Humerus

9 Humerus

Orientation and general presentation (Figs 9.1 & 9.2)

The humerus (1) articulates medially with the scapula (2) through the scapulohumeral joint. The proximal epiphysis shows an intertubercular sulcus (3) limited by the greater tubercle (HGT) and the lesser tubercle (HLT) laterally and medially, respectively. The posterolateral aspect of the diaphysis presents a slightly V-shaped bony crest, the posterior (4) and anterior (5) branches of which are usually visible (dotted lines on figures are just next to the branches). The deltoid tuberosity (HDT) is at the intersection of both branches. The distal epiphysis has a medial epicondyle (HME) and a lateral epicondyle (HLE). Both upper (HMU) and lower (HML) angles of the medial epicondyle are usually well developed. The same epiphysis shows two joint surfaces: the humeral capitulum (6) and the humeral trochlea (7), articulating with the radius (8) and ulna (9) respectively.

Figure 9.1 Humerus (3D model).

A General position: anterior view. B Isolated bone: lateral view. C Proximal epiphysis: anterior view. D Distal epiphysis: anterior view.

Figure 9.2 Humerus (anatomic specimen).

A Humeral head and diaphysis: frontal view. B Humeral head: superior view. C Humeral head and diaphysis: posterior view. D Distal epiphysis: anterior view.

Humerus – Greater Tubercle (HGT)[R,L]

Landmark HGT

The greater tubercle is a large protuberance located laterally on the proximal epiphysis. The point to palpate is located on the center of its upper edge (see Figs 9.1 & 9.2).

The palpator stands behind the sitting subject, whose elbow is flexed.

The upper arm is in neutral position (in this position, the forearm should be parallel to the sagittal plane).

First locate SAA, SAE and SAT (see pp 56, 58 and 57) with your first, second and third fingers respectively.

Then, with your second finger, glide down and anteriorly (about half-a-finger-pulp width) to palpate the upper edge of the greater tubercle.

Select this point.

Manual palpation tip

• The deltoid muscle covers this tubercle and must be well relaxed to facilitate the palpation. To achieve this, support the subject’s forearm with your non-palpating hand.

• Mobilize the subject’s shoulder joint with small motions of abduction/adduction in order to feel more easily the upper edge of the greater tubercle gliding under your second finger.

Observe the humerus from a lateral view.

Locate the greater tubercle and the edge above it (blue line). The point to select is the center of the edge.

Move to a posterior view. Check that the most lateral point of the edge has been selected.

Tags: Color Atlas of Skeletal Landmark Definitions Guidelines for Repr

Sep 9, 2016 | Posted by admin in MANUAL THERAPIST | Comments Off

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