Tubercle of the humerus anatomy. Treatment of a fracture of the greater tubercle of the humerus

The upper limb girdle (shoulder girdle) is a set of bones and muscles that provide support and movement of the arms. It covers the area from the shoulder joint to the elbow. The bone structure consists of the clavicle, shoulder blades and humerus, followed by the forearm and hand.

The bones of the shoulder girdle connect the acormioclavicular joints (the bony connection between the acromion and the collarbone). The shoulder girdle is attached to the skeleton using the sternoclavicular joints, muscles and ligaments that hold the scapula and upper limb.

Shoulder injuries are common, especially among professional athletes and people who do heavy physical work with their hands. Pathologies are manifested by pain, crepitus, and deformation. Conservative treatment is usually carried out, but in severe cases surgery is necessary.

Shoulder anatomy

Not all people know how many bones make up the shoulder girdle. The skeleton of the upper limb girdle is formed by the following bones: 2 shoulder blades, 2 clavicles, humerus.

The scapula is a triangle-shaped bone that is located on the back surface of the body. The clavicle is a paired bone that is curved along its long axis in the shape of the letter S. It is located horizontally along the front and upper surface of the body. The shoulder girdle includes the humerus.

A diagram of the bones of the shoulder girdle is presented below.

Some people are interested in the question of what type of bones of the upper limb girdle are. The scapula is a flat bone, while the clavicle and humerus are tubular.

The ligamentous apparatus of the shoulder consists of the acromioclavicular joint and the shoulder joint. The acromioclavicular joint is strengthened by the coracoclavicular ligament. The scapula is supported by the coracoacromial and superior transverse ligaments. The shoulder joint is strengthened by the coracobrachial ligament, as well as the fibers of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles.

Thanks to the muscles, tendons and ligaments, the upper limb has the correct position, it is strengthened and is capable of performing a variety of movements.

The muscles of the shoulder girdle include: motors, coordinators, stabilizers of the scapula. The motor muscles include the deltoid, latissimus dorsi, and pectoralis major. They are involved in performing basic arm movements (extension, adduction, abduction, rotation). The group of coordinating muscles may include: subscapularis, supraspinatus, infraspinatus, teres minor. They are necessary to ensure that movements in the shoulder are coordinated. Scapula stabilizers include the trapezius, rhomboid major, rhomboid minor, serratus anterior, pectoralis minor, and levator scapulae muscles. They regulate the movement of the shoulder blades.

Structure and functions of the clavicle

The clavicle is the only bone in the human body that connects the skeleton to the upper limb. Tubular bone mainly consists of spongy substance. It has a horizontal position and runs along the upper edge of the chest. The clavicle consists of a body and 2 ends:

The medial (sternal) end connects to the sternum.
Lateral (acromial) faces the collarbone.

The clavicle consists of a body and 2 ends

The medial end, like the sternum, has a convex curve forward, and its other part is curved backward. The middle part of the bone is slightly compressed from top to bottom. On its lower surface there is an opening through which blood vessels and nerves pass. On the lower surface of the medial end there is a depression to which the ligament connecting the clavicle and the cartilage of the first rib is attached. At the humeral end there is a cone-shaped tubercle and a trapezoidal line. Closer to the lateral end of the lower surface of the body of the clavicle there is a recess for the attachment of the subclavian muscle.

The front and top parts of the bone are smooth, and the lower surfaces to which the muscles and ligaments are attached have roughness in the form of tubercles and lines. On the inner surface of the thick medial end there is a large oval joint - this is the junction of the clavicle with the sternum. The lateral end is wider than the medial end, but not as thick. Above its lower surface is the acromioclavicular joint, which connects the collarbone to the bony outgrowth of the scapula (acromion).

The bony joints of the acromioclavicular joint are oblique, flat, and elliptical in shape. There is a dense fibrous membrane around it, which is strengthened by ligaments. The sternoclavicular joint is also surrounded by a wide fibrous membrane and 3 powerful ligaments. This joint is involved in movements along axes that are perpendicular to each other.

The collarbone performs a supporting function, since the scapula and arm are attached to it. In addition, the bone connects the upper limb to the skeleton, providing it with a wide range of movements. Together with the scapula and muscles, the clavicle transmits forces that affect the arms and the rest of the skeleton. In addition, the bone protects blood, lymphatic vessels, and nerves that are located between the neck and upper limb from pinching.

Clavicle injuries

As you can see, the collarbone performs important functions, but it bears a large load, so it is susceptible to various injuries:

Fracture. In most cases, the fracture occurs in the middle of the bone body. There is a left and right clavicle, usually one of them is injured, a bilateral fracture rarely occurs. A fracture most often occurs when a person falls on their arm or receives a direct blow. There is a risk of injury to the fetus' collarbone as it passes through the birth canal. After a fracture of the collarbone, the arm lengthens, the limb in the collarbone area becomes deformed, and the victim cannot lift it.
Dislocation of the acromial end. The articular surfaces are displaced after a fall on the shoulder. Features of the injury: after the impact, the scapula is pushed down, the collarbone is not so mobile, so it does not move behind it, as a result, the ligaments connecting the bones are torn, and the acromioclavicular joint is dislocated. The injury is manifested by elongation of the arm, swelling and deformation. When you press on the collarbone, it falls into place; after the pressure stops, it rises again.
Osteolysis of the clavicle. This is a rare disease characterized by complete destruction (resorption) of bone without replacement by other tissue. The exact causes of the pathology are not known, but doctors suggest that it is associated with autoimmune diseases of bone tissue. The only symptom is slowly healing fractures.

If clavicle injuries are suspected, MSCT (multislice computed tomography) is prescribed - this is a modern study that uses X-rays and conducts a multi-slice scan of the clavicle. Multislice CT allows for qualitative and detailed examination of morphological changes in bones and surrounding tissues.

