Title: Bone Wizardry / OMM Mastery / 11.Chapman points
Tags: #BW_OMM::Content::Mechanism #BW_OMM::Content::Viscerosomatic #BW_OMM::Type::Cloze BoneWizardry bonewizardry-free omm omt
On every note of this deck, unless a note says otherwise:
Review Links: - Bone Wizardry viscerosomatic reflexes
- Practice: Chapman Points QBank
Show outside sources
- StatPearls Chapman points
- NBOME OPP/OMT blueprint
- ACOFP osteopathic pain management

Q: Anterior chapman points:
Medial clavicle = [...]
A: Ear
Q: Anterior chapman points:
Lateral superior rib 1 = [...]
A: nose
Q: Anterior chapman points:
Medial superior rib 1 = [...]
A: pharynx
Q: Anterior chapman points:
1st rib interspace = [...]
A: tonsils
Q: Anterior chapman points:
Lateral rib 2 = [...]
A: sinus
Q: Anterior chapman points:
Medial rib 2 = [...]
A: larynx/tongue
Q: Anterior chapman points:
2nd rib interspace on the right = [...]
A: thyroid, bronchus, esophagus, and myocardium
Q: Anterior chapman points:
2nd rib interspace on the left = [...]
A: heart
Q: Anterior chapman points:
3rd rib interspace = [...]
A: upper lung
Topic: Chapman points
Bone Wizardry Lock: Head and neck Chapman points cluster near the clavicle and upper ribs. Laterality matters at the 2nd rib interspace: right = thyroid, bronchus, esophagus, myocardium; left = heart alone.

Q: Anterior chapman points:
4th rib interspace = [...]
A: lower lung
Q: Anterior chapman points:
5th rib interspace on the right = [...]
A: liver
Q: Anterior chapman points:
5th rib interspace on the left = [...]
A: stomach acid
Q: Anterior chapman points:
6th interspace on the right = [...]
A: liver and gallbladder
Q: Anterior chapman points:
6th rib interspace on the left = [...]
A: stomach motility
Q: Anterior chapman points:
7th rib interspace on the right = [...]
A: pancreas
Q: Anterior chapman points:
7th rib interspace on the left = [...]
A: Spleen
Q: Anterior chapman points:
8, 9, and 10th rib interspaces = [...]
A: small intestine
Q: Anterior chapman points:
tip of 12th rib = [...]
A: appendix
Comment 2: Make sense tho don't it, your liver is on the right
Comment 4: both on the right, liver is pretty big so it gets two spots.
Comment 9: Boards love the appendix
Topic: Chapman points
Bone Wizardry Lock: Liver claims two spots on the right (5th and 6th interspaces). Stomach claims two on the left (5th = acid, 6th = motility). Pancreas 7th right, spleen 7th left. Ribs 8 through 10 are all small intestine, no laterality needed.

Q: Anterior chapman points:
1 inch lateral and 2 inches superior to umbilicus = [...]
A: adrenal gland
Q: Anterior chapman points:
1 inch lateral and 1 inch superior to umbilicus = [...]
A: kidney
Q: Anterior chapman points:
Around umbilicus = [...]
A: bladder
Q: Anterior chapman points:
Pubic tubercle = [...] females only
A: ovary and urethra
Q: Anterior chapman points:
Lower innominate = [...]
A: uterus
Q: Anterior chapman points:
Anterior right thigh from proximal to distal = [...]
A: cecum, ascending and part of transverse colon
Q: Anterior chapman points:
Posterior lateral thigh = [...]
A: prostate
Q: Anterior chapman points:
Anterior left thigh from proximal to distal = [...]
A: last 1/3 of transverse to rectum
Q: Anterior chapman points:
Tip of coracoid = [...]
A: cerebellum
Comment: Adrenal gland is superior to the kidneys, so it makes sense that the chapman point is as well.
Topic: Chapman points
Bone Wizardry Lock: Below the umbilicus: adrenal 2 inches up, kidney 1 inch up, bladder at the navel ring. Right anterior thigh runs cecum, ascending, and part of transverse colon; left anterior thigh runs the last third of transverse colon to the rectum.

Q: Anterior chapman points:
[...] = [...]
A: Lateral superior portion of humerus; retina and conjunctiva
Topic: Chapman points
Bone Wizardry Lock: Lateral superior humerus to retina and conjunctiva is the outlier in the Chapman map. Not a gut organ. It will not fit the rib-interspace pattern, which is exactly why boards use it.

Q: Chapman's points are thought to represent [...] reflexes.
A: viscero-somatic
Comment: Therefore, a Chapman's point represents the somatic manifestation of a visceral dysfunction.
Topic: Chapman points
Bone Wizardry Lock: Chapman points are the somatic imprint of visceral disease. Treat the point and you break the viscerosomatic reflex arc at the musculoskeletal end, same arc that shows as segmental TART findings.

Q: Where is the posterior chapman's point for the appendix located?
[...]
A: TP of T11
Topic: Chapman points
Bone Wizardry Lock: Appendix gets two landmarks: anterior tip of 12th rib and posterior TP of T11. Boards favor the posterior one. Know both before the exam.

Q: [...]: a hypersensitive nodule within a taut band of skeletal muscle or fascia, locally painful on compression and capable of reproducing referred pain at a distance.
A: Travell's myofascial trigger point
Comment: Push on the taut band in clinic and you get two responses: pain right there at the spot, and a referred pattern that reproduces the patient's distant complaint. Autonomic signs like sweating can come with it.
Topic: Chapman points
Bone Wizardry Lock: Trigger points are a muscle finding, not lymphatic. Palpate for the taut band, compress it, and watch for referred pain. That referral map is what separates a trigger point from ordinary muscle soreness.

Q: Where is the trigger point for supraventricular tachyarrhythmias located?
[...]
A: right pectoralis muscle
Comment: Right pectoralis harbors a trigger point associated with supraventricular tachyarrhythmias. The taut band reproduces chest pain when compressed.
Topic: Chapman points
Bone Wizardry Lock: SVT plus anterior chest wall tenderness points to right pectoralis trigger point. If the board stem gives you tachycardia with a musculoskeletal finding, think trigger point before Chapman.

Name some common techniques used to treat trigger points:
1. Spray and stretch
2. Injection with local anesthetic/dry needling
3. Muscle energy
4. MFR
5. Reciprocal inhibition
Topic: Chapman points
Bone Wizardry Lock: Spray and stretch is the classic noninvasive first step. Dry needling and local anesthetic injection target the same taut band by different means. Muscle energy and reciprocal inhibition work through neurological inhibition of the agonist-antagonist pair.

Q: What is the difference between a trigger point and a tenderpoint?
[...]
A: Trigger points refer pain when pressed, tenderpoints do not
Topic: Chapman points
Bone Wizardry Lock: The one-line separator: trigger points refer pain to a distance, tenderpoints stay local when pressed. Travell = trigger. Jones = tenderpoint. Two different systems that both show up on boards.