Chapman's points

Question 1

Pain characteristics applicable to chapman’s point

Answer 1

pinpoint, sharp, non-radiating

located under the physician’s finger tip

pain is greater than expected

patient is usually unaware of the sore spot

Question 2

Chapman steps

Answer 2

firm pressure with finger pad of one finger

apply somewhat heavy or uncomfortable pressure to gangliform mass

slowly move tip of finger in circular fashion (attempt to flatten the mass as if to mobilize a localized fluid accumulation)

continue the moving pressure for 10-30 seconds

can alternate clockwise/counter-clockwise

Question 3

when to cease chapman

Answer 3

mass disappears
or
Pt/physician cannot tolerate treatment any longer

Question 4

a nontender chapman reflex

Answer 4

indicates nothing by itself

Question 5

never ignore a tender chapman reflex

Answer 5

unless you have a good explanation for the findings

Question 6

chapman contraindications

Answer 6

anytime a pt is in emergent care

patient refusal

relative contraindication with fracture/cancer/inpatient instability

Question 7

post treatment instructions for chapman

Answer 7

may be some post-treatment pain/discomfort.

drink plenty of water over next 24 hours

may take normal pain management drugs

rest

Question 8

arms chapman

Answer 8

anterior
none

posterior

Superior medial border of scapula
C2 lateral to spinous process

Question 9

middle ear

Answer 9

anterior: superior medial 1/3 of clavicle
posterior: occiput 2cm lateral from midline

Question 10

larynx

Answer 10

Anterior:
On rib 2 at costochondral junction

Posterior:
Lateral to spinous process of C2

Question 11

sinuses

Answer 11

Anterior
Superior border of rib 2, inferior medial clavicle

Posterior
Below occiput, lateral to spinous process of C2

Question 12

tonsils

Answer 12

anterior
between ribs 1/2 just lateral to the manubrium

posterior:
none

Question 13

retina/conjunctiva

Answer 13

anterior
lateral humerus

posterior
none

Question 14

tongue

Answer 14

anterior
medial rib 2 at costochondral juntion

posterior
Lateral to spinous process of C2

Question 15

Spleen

Answer 15

anterior
between ribs 7/8 at the costochondral junction on THE LEFT

posterior
lateral to spinous process of T7 on THE LEFT

Question 16

Tonsils

Answer 16

Anterior
between ribs 1/2 just lateral to manubrium

posterior
none

Question 17

esophagus

Answer 17

anterior
between ribs 2/3 parasternally

posterior
lateral to T2 spinous process

Question 18

stomach

Answer 18

LEFT
Anterior
Between ribs 5/6 & 6/7 at costochondral
junction

Posterior
Lateral to T5 & T6 spinous processes

Question 19

liver

Answer 19

RIGHT

Anterior
Between ribs 5/6 & 6/7 at costochondral
junction

Posterior
Lateral to T5 & T6 spinous processes

Question 20

gallbladder

Answer 20

RIGHT

Anterior
Between ribs 6/7 at costochondral
junction

Posterior
Lateral to T6 spinous processes

Question 21

pancreas

Answer 21

RIGHT

Anterior
Between ribs 7/8 at costochondral
junction

Posterior
Lateral to T7 spinous processes

Question 22

small intestines

Answer 22

BILATERALLY

anterior

between ribs 8/9 9/10 10/11 at costochondral junction

posterior

lateral to T8, T9, and T10 spinous process

Question 23

intestine peristalsis

Answer 23

BILATERALLY

anterior
lateral to AIIS

posterior
superior surface of rib 11, medial to the rib angle

Question 24

Appendix

Answer 24

RIGHT

anterior
tip of 12th rib

posterior
lateral to T12 spinous process

Question 25

rectum

Answer 25

posterior Posterior-lateral sacrum ½ way between sacral sulcus and ILA

Question 26

bronchus

Answer 26

Anterior Between ribs 2/3 at sternal border Posterior Lateral to spinous process of T2

Question 27

upper lung

Answer 27

Anterior Between ribs 3/4 at sternal border Posterior Lateral spinous process of T3

Question 28

lower lung

Answer 28

Anterior Between ribs 4/5 at sternal border Posterior Lateral spinous process of T4

Question 29

myocardium

Answer 29

Anterior between ribs 2/3 parasternally Posterior superior border of T3 (lateral to spinous process)

Question 30

kidneys

Answer 30

anterior anterior abdominal wall 1cm superior/lateral to umbilicus posterior lateral to spinous process of L1

Question 31

ureters

Answer 31

anterior none posterior Transverse process of L2

Question 32

bladder

Answer 32

Anterior umbilicus posterior transverse process of L2

Question 33

prostate

Answer 33

Anterior posterior aspect of IT band Posterior S1, sacral sulcus

Question 34

urethra

Answer 34

Anterior superior surface of pubic bone Posterior none

Question 35

seminal vesicles

Answer 35

Anterior none Posterior anterior/superior surface of PSIS and posterior femoral head

Question 36

uterus

Answer 36

Anterior 2cm lateral to inferior pubic bone Posterior posterior Transverse process of L5 and sacral sulcus

Question 37

ovaries

Answer 37

Anterior Pubic tubercle Posterior inferolateral portion of T10

Question 38

broad ligament

Answer 38

Anterior posterior aspect of IT band Posterior S1, Sacral sulcus

Question 39

Vagina

Answer 39

Anterior none Posterior Sacral sulcus

Question 40

Fallopian Tubes

Answer 40

Anterior none Posterior Posterior femoral head superomedial to PSIS

Question 41

Thyroid

Answer 41

Anterior between ribs 2/3 at parasternal border Posterior lateral to Spinous process of T2

Question 42

Adrenal

Answer 42

Anterior 2cm superior and 2cm lateral to umbilicus Posterior lateral to spinous process of T11