What Is the Greater Tubercle?

Large nodules belong to the humerus. It is an important part of the human body. It is located on the limbs of the human body. There is a protrusion on the outer side of the humerus near the proximal humerus. "Large nodules" is a medical term. Large nodules are prone to fracture in life, and it is not easy to recover after fracture.

The large humerus nodule is a bony bulge on the upper side of the upper humerus, which is a cancellous bone. It is the attachment site of the superior, inferior, and small round muscles. The large tuberosity of the humerus faces outward, constituting the outer wall of the tuberosity, and the long biceps tendon passes through the tuberosity. Fractures of the greater tuberosity of the humerus are more common in adults. ^[1]

The humerus nodule is a bone bulge on the outside of the upper end of the humerus. The anterior medial part of the nodule is the biceps tendon groove, through which the long head tendon of the biceps passes.

Onset

Fractures of the large tuberosity of the humerus are often complicated by anterior dislocation of the shoulder joint. Simple large tuberosity fractures are rare. Fractures are mostly caused by indirect external forces. When the arm falls, the shoulders are abducted. Violence is transmitted upwards along the arms. The large humerus nodules can collide with the acromion, and then contract due to the strong contraction of the muscles, such as the superior muscle A large nodule fracture occurred. A large humeral tuberosity fracture occurs during anterior and lower dislocation of the shoulder joint. The mechanism is the same as above. However, it can also occur after the dislocation of the shoulder, a strong pull of the tendon sleeve or a fracture of the humeral nodule and the anterior and inferior edge of the scapula. Simple fractures can only appear as cracks, and can sometimes shift slightly inward and upward. When the anterior dislocation of the shoulder joint occurs, the large nodule can be more obviously separated and displaced due to the pull of the superior muscles.

Clinical manifestations and diagnosis

There is a clear history of trauma, shoulder pain after injury, obvious swelling below the acromion, inability to move the arm, especially abduction and external rotation, that is, large nodule fractures should be thought of. The tenderness point is concentrated under the acromion, and sometimes the bone friction sign can be touched. Fractures with shoulder dislocation may have signs of shoulder dislocation, but pain and local swelling are more severe than simple shoulder dislocation. Confirmation depends on X-ray examination, it is best to take a positive film. Fractures are sometimes missed due to fluoroscopy. ^[2]

In order to correctly describe the morphological structure and positional relationship of human organs, human anatomy provides a unified term of axis, plane and orientation in order to unify understanding and avoid misunderstanding. Mastering these concepts and terms is an important principle for studying human anatomy This is also very important in clinical practice.

There are 206 bones in adults. According to their positions in the human body, they can be divided into four parts: trunk bone, upper limb bone, lower limb bone, and skull bone. Among them, 51 trunk bones, 64 upper limb bones, 62 lower limb bones, and skull 29 Piece. Bone weight accounts for about 1/5 of the body weight in adults and 1/7 in newborns. Each bone is an organ with a certain shape and function, which is both hard and elastic.
(I) The shape of bone Bone has different shapes, which can be divided into long bone, short bone, flat bone and

(1) Trunk bone Trunk bone includes vertebra, sternum and ribs. The trunk bone of an adult consists of 24 separated vertebrae, 1 metatarsal bone, 1 coccyx, 1 sternum, and 12 pairs of ribs, totaling 51 pieces.
1. Vertebrate vertebrae in early childhood, the total number of vertebrae is 33 to 34, namely 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae and 4 to 5 vertebrae. In adulthood, 5 sacral vertebrae heal into 1 sacrum, and 4 to 5 tail vertebrae heal into 1 coccyx. Therefore, the total number of vertebrae in adults is generally 26.

