Humerus (bone)

Authors

Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

Figure 1: Left Humerus (Anterior view)¹

Figure 2: Left Humerus (Posterior view)¹

Figure 3: Longitudinal section of the Humeral Head¹

Ossification

Figure 4: Plan of Ossification of the Humerus¹

Figure 5: Epiphyseal lines of the Humerus in young adults¹

Sites

Humeral Head

• LAteral attachment of GH capsule²
• The humeral head landmark is divided by an imaginary line that separates the humeral head from the rest of the humerus²

Deltoid tuberosity

Deltoid Muscles OIAN

Muscle	Origin	Insertion	Nerve	Action
Anterior Deltoid	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#insertion	?var:ref-deltoid-muscle-anterior.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#action
Lateral Deltoid	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#insertion	?var:ref-deltoid-muscle-lateral.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#action
Posterior Deltoid	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#insertion	?var:ref-deltoid-muscle-posterior.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/deltoid.html#action

Greater Tubercle

• Located on the lateral neck of humerus²
• Separated from Lesser tubercle via the intertubercular groove²
• The greater tubercle of the humerus serves as an attachment site for some of the tendons of the RTC²
  • Supraspinatus^2,3
  • Infraspinatus^2,3
  • Teres Minor^2,3

Muscle	Origin	Insertion	Nerve	Action
Supraspinatus	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/supraspinatus.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/supraspinatus.html#insertion	?var:ref-supraspinatus.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/supraspinatus.html#action
Infraspinatus	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/infraspinatus.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/infraspinatus.html#insertion	?var:ref-infraspinatus.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/infraspinatus.html#action
Teres Minor	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/teres_minor.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/teres_minor.html#insertion	?var:ref-teres-minor.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/teres_minor.html#action

Lesser Tubercle

• Located on the lateral neck of humerus²
• Separated from Greater tubercle via the intertubercular groove²
• Lesser tubercle serves as an attachment site for part of the RTC (subscapularis)^2,3.

Lesser tubercle of humerus attachment OIAN

Muscle	Origin	Insertion	Nerve	Action
Subscapularis	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/subscapularis.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/subscapularis.html#insertion	?var:ref-subscapularis.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Intrinsic Shoulder Muscles/Rotator Cuff/subscapularis.html#action
Pec Major	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Anterior Muscles/pectoralis_major.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Anterior Muscles/pectoralis_major.html#insertion	?var:ref-pectoralis-major.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Axioappendicular Anterior Muscles/pectoralis_major.html#action

Lateral Epicondyle of Humerus

Dysfunction:

• Lateral epicondylitis (Tennis elbow)

Humerus in line with crest of less tubercle

Muscle	Origin	Insertion	Nerve	Action
Coracobrachialis	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Arm Anterior Muscles/coracobrachialis.html#origin	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Arm Anterior Muscles/coracobrachialis.html#insertion	?var:ref-coracobrachialis.nerve	/The Archive/Anatomy/Skeletal Muscles/Upper Limb Muscles/Arm Anterior Muscles/coracobrachialis.html#action

Intertubercular groove

• Provides a passage for the Biceps Brachii Long Head tendon to attach to the superior rim of the glenoid fossa²

Anatomy

• The angle of the walls of the intertubercular groove can vary widely²
• Separates the Greater Tubercle from the Lesser Tubercle²
• The roof is formed by the transverse ligament²

Function

• Allows the proximal tendon of the biceps Brachii Long Head to travel from its origin on the labrum and supraglenoid notch on the scapula, down the neck of the humerus and to the muscle belly²

Dysfunction

• Anatomic anomalies are associated with:
  • RTC tendinopathy²
  • Bicipital Tendinopathy²

Surgical Neck

• The Surgical Neck of the humerus refers to the region inferior to the greater and lesser tuberosities, where the shaft of the humerus joins the upper margins².
• The Axillary Nerve and Posterior Humeral Circumflex Artery run in close proximity to the medial aspect of the surgical neck².
  • Fractures at the Surgical Neck most commonly cause Axillary Nerve damage².
• The Surgical Neck of the humerus fractures more commonly than the Anatomical Neck².

Anatomical Changes

• Humeral Retroversion

Dysfunction

• Lateral epicondylitis (Tennis elbow)

Fracture

• Proximal humeral fx: Can have associated neural complications
  • Radial n: Wrist ext & Elbow str
  • Axillary n: Deltoid weakness

References

1.

Gray H. Anatomy of the Human Body. 20th ed. (Lewis WH, ed.). Lea & Febiger; 1918. https://www.bartleby.com/107/

2.

Dutton M. Dutton’s Orthopaedic Examination, Evaluation, and Intervention. 5th ed. McGraw Hill Education; 2020.

3.

Gilroy AM, MacPherson BR, Wikenheiser JC, Voll MM, Wesker K, Schünke M, eds. Atlas of Anatomy. 4th ed. Thieme; 2020.