For ordinary clavicle fractures, conservative treatment is carried out, and the patient is given a fixing bandage. If fragments are displaced and soft tissue is damaged, surgery is performed, and bone fragments are connected using special plates, knitting needles or rings. The rehabilitation period plays an important role, when the patient is taught to move the injured arm again.

Anatomical structure and functions of the scapula

A paired triangular bone is located on the back surface of the body on both sides of the spine. Its base is at the top and the pointed end is at the bottom. It is a flat, wide bone that is slightly curved backwards.

The scapula is a paired triangular bone

The scapula consists of an anterior (costal) and posterior (dorsal) surface.

Anatomy of the posterior part of the scapula:

The spine is a protruding plate of bone that crosses ¼ of the bone and separates the supra- and infraspinatus fossae.
The acromion process is an elongated, triangular-shaped process at the top of the bone that ends at the spine.
The coracoid process is the hamate bone. Which is located between the upper edge, the neck of the scapula.
The neck is the slight narrowing that separates the rest of the scapula from the outer corner.
Body of the scapula.
Inner edge of the shoulder blade.
External corner.

The structure of the scapula in front is simple; it has a wide fossa to which the subscapularis muscle is attached. The inside of the cavity is covered with ridges to which tendons and muscle fibers are attached. In the upper part of the socket there is a transverse depression where the scapula bends along a line that runs at an angle of 90° through the middle of the glenoid fossa, which includes the head of the humerus.

There are 3 angles:

The superior angle is formed by the superior and medial borders of the bone. It is thin, has a smooth surface and a rounded shape, and fibers of the muscle that elevate the scapula are attached to it.
Lower. The lateral border of the scapula forms a lower angle with the medial border. This is the lowest thick section of bone with a rough texture. The teres major and several fibers of the latissimus dorsi muscle are attached to it posteriorly.
Lateral. This is the thickest part of the scapula and contains the articular socket that connects to the humerus. At the apex of the lateral angle is the supraglenoid tuberosity, to which the head of the biceps is attached.

There are 3 edges of the scapula:

The top one is considered the thinnest and shortest. It has a concave shape, occupies the area from the upper angle to the coracoid process.
Lateral - the thickest edge of the scapula. It starts from the lower edge of the articular socket, passes down and back to the lower corner of the bone.
The medial edge is the longest edge, which occupies the area from the upper to the lower corner of the bone.

Thanks to the articulations, the scapula connects the humerus and collarbone, providing mobility to the upper limb. The paired bone protects important organs and blood vessels from damage. And also the scapula, together with the muscles, performs a motor function, it allows you to rotate, abduct (to the side, back, forward), and understand the arms.

Pathologies of the scapula

When the scapula is injured, the quality of life decreases; people are not able to care for themselves or perform physical work. The shoulder blades can be damaged by a fall on your back, shoulder or arm, a direct blow, an accident, or a work-related injury.

There is a possibility of bone fracture in the following areas: neck, glenoid, spine, coracoid process, acromion, superior or inferior angle. And longitudinal, transverse or multi-fragmented damage is also possible.

When a fracture occurs, the “Comolli triangle” appears - this is a triangle-shaped swelling. On palpation, the pain in the damaged area intensifies. A displaced fracture is accompanied by a crunching sound from bone fragments. In case of intra-articular injury, the shoulder and arm are raised. Blood accumulates in the cavity of the bone connection, so the size of the shoulder increases. When the neck is damaged, the shoulder drops slightly, the acromion protrudes forward, and the coracoid process moves slightly back. With an open fracture, a wound appears through which bone fragments are visible.

Dislocation of the scapula is a rare occurrence. The injury occurs if a person makes a strong jerk with his arm or shoulder, as a result, the bone is displaced. After a dislocation, the coracoid process of the scapula protrudes through the skin, causing sharp pain that intensifies with movement.

Bursitis is an inflammation of the synovial (periarticular) bursae of the shoulder joint. Typically, the disease develops against the background of infection, injury, or an autoimmune disease. With bursitis, pain occurs, the damaged area turns red, swells, a feeling of numbness appears, and it is difficult for the victim to move his arm.

Multi-slice computed tomography will help detect scapular pathologies.

For ordinary fractures, a special splint is placed on the arm on the damaged side, which must be worn for 4 weeks. Then physiotherapy and massage are prescribed, the patient must develop the limb with the help of special exercises. For intra-articular injuries, surgery is indicated.

Bursitis is treated with the use of NSAIDs, steroid hormones, antibacterial agents, analgesics, chondroprotectors, and vitamin-mineral complexes.

Anatomy of the humerus

The humerus is a wide, long tubular structure. It is part of the movable upper limb, unites the ulna, radius, and hand with the human skeleton. Around the humerus there are muscles, nerve trunks, and lymphatic vessels.

The shoulder structure has the following structure:

The body of the bone (diaphysis), which is located between the epiphyses.
Metaphysis is the section of bone that is adjacent to the epiphyseal plate.
Epiphysis – upper proximal, lower distal end of the structure.
Apophysis is a process of bone next to the epiphysis, to which muscle fibers are attached.

At the proximal end of the humerus is the smooth round head of the humerus, the articular cavity of the scapula, which form the shoulder joint. Next comes the anatomical neck - this is a narrow groove between the head and the body of the shoulder. Just below the neck there are 2 muscle tubercles (large and small), to which the rotator cuff muscles are attached. Under the tubercles it narrows again, forming a body. On its outer part, almost in the middle, there is a deltoid tuberosity, to which the fibers of the muscle of the same name are attached. On its posterior edge there is a groove of the radial nerve in the form of a flat, gentle groove.

