum mark the intercostal spaces (the space below the rib of the same number).
Schematic, not to scale. Charts disagree on exact spots, and these points are a teaching model, not a diagnostic test.

Anterior view: the patient's right is on your left. The first number to anchor is the second intercostal space, right beside the sternum, which holds four organs at once.

Anterior points by region

Head and neck

OrganAnterior point
Middle earUpper border of the clavicle, toward its medial end where it crosses the first rib
SinusesUpper border of the second rib, a little lateral to the sternum (charts vary on the exact distance)
PharynxFirst rib, just below the sternoclavicular joint
TonsilsFirst intercostal space beside the sternum
Larynx and tongueSecond rib region beside the sternum (charts vary)
EyeFront of the humerus near the surgical neck

Chest

OrganAnterior point
Thyroid, esophagus, heart (myocardium), bronchiSecond intercostal space beside the sternum
Upper lungThird intercostal space beside the sternum
Lower lungFourth intercostal space beside the sternum

Upper abdomen

OrganAnterior point
LiverRight fifth and sixth intercostal spaces
GallbladderRight sixth intercostal space
PancreasRight seventh intercostal space
Stomach acidityLeft fifth intercostal space
Stomach peristalsisLeft sixth intercostal space
SpleenLeft seventh intercostal space
Small intestineEighth to tenth intercostal spaces near the costal margin, both sides
PylorusLower sternum toward the xiphoid (descriptions vary)

Around the umbilicus and pelvis

OrganAnterior point
AdrenalAbout 1 inch lateral and 2 inches above the umbilicus
KidneyAbout 1 inch lateral and 1 inch above the umbilicus
BladderAround the umbilicus
AppendixTip of the right twelfth rib
OvaryPubic tubercle region
UrethraSuperior pubic ramus, about 2 cm lateral to the symphysis
UterusInferior pubic ramus
RectumNear the lesser trochanter
Prostate and broad ligamentLateral thigh along the IT band

The colon on the IT bands

The colon is laid out along the front and side of both thighs, upside down:

  1. Top of the right thigh: cecum and ileocecal region.
  2. Down the right thigh: ascending colon to the hepatic flexure near the knee.
  3. Around both knees: transverse colon and its flexures.
  4. Up the left thigh from the knee: descending colon.
  5. Top of the left thigh: sigmoid colon.

This map is a schematic. It has nothing to do with the embryologic split of the transverse colon into a proximal two thirds (midgut) and a distal third (hindgut).

Posterior points

Most posterior points sit in the paraspinal tissue at the levels below. Course charts list them less consistently than the anterior points, and boards ask about them far less.

OrganPosterior region
Middle earC1, transverse process or posterior arch
Sinuses, pharynx, larynx, tongueC2
Thyroid, esophagus, bronchi, heartT2 to T2-T3
Upper lung / lower lungT3-T4 / T4-T5
Liver, stomach acidityT5-T6 on the same side
Gallbladder, stomach peristalsisT6-T7 on the same side
Pancreas, spleenT7-T8 on the same side
Small intestineT8-T11
Adrenal / kidney / bladderT11-T12 / T12-L1 / L1-L2
AppendixRight T11 region (other maps differ)
ColonL2-L4
RectumLateral mid-sacrum

How Chapman points relate to viscerosomatic reflexes

Chapman reflexes are a kind of viscerosomatic reflex: organ input showing up in the body wall. If a question asks what type of reflex a Chapman point is, the answer is viscerosomatic. What differs is the form. Classic viscerosomatic findings are segmental TART changes in the paraspinal tissue at the levels that supply an organ. Chapman points are discrete, mapped nodules: the anterior ones on the chest, abdomen and pelvis, the posterior ones in the paraspinal tissue. A tender nodule in an intercostal space points to a Chapman answer; boggy, restricted paraspinal segments point to the segmental map.

Frequently asked

What are Chapman reflex points?

Small, firm, tender nodules in the deep fascia at consistent spots, each traditionally linked to an organ. They are used in osteopathic teaching as a visceral reflex map, mostly on the front of the body.

Where is the Chapman point for the appendix?

At the tip of the right twelfth rib. It is separate from McBurney's point.

Where are the kidney and adrenal Chapman points?

Both are about 1 inch lateral to the umbilicus: the kidney point about 1 inch above it and the adrenal point about 2 inches above it.

How is the colon represented in Chapman reflexes?

Along the IT bands, upside down: cecum at the top of the right thigh, ascending colon down the right thigh, transverse colon near the knees, descending colon up the left thigh and sigmoid colon at the top of the left thigh.

Are Chapman points diagnostic?

No. They are a traditional teaching model with limited evidence. They cannot confirm or exclude disease, though exams still test their locations.

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