The lower edge of the bone is wide, curved anteriorly, muscle fibers are attached to it, and it also participates in the structure of the elbow joint. The joint consists of the condyle of the humeral structure with the bones of the forearm. The inner edge of the condyle is the block of the humerus that connects to the ulnar structure. The head of the condyle, together with the radial structure, forms the humeroradial articulation. Above the condylar head is the radial fossa. On both sides of the trochlea are the ulnar and coronoid fossa. The humerus has lateral and medial epicondyles (rough convexities) on the outside and inside. On the surface of the medial process there is a groove with the ulnar nerve trunk.

The functions of the humerus, despite its simple structure, are important. It increases the swing when a person moves his arm. This structure helps maintain balance when the center of gravity shifts during walking. It helps determine the correct support of a person on the upper limbs in various specific body positions (for example, while climbing stairs).

Shoulder injuries

Shoulder dislocation is a common occurrence that is associated with arm mobility. The displacement can be anterior, posterior, or inferior. When a dislocation occurs, the mobility of the limb is limited, pain and swelling appear. When the nerve is compressed, a feeling of numbness occurs.

A fracture most often occurs from a direct blow to the shoulder, falling backwards onto the elbows, or falling forward onto the arms. Typically, the integrity of bones is compromised in weak areas:

Anatomical and surgical neck of the humerus.
The area near the condyles.
The area near the head of the humerus.
The middle of the bone.

The injury is manifested by severe pain and impaired mobility. After some time, the shoulder swells, hematomas appear, and the damaged area becomes deformed.

Osteomyelitis is a purulent inflammation of the bone due to the penetration of microbes into the bone marrow through the blood. This disease is common because the humerus is abundantly supplied with blood. The pathological process provokes the destruction of bone tissue, as a result, fractures form without significant external influence.

Reference. Among the commonly diagnosed pathologies of the humerus are arthritis (inflammation of the joint).

Pseudarthrosis is also a common pathology. Not all patients know what it is. This is an abnormally formed joint that appears at the site of a non-union fracture of the humerus. With pathology, the functionality of the hand is impaired, but there is no pain.

Palpation and visual inspection can identify injuries and diseases of the humerus. X-rays can help differentiate a fracture from a dislocation. MRI and multi-slice computed tomography can detect malignant tumors. A multislice tomograph will help to examine the bone structure in detail and determine pathological changes.

When a dislocation occurs, a health care worker gives the victim a painkiller, compares the fragments of the joint, and then immobilizes the limb. Simple fractures are also treated conservatively. If the bone fragments are displaced, then surgery is necessary. The bone fragments are connected using knitting needles or screws, and then a Turner plaster splint is applied. If necessary, skeletal traction is performed first.

Exercise therapy will help develop the shoulder joint for flexibility. During rehabilitation, mechanotherapy and physiotherapy are indicated.

The most important

Now you know which bones form the shoulder girdle. The shoulder blades, collarbone and humerus take part in the formation of important joints, and thanks to muscles and ligaments, they provide mobility of the upper limb. Fractures of the clavicle and humerus occur more often than injuries to the scapula. This is due to the fact that the scapula is a fairly strong bone, which is protected by a thick layer of muscle. After identifying an injury, the affected limb is immobilized, and in case of complex fractures, an operation is performed to compare bone fragments. Therapeutic gymnastics and physiotherapy will help speed up recovery.

Anatomically, the humerus is part of the upper limb - from the elbow to the shoulder joint. Knowing where each of its elements is located is useful for the overall development and understanding of the mechanics of the human body. The structure, development, and possible injuries of this critical structure are described below.

When studying the structure of the humerus, we distinguish: the central part of the body (diaphysis), proximal (upper) and distal (lower) epiphyses, where ossification (ossification) occurs last, metaphyses, small epiphyseal tubercles - apophyses.

On the upper epiphysis there is a weakly defined anatomical neck, which passes into the head of the humerus. The lateral part of the pommel of the bone is marked by a large tubercle - one of the apophyses to which the muscles are attached. In front of the upper epiphysis there is a small tubercle that performs the same function. Between the proximal end of the bone and the body, the surgical neck of the humerus stands out, which is especially vulnerable to injury due to a sharp change in the cross-sectional area.

The cross-section changes from one epiphysis to another. Round at the upper epiphysis, towards the lower it becomes triangular. The body of the bone is relatively smooth; an intertubercular groove begins on its anterior surface near the head. It is located between the two apophyses and spirally deviates to the medial side. Almost in the middle of the height of the bone, somewhat closer to the upper part, a smoothed deltoid tuberosity protrudes - the place of attachment of the corresponding muscle. In the trilateral area near the distal epiphysis, posterior and anterior edges are distinguished - medial and lateral.

The distal epiphysis has a complex shape. On the sides there are protrusions - condyles (internal and external), easily detectable by touch. Between them there is a so-called block - a formation of a complex shape. In front there is a spherical capitate elevation. These parts have evolved to contact the radius and ulna bones. The epicondyles are protrusions on the condyles that are used to attach muscle tissue.

The upper epiphysis together with the scapular cavity make up a spherical and extremely mobile shoulder joint, responsible for the rotational movements of the arm. The upper limb carries out actions within approximately a hemisphere, in which it is assisted by the bones of the shoulder girdle - the collarbone and scapula.

The distal epiphysis is part of the complex elbow joint. The connection of the shoulder lever with the two bones of the forearm (radius and ulna) forms two of the three simple joints of this system - the humeroulnar and humeroradial joints. In this area, flexion-extension movements and slight rotation of the forearm relative to the shoulder are possible.

Functions

The humerus is essentially a lever. Anatomy predetermines its active participation in the movements of the upper limb, increasing their range. Partially when walking, it compensates for the periodic shift of the body’s center of gravity to maintain balance. It can play a supporting role and take on part of the load while climbing flights of stairs, playing sports, or in certain body positions. Most of the movements involve the forearm and shoulder girdle.

Development

Ossification of this cartilage structure is completed only upon reaching 20-23 years of age. Anatomy studies performed using x-rays show the following picture of ossification of the shoulder.

The point of the medial region of the head of the humerus originates in the womb or in the first year of life.
The lateral part of the upper epiphysis and the greater apophysis acquire their own ossification centers by 2-3 years.
The lesser tubercle is one of the rudiments of osteogenesis of the humerus and begins to harden at the age of 3 to 4 years in young children.
At about 4-6 years the head becomes completely ossified.
By the age of 20-23, osteogenesis of the humerus is completed.

Damage

The mobility of the shoulder joints explains the frequency of injury to individual areas of the shoulder. Fractures of bone formations can occur when exposed to significant force. The surgical neck of the bone often suffers, being an area of stress concentration due to mechanical stress. Joint pain can signal a variety of problems. For example, glenohumeral periarthritis - inflammation of the shoulder joint - can be considered as a likely sign of neck osteochondrosis.

The displacement of bones in a joint relative to each other, which is not eliminated due to the elasticity of the supporting tissues, is called a dislocation. It is not always possible to differentiate a dislocation from a fracture without medical equipment. This phenomenon may be accompanied by a fracture of the humeral neck or breaking off of the greater tubercle. Reducing a dislocation on your own, without the appropriate knowledge and experience, is strictly not recommended.

ENCYCLOPEDIA OF MEDICINE /SECTION^

ANATOMICAL ATLAS

The structure of the humerus

The humerus is a typical long tubular bone that forms the proximal (upper) part of the arm. It has a long body and two ends, one of which articulates with the scapula at the shoulder joint, the other with the ulna and radius bones at the elbow joint.

The apex of the humerus—its proximal end—has a large, smooth, hemispherical articular surface that articulates with the glenoid cavity of the scapula to form the shoulder joint. The head is separated from the rest by a narrow interception - an anatomical neck, below which there are two bony protrusions - the greater and lesser tubercles. These tubercles serve as sites of muscle attachment and are separated by the intertubercular groove.

BODY OF HUMERUS

_(DIAPHYSUS)_

There is a slight narrowing at the top of the body of the humerus - the surgical neck is a common site for fractures. The relatively smooth surface of the diaphysis has two distinctive features. Approximately in the middle of the length of the body of the humerus, closer to its upper epiphysis on the lateral (side) surface, there is a deltoid tuberosity, to which the deltoid muscle is attached. Below the tuberosity, a spiral groove of the radial nerve runs along the posterior surface of the humerus. In the deepening of this groove pass the radial nerve and deep arteries of the shoulder.

The lateral edges of the diaphysis in its lower part pass into protruding medial (internal) and lateral epicondyles. The articular surface is formed by two anatomical formations: the trochlea of the humerus, which articulates with the ulna, and the head of the condyle of the humerus, which articulates with the radius.

Humerus, posterior view

humerus

Articulates with the glenoid cavity of the scapula at the shoulder joint.

Anatomical -

It is a remnant of the growth plate where bone growth occurs in length during childhood.

Body of humerus

The diaphysis makes up the bulk of the length of the bone.

Radial nerve groove

It runs obliquely along the posterior surface of the middle part of the body of the humerus.

Humerus block

Medial epicondyle -

More prominent bony projection than the lateral epicondyle.

Greater tuberosity

Place of muscle attachment.

Humerus, front view

Lesser tubercle

Place of muscle attachment.

Surgical neck

Narrow interception, frequent site of fractures.

Deltoid tuberosity

Insertion site of the deltoid muscle.

Head -

humeral condyle

It has a spherical shape, articulates with the head of the radius.

Lateral epicondyle

External bony prominence.

Anatomical neck

Intertubercular groove

It contains the tendon of the biceps brachii muscle.

At these points the bone can be easily felt under the skin.

Humerus fractures

Most fractures of the upper humerus occur at the level of the surgical neck as a result of a fall on an outstretched arm. Fractures of the body of the humerus are dangerous due to possible injury to the radial nerve, which lies in the groove of the same name on the posterior surface of the bone. Damage to it can cause paralysis of the muscles of the back of the forearm, which is manifested by drooping of the hand. H This x-ray shows a fracture of the upper body of the humerus. This injury usually occurs when falling on an outstretched arm.

In children, humerus fractures are often localized in the supracondylar region (in the lower part of the humerus body above the elbow joint). Typically, the mechanism of such an injury is a fall on the arm, slightly bent at the elbow. This can damage nearby arteries and nerves.

Sometimes, with complex fractures of the humerus, there is a need to stabilize it with a metal pin, which holds the bone fragments in the correct position.

Medial epicondyle

A bony prominence that can be felt on the inside of the elbow.

Humerus block

Articulates with the ulna.

The long tubular bone, divided into a diaphysis, proximal and distal epiphyses, fossa, tubercle and surgical neck, is the humerus. A fracture in this area is a common occurrence in surgical practice, occurring in both young and elderly people. Shoulder injuries occur due to impacts and falls and are one of the most common household injuries.

What is the humerus

Fractures of the upper sections. They can form due to damage to the head, separation of the small or large tubercle, or fracture of the necks. Falling on an abducted arm, elbow or shoulder are the main causes of injury. Patients complain of pain, swelling, and pain when trying to perform active movements. Passive actions are not very limited. A displaced fracture is accompanied by severe pain, deformation occurs in the joint area, and the limb becomes shorter. Crunching of bones and swelling accompany the damage.
Fracture of the middle part of the shoulder. Occurs when you fall on your arm or get hit on the shoulder. There are comminuted, oblique, transverse, and helical fractures. Accompanied by damage to the radial nerve, arteries, and veins. The victim experiences swelling, pain, deformation, crepitus, and pathological bone mobility. The patient cannot straighten his fingers and wrist. To make a diagnosis, an x-ray is taken, based on the results of which treatment is prescribed.
Fracture in the lower sections. There are extra-articular and intra-articular fractures. Extra-articular injuries include supracondylar injuries, and intra-articular injuries include injuries to the trochlea, capitate eminence of the humerus, and intercondylar fractures. Supracondylar injuries of the shoulder can be flexion or extension. The shoulder swells greatly and there is severe pain. With flexion fractures, the forearm lengthens, and with extension fractures, it shortens. Injuries to the condyles are accompanied by accumulation of blood in the elbow, while transcondylar injuries are accompanied by pain, swelling, and limitation of movements in the joints.

Treatment

Simple fractures are fixed with a plaster splint for about a month. Immobilization should ensure complete immobility of the arm. If the fragments are displaced, surgery or repositioning is performed under anesthesia. Fractures are fixed with knitting needles, screws, a Turner bandage, and adhesive plaster or skeletal traction is used. For rehabilitation, physical therapy, mechanotherapy, and physiotherapeutic procedures are carried out.

Splint for humerus fracture

To fix the damage, use a Kramer splint, which is applied across the back from the healthy shoulder. For a fracture of the elbow joint, a wire splint is used; for damage to the wrist joint, a long plywood splint is used. Fixation is made on the forearm. In some cases, a ball of cotton wool should be placed in the patient's palm. If the forearm is fractured, 2 splints are applied, after first fixing the arm in the palm-up position. The bent limb is suspended on a scarf.

Photo of the humerus

Video

Humerus, humerus, is a long lever of movement and develops like a typical long tubular bone. According to this function and development, it consists of a diaphysis, metaphyses, epiphyses and apophyses. The upper end is equipped with a spherical articular head, caput humeri (proximal epiphysis), which articulates with the glenoid cavity of the scapula. The head is separated from the rest of the bone by a narrow groove called the anatomical neck, collum anatomicum. Immediately behind the anatomical neck there are two muscular tubercles (apophyses), of which the larger one, tuberculum majus, lies laterally, and the other, smaller one, tuberculum minus, slightly anterior to it. From the tubercles downwards there are bone ridges (for muscle attachment): from the large tubercle - crista tuberculi majoris, and from the small tubercle - crista tuberculi minoris. Between both tubercles and ridges there is a groove, sulcus intertuberculdris, in which the tendon of the long head of the biceps muscle is located. The part of the humerus lying immediately below both tubercles at the border with the diaphysis is called the surgical neck - collum chirurgicum (the place of the most common fractures of the shoulder).

Body of humerus in its upper part it has a cylindrical outline, while at the bottom it is clearly triangular. Almost in the middle of the body of the bone, on its lateral surface there is a tuberosity to which the deltoid muscle, tuberositas deltoidea, is attached. Behind it, along the posterior surface of the body of the bone, from the medial side to the lateral side, a flat groove of the radial nerve, sulcus nervi radidlis, seu sulcus spiralis, runs in the form of a gentle spiral.

The widened and slightly bent anteriorly lower end of the humerus, condylus humeri, ends on the sides with rough protrusions - the medial and lateral supramidal fissures and, epicondylus medialis et lateralis, lying on the continuation of the medial and lateral edges of the bone and serving for the attachment of muscles and ligaments (apophyses). The medial epicondyle is more pronounced than the lateral one, and on its posterior side it has a groove for the ulnar nerve, sulcus n. ulnaris. An articular surface is placed between the epicondyles for articulation with the bones of the forearm (disgal epiphysis). It is divided into two parts: medially lies the so-called block, trochlea, which looks like a transversely located roller with a notch in the middle; it serves for articulation with the ulna and is covered by its notch, incisura trochlearis; above the block, both in front and behind, is located along the fossa: in front is the coronoid fossa, fossa coronoidea, behind is the fossa of the olecranon, fossa olecrani. These pits are so deep that the bony partition separating them is often thinned to the point of being translucent, and sometimes even perforated. Lateral to the block is the articular surface in the form of a segment of a ball, the head of the condyle of the humerus, capitulum humeri, which serves for articulation with the radius. Anteriorly above the capitulum there is a small radial fossa, fossa radialis.

Ossification. At the time of birth, the proximal epiphysis of the shoulder still consists of cartilaginous tissue, so the head of the humerus is almost not visible on an x-ray of the shoulder joint of a newborn. Subsequently, three points appear sequentially:

in the medial part of the head of the humerus (0-1 year) (this bone core can also be present in a newborn);
in the greater tubercle and lateral part of the head (2-3 years);
in tuberculum minus (3-4 years).

These nuclei merge into a single head of the humerus (caput humeri) at the age of 4-6 years, and synostosis of the entire proximal epiphysis with the diaphysis occurs only at the 20-23rd year of life. Therefore, on radiographs of the shoulder joint belonging to children and young people, according to the indicated ages, clearings are noted at the site of the cartilage separating the parts of the proximal end of the humerus that have not yet fused from each other. These lucencies, which represent normal signs of age-related changes, should not be confused with cracks or fractures of the humerus.

Which doctors to contact for examination of the humerus:

Traumatologist

What diseases are associated with the humerus:

What tests and diagnostics need to be performed for the humerus:

X-ray of the humerus

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Other anatomical terms starting with the letter "P":

Esophagus

Chin

Spine

Navel (navel)

Penis

Prostate

Crotch

Liver

Parathyroid glands

Pancreas

Bud

Medulla

Pleura

Peripheral nerves

Membranous labyrinth

Subglottic cavity

Oral cavity

Rectum

Plasma

Vertebrae

Lumbar vertebrae

Shoulder joint

Groin area

Shoulder

Forearm

Finger

Peripheral nervous system

Parasympathetic nervous system

Sweat gland

Sex glands

Prostate

Placenta

Epididymis and periovarian

Paraganglia

Right ventricle

Conduction system of the heart

Atrioventricular node

Pericardium

Brachiocephalic trunk

Subclavian artery

Axillary artery

Brachial artery

Popliteal artery

Anterior tibial artery

Brachiocephalic veins

Anterior jugular vein

Subclavian vein

Vertebral venous plexuses

Right lymphatic duct

Isthmus of the rhombencephalon

Forebrain

The proximal border of the shoulder is the lower edge of m. pectoralis major in front and latissimus dorsi in back. The distal border is a circular line above both condyles of the humerus.

The humerus is divided into a proximal, distal end and diaphysis. The proximal end has a hemispherical head. Its smooth spherical surface faces inward, upward and somewhat backward. It is limited along the periphery by a grooved narrowing of the head - the anatomical neck. Outward and anterior to the head there are two tubercles: the lateral greater tubercle (tuberculum majus) and the lesser tubercle (tuberculum minus), which is located more medially and anteriorly. Below, the tubercles turn into scallops of the same name. The tubercles and scallops are the site of muscle attachment.

Between these tubercles and ridges there is an intertubercular groove. Below the tubercles, corresponding to the zone of the epiphyseal cartilage, a conditional boundary is determined between the upper end and the body of the humerus. This place is somewhat narrowed and is called the “surgical neck”.

On the anterior outer surface of the body of the humerus, below the crest of the tuberculum majoris, there is a deltoid tuberosity. At the level of this tuberosity, a groove runs along the posterior surface of the humerus in the form of a spiral from top to bottom and from inside to outside (sulcus nervi radialis).

The body of the humerus is triangular in the lower part; here three surfaces are distinguished: posterior, anterior medial and anterior lateral. The last two surfaces pass into one another without sharp boundaries and border the rear surface with well-defined edges - outer and inner.

The distal end of the bone is flattened anteroposteriorly and expanded laterally. The outer and inner edges end in well-defined tubercles. One of them, the smaller one, facing laterally, is the lateral epicondyle, the other, the larger one, is the medial epicondyle. On the posterior surface of the medial epicondyle there is a groove for the ulnar nerve.

Below the lateral epicondyle there is a capitate eminence, the smooth articular surface of which, having a spherical shape, is oriented partly downward, partly forward. Above the capitate eminence is the radial fossa.

Medial to the capitate eminence is the block of the humerus (trochleae humeri), through which the humerus articulates with the ulna. In front above the trochlea there is a coronoid fossa, and behind there is a rather deep ulnar fossa. Both fossae correspond to the processes of the same name of the ulna. The area of bone separating the ulnar fossa from the coronoid fossa is significantly thinned and consists of almost two layers of cortical bone.

The biceps brachii muscle (m. biceps brachii) is located closer to the surface than the others and consists of two heads: a long one, starting from the tuberculum supraglenoidale scapulae, and a short one, extending from the processus coracoideus scapulae. Distally, the muscle attaches to the tubercle of the radius. M. coracobrachialis originates from the coracoid process of the scapula, is located medial and deeper than the short head of the biceps muscle and is attached to the medial surface of the bone. M. brachialis originates on the anterior surface of the humerus, lies immediately beneath the biceps muscle, and inserts distally on the tuberosity of the ulna.

The extensors include the triceps brachii muscle (m. triceps brachii). The long head of the triceps muscle starts from the tuberculum infraglenoidae scapulae, and the radial and ulnar heads start from the posterior surface of the humerus. Below, the muscle is attached by the wide aponeurotic tendon to the olecranon process.

The elbow muscle (m. anconeus) is located superficially. It is small and triangular in shape. The muscle originates from the lateral epicondyle of the humerus and the collateral ligament of the radius. Its fibers diverge, lie fan-shaped on the bursa of the elbow joint, partially woven into it, and are attached to the crest of the dorsal surface of the ulna in its upper part. N. musculocutaneus, perforating m. coracobrachialis, passes medially between m. brachialis etc. biceps. In the proximal part of the shoulder it is located outside the artery, in the middle it crosses it, and in the distal part it passes medial to the artery.

Blood supply is provided by a. brachialis and its branches: aa.circumflexae humeri anterior and posterior, etc. The extensors are innervated by the p. radialis. It passes at the top of the shoulder behind a. axillaris, and below is included in canalis humeromuscularis along with a. and v. profunda brachii, which are located medially from the nerve.

The nerve encircles the bone in a spiral manner, descending in the upper part between the long and medial heads of the triceps muscle, and towards the middle of the shoulder it passes under the oblique fibers of the lateral head. In the distal third of the shoulder, the nerve is located between mm. brachialis and brachioradialis.

Rice. 1. Humerus (humerus).

A-front view; B-rear view.

A. 1 - greater tubercle of the humerus; 2 - anatomical neck of the humerus; 3 - head of the humerus; 4 - lesser tubercle of the humerus; 5 - intertubercular groove; 6 - crest of the lesser tubercle; 7 - crest of the greater tubercle; 8 - deltoid tuberosity of the humerus; 9 - body of the humerus; 10 - anteromedial surface; 11 - medial edge of the humerus; 12 - coronoid fossa; 13 - medial epicondyle; 14 - block of the humerus; 15 - head of the condyle of the humerus; 16 - lateral epicondyle; 17 - radial fossa; 18 - anterolateral surface.

B. 1 - head of the humerus; 2 - anatomical neck; 3 - greater tubercle; 4 - surgical neck of the humerus; 5 - deltoid tuberosity; 6 - groove of the radial nerve; 7 - lateral edge of the humerus; 8 - fossa of the olecranon process; 9 - lateral epicondyle of the humerus; 10 - block of the humerus; 11 - groove of the ulnar nerve; 12 - medial epicondyle of the humerus; 13 - medial edge of the humerus.

Skeletal bones are unique formations that arose during the process of evolution. Each bone has a unique structure, best suited for performing work, which is associated not only with supporting the body and moving it in space, but also with protecting organs. The main and largest component of the arm is the humerus, which is surrounded by muscles, nerves and choroid plexuses. There are also joints in which this bone takes part - the humerus and the elbow, with the help of which many functions are performed.

Proximal end

The part that is located near the shoulder joint is called the proximal end. Here is the nerve plexus of the shoulder, the anatomy of which consists of three bundles that can be damaged by injury. The head of the humerus is involved in the formation of the joint; it has a structure that is different from other areas, which allows you to perform the range of arm movements that is familiar to every person.

The head of the bone is smooth and covered with cartilage, which is required for the joint, but it is larger in volume than the surface with which it comes into contact, as a result of which shoulder dislocations occur. Below is the anatomical neck, it is a groove, and the human joint capsule is attached to it.

Below the anatomical neck, the structure suggests the presence of two tubercles - large and small; many muscles are attached to them in humans; there is also a nerve plexus nearby. The rotator cuff of the shoulder, which is responsible for rotation and function, is attached to these formations. The anatomy of these formations is such that it is in this place that fractures appear during a fall, and not only the rotator cuff suffers, but also other muscles, as important anatomical formations of this part of the limb.

A ridge extends down from each of the tubercles, which bears the same name. Together with the tubercles, the ridges form another formation - the intertubercular groove. In this place lies the tendon of the long head of the biceps muscle, which is also involved in the movement of the shoulder joint and its normal function. The rotator cuff is also located in this place, the tendons of which can be damaged if injured.

If you look below, there is a formation that is no different from the body of the bone, but is important in the practical work of a doctor. The anatomy of this section of the shoulder is designed in such a way that a surgical neck is located under the head. This place received its name as the weakest place in humans, which is most often subject to injury. Especially in the elderly, the bone breaks in this area, sometimes with muscle damage from fragments. In a child, this place corresponds to the growth zone of the arm and its bone component.

Body of bone

The main part of the bone is, of course, the body, which performs significant functions; it accounts for the bulk of the mass, like a lever. It is hidden in the thickness of the muscles and has a circular cross-section in the upper section, and a triangular cross-section in the lower section. The triangular shape of the bone is given by ridges, among which there are anterior, external and internal. There are also three surfaces: one back, and also outer and inner. There are nutrient openings in the body area; small arteries of the arm pass through them, delivering blood inside the bone.

In this part of the arm there is one formation located in this place - the groove of the radial nerve. It runs in a spiral, surrounded by muscles, here the radial nerve passes almost close to the bone, which can also be damaged by injury. Then below it goes into the thickness of the muscles, and if the condyle of the bone is fractured, the ulnar nerve, located on the inside, can be damaged. On the inner surface there is another formation no less important for the human hand; it is called the deltoid tuberosity and serves to fix the tendon of the muscle of the same name. Next to it there is also a vascular and nerve plexus.

Distal end

The part near the elbow is called the distal end and has its own structure. The anatomy of this area is such that, in addition to the attachment of muscles, this component of the arm is involved in the formation of the joint. There is also a plexus of blood vessels and nerves that can be damaged by injury or fracture.

The lowest part, which participates in the formation of the joint, is called the condyle of the humerus. Its anatomy is complex, on the inside it is formed by the shoulder block, the ulna bone articulates with it using a joint, and on the outside the head, which forms the articular surface with the radius. But this is not the whole structure of this part of the arm; in addition to the thickness of the soft tissues, the coronoid fossa is located on the front surface, the function of which is that the coronoid process of the ulna bone enters it during flexion. Nearby is a less pronounced radial fossa, its functions are similar, only it is intended for the radius.

On the back of the arm in this section there are also muscles and the choroid plexus. The structure of this section of the shoulder is represented by the olecranon fossa; it enters it during extension of the joint.

In the upper part of the condyle there are epicondyles, muscles are attached to them, as well as the joint capsule. The external and internal epicondyle are distinguished; muscle tendons are fixed to them, the functions of which are to move the forearm and shoulder. Ridges rise upward from each epicondyle; this is the attachment point for the muscles of the shoulder and forearm.

Due to greater muscle attachment, the development of the internal epicondyle occurs more strongly. On its posterior surface is the ulnar nerve plexus and there is a groove for this nerve.

This formation has a protrusion to which the muscles are fixed (flexor carpi radialis); it is called the supracondylar process. The condyles, as the site of attachment of tendons, can be felt under the skin, as well as the groove of the ulnar nerve. These projections can be landmarks that can be used to guess where the choroid or nerve plexus is located.

The structure of any part of the humerus is as simple as it is unique; like a cuff, it is surrounded by muscles, blood vessels and nerves. This powerful lever helps a person perform many functions without which it is difficult to imagine everyday life.

In the complex structure of the human upper limbs, the main attention is paid to the bone elements - the bones of the shoulder, forearm and hand. The anatomy of the humerus is important to a person's daily life. Traumatic situations are dangerous for the structure and often happen in everyday life and road accidents, where it is important to be able to provide proper first aid and not harm the victim through inappropriate actions.

Structure and functions of the humerus

The humerus is the largest bone; according to the classification it is classified as a long tubular bone; as the body grows, it elongates in length. The free mobile upper limb includes the shoulder, forearm - the ulnar and radial bone structures, the components of the hand - the carpometacarpal area and the phalanges (bones) of the fingers. The shoulder region unites them with the frame of the human torso. Takes part in the formation of the shoulder and elbow joints, which perform the basic functional actions of the hands. Surrounded by muscle groups, nerve trunks, arteriovenous plexuses and lymphatic vessels. Bone originates from cartilaginous tissue and completely ossifies before age 25. The structure of the shoulder structure includes the following anatomical formations:

diaphysis - the body located between the epiphyses;
metaphysis - growth zone;
epiphysis - proximal and distal ends;
apophyses - tubercles for attaching muscle fibers.

Top edge

The upper part of the bone is one of the components of the shoulder joint.

The proximal end of the bone structure is involved in the structure of the shoulder ball-shaped joint, formed by the smooth round head of the humerus and the glenoid cavity of the scapula. The larger volume of the humeral head compared to the contacting surface contributes to dislocations. It is separated from the body of the bone by a narrow groove. The formation is called an anatomical narrow neck. Two muscle tubercles protrude from the outside: the large lateral (lateral) and the small tubercle located in front of the lateral one. The cuff of the shoulder girdle, which is responsible for the rotational function, is attached to the latter. Nearby is a plexus of nerves. This is the location of frequent fractures resulting from falls. From the tubercles downwards follow the same name, large and small ridges, between which there is a groove for attaching the tendons of the long head as part of the biceps muscle.

The border area below after the tubercles, between the epiphysis and diaphysis, is called the surgical neck. It serves as a weak point susceptible to fractures, especially in old age. In children, this is the growth zone of the upper limb.

Body of bone structure

Performs the functions of a lever, which is facilitated by anatomical features. At the top, the diaphysis is cylindrical (round), closer to the distal end it is triangular due to 3 ridges (internal, external and anterior), 3 surfaces are defined between them. On the outer part, almost in the middle, there is a tuberosity of the deltoid muscle, where the muscle fibers are attached. On the posterior edge, a flat flat groove runs in a spiral shape - the groove for the radial nerve.

Bottom edge

The bottom of the bone has a rather complex triplication.

The wide, forward-curved lower end is intended not only for attaching muscles, but also takes part in the structure of the elbow joint. The articulation includes the condyle of the humerus bone with the structures of the forearm. The inner edge of the condyle forms a block for coupling with the ulna. To create the humeroradial joint, the condylar head is isolated. The radial fossa is visible above it. On both sides above the block there are 2 more depressions: at the back - the ulnar fossa, the coronary - in front. The outer and inner edges of the bone end in rough convexities - the lateral and medial epicondyles, which serve to fix muscle fibers and ligaments. The medial process is larger; on its posterior edge there is a groove in which the ulnar nerve trunk lies. The condyles and groove of the ulnar nerve are palpated under the skin, which is of diagnostic value.

Causes and symptoms of fractures

Features of damage and their signs are presented in the table:

Fracture location	Cause	Symptoms
Head and anatomical neck	Fall on elbow or direct blow	Bleeding (hematoma)
		Swelling
		Painful movements
Surgical neck	Fall with emphasis on the adducted and abducted arm	Without displacement - local increasing pain with axial load
		With displacement - severe pain, dysfunction
		Shoulder axis offset
		Shortening
		Pathology of movements
Apophyseal fractures	Shoulder dislocation, blow	Pain
		Swelling
		A distinct crunching sound (crepitus) when moving
Diaphysis	Blows, fall on elbow	Hematoma
		Pain syndrome
		Disruption
		Crepitus
		Pathological mobility
		Shoulder deformity
Distal end (transcondylar fractures)	Aimed blow or mechanical impact	All previous symptoms
Distal end (transcondylar fractures)	Aimed blow or mechanical impact	Bent forearm

ENCYCLOPEDIA OF MEDICINE /SECTION^

ANATOMICAL ATLAS

The structure of the humerus

The apex of the humerus - its proximal end - has a large, smooth, hemispherical articular surface that articulates with the glenoid cavity of the scapula to form the shoulder joint. The head is separated from the rest by a narrow interception - an anatomical neck, below which there are two bony protrusions - the greater and lesser tubercles. These tubercles serve as sites of muscle attachment and are separated by the intertubercular groove.

BODY OF HUMERUS

_(DIAPHYSUS)_

The lateral edges of the diaphysis in its lower part pass into protruding medial (internal) and lateral epicondyles. The articular surface is formed by two anatomical formations: the block of the humerus, which articulates with the ulna, and the head of the condyle of the humerus, which articulates with the radius.

Humerus, posterior view

humerus

Articulates with the glenoid cavity of the scapula at the shoulder joint.

Anatomical -

It is a remnant of the growth plate where bone growth occurs in length during childhood.

Body of humerus

The diaphysis makes up the bulk of the length of the bone.

Radial nerve groove

It runs obliquely along the posterior surface of the middle part of the body of the humerus.

Humerus block

Medial epicondyle -

More prominent bony projection than the lateral epicondyle.

Greater tuberosity

Place of muscle attachment.

Humerus, front view

Lesser tubercle

Place of muscle attachment.

Surgical neck

Narrow interception, frequent site of fractures.

Deltoid tuberosity

Insertion site of the deltoid muscle.

Head -

humeral condyle

It has a spherical shape, articulates with the head of the radius.

Lateral epicondyle

External bony prominence.

Anatomical neck

Intertubercular groove

It contains the tendon of the biceps brachii muscle.

At these points the bone can be easily felt under the skin.

Humerus fractures

Sometimes, with complex fractures of the humerus, it becomes necessary to stabilize it with a metal pin, which holds the bone fragments in the correct position.

Medial epicondyle

A bony prominence that can be felt on the inside of the elbow.

Humerus block

Articulates with the ulna.