(1) General shape of vertebra: Each vertebra is composed of vertebral body and vertebral arch.
Vertebralbody is the anterior part of the vertebra. It is short cylindrical and is the main part to support body weight.
Vertebralarch is an arch plate attached to the back of the vertebral body. The part connecting the vertebral arch and vertebral body is called the pedicle, and its upper and lower edges have all traces, which are called the supra-vertebral notch and the sub-vertebral notch. When the vertebrae are overlapped, the lower vertebrae of the upper vertebrae and the upper vertebrae of the lower vertebrae form a hole called the intervertebral foramen, through which spinal nerves and blood vessels pass. The vertebral arch surrounds the vertebral bodythe hole is called the foramen. The vertebral foramen of all vertebrae are superimposed together to form a longitudinal tube called the spinal canal, which contains the spinal cord and spinal nerve root. Each vertebral arch has 7 protrusions: a pair of transverse processes protruding to both sides, a pair of upper articular processes upward, a pair of lower articular processes downward, and a spinous process backward.
(2) The main features of each vertebrae There are seven cervicalvertebrae in the cervical spine, which are characterized by transverse process holes in the transverse process and vertebral arteries and veins. The spinous processes of the 2nd to 6th cervical vertebrae are short and the ends are bifurcated. The 1st, 2nd, and 7th cervical vertebrae are special cervical vertebrae.
The first cervical vertebra, also called atlas, has no vertebral body, spinous processes, and articular processes. It is shaped like a ring and consists of anterior arch, posterior arch, and two lateral masses.
The second cervical vertebra is also called the axis vertebra, and a finger-shaped protrusion protruding from the vertebral body is called a tooth process.
The seventh cervical vertebra is also called vertebraeprommens. The spinous process is particularly long, and the ends become thick and not bifurcated. When the head is flexed forward, the process is particularly raised and easily accessible under the skin, which is a sign of clinical count of vertebrae.
There are 12 thoracicvertebrae in the thoracic spine, and there are vertebral ribs and transverse ribs on the side of the vertebral body and in front of the tip of the transverse process.
There are 5 lumbarvertebrae in the lumbar spine, which is the largest in the vertebrae. The vertebral body is hypertrophic, the spinous processes are plate-shaped and horizontally extended, and there is a large gap between adjacent spinous processes.
The sacrum of the sacrum is triangular, with its bottom facing upwards and its tip facing downwards. The leading edge of the bottom protrudes forward called the promontory, an important landmark for female pelvic measurements. The tip of the sacrum goes forward and connects to the coccyx.
There are auricular surfaces on both sides of the sacrum, and there is a pipe running through the entire length in the center as the sacral canal, which is continuous with the spinal canal, and the sacral canal hole is formed by the downward opening. The anterior metatarsal bone is slightly concave and smooth, with 4 pairs of anterior metatarsal holes; the posterior bulge is rough, and there are 4 pairs of posterior metatarsal holes.
The coccyx of the coccyx is triangular, with the bottom facing upwards, connected to the sacrum by cartilage and ligaments, with the tip down and the lower end free.
2. The sternum sternum is a flat bone located in the middle of the front of the chest. It is divided into three parts: the sternum stem, the sternum body, and the xiphoid process from top to bottom. The wide upper part of the sternum is called the sternal stalk. The middle part of the sternum is called a sternal body, and its side edge connects the 2nd to 7th rib cartilage. The sternal body and the sternum stem meet to form a forward-shaped transverse bulge called the sternum angle, which can be touched on the surface of the body. It is flat against the second rib cartilage and is an important sign for counting ribs. The lower end of the sternum is a thin thin piece of bone called a xiphoid process, which is cartilage at an early age, and is fully ossified only in old age.
3 There are 12 pairs of rib RIBS, which are composed of ribs and rib cartilage. The ribs are slender arch-shaped flat bones, which can be divided into the middle body and the front and rear ends. The front end of the rib is connected to the rib cartilage, and the rear end is called the rib. The ribs have inner and outer sides and upper and lower edges. There is a sulcus near the lower edge of the inner surface, and the intercostal blood vessels and nerves run along this sulcus.

(II) Upper Extremity Bone The upper extremity bone includes upper extremity bone and free upper extremity bone, with a total of 64 pieces on both sides.
1. Upper limb girdle includes collarbone and scapula.

(1) Clavicle: "~", located on both sides of the anterior upper thorax. The full length can be felt under the skin and is an important bony sign. The medial end is thick for the sternum end, which is related to the sternal stem; the lateral end is flat for the acromion end, which is related to the scapula. The junction of the middle and outer clavicle 1/3 is fragile and prone to fracture.
(2) Scapula scapula: It is a triangular flat bone, which is located behind the thorax and outside, between the 2nd to 7th ribs, with three edges, triangles, and two sides.
The outer corner of the upper edge has a curved finger-shaped protrusion called the coracoid process, which is accessible on the body surface. The inside edge is thin and long, and the outside edge is slightly thick.
The upper and lower corners are the upper and lower ends of the inner edge, respectively, and are flat against the second and seventh ribs, respectively, and can be used as body surface marks. The lateral angle is the thickest and has a pear-shaped articular surface called the glenoid, which is related to the humeral head.
The front is a large shallow fossa, facing the ribs called the subscapular fossa; the back is divided by a horizontal scapula into the upper and lower fossa. The protuberances extending outward at the lateral end of the scapula are called acromion.
2. Free upper limb bones include the humerus, radius, ulna, and hand bones. Except for the carpal bones of the hand bones, all are long bones.
(1) Humerus: located on the arm, divided into one body and two ends. The swollen hemisphere is called the humeral head, which is related to the glenoid-related segment of the scapula. The shallow groove around the head is called the anatomical neck. There are large nodules and small nodules on the outside and front of the humeral head. The shallow superficial sulcus between the large and small nodules is called the internodal sulcus, in which the long biceps tendon passes. The upper end of the humerus and the body junction is slightly called the surgical neck, which is a common site for fractures.
The humerus body has a rough "V" -shaped deltoid trochanter on the outer side of the middle part of the humerus, which is the attachment point of the deltoid. At the back of the body, there is a shallow sulcus that spirals from the inside up and down and is called the radial nerve sulcus. The radial nerve passes through it. Fractures of the humeral shaft can easily damage the radial nerve.
The lower end of the humerus is flat front and back and slightly curled forward. The outer part has a hemispherical humeral head, related to the radius. The inner part has a humeral tackle, which is shaped like a tackle, and a ulna related segment. There is a protrusion on the outer side of the small head and the inner side of the pulley, which are called outer epicondyle and inner epicondyle respectively. There is a shallow groove behind the medial epicondyle called the ulnar nerve groove, through which the ulnar nerve passes. When the epicondyle of the humerus is fractured, it is easy to damage the ulnar nerve.
(2) radius: located on the outer side of the forearm, divided into one body and two ends. The upper end is small and has a slightly enlarged radial head. Above the head there are joints associated with the small head of the humerus; the periphery of the head has a circular articular surface and the radial cut related sections of the ulna. The tapered part below the head is called the radial neck, and there is a tuberosity inside the neck called the radial tuberosity. The lower end is thick, and the articular surface on the inner side is called the ulnar notch, which is related to the ulnar head. The lateral part of the lower end is protruding downwardly called the radial styloid process.
(3) Ulna: located on the inner side of the forearm, divided into one body and two ends. The upper end is relatively thick, and the front half of the crescent-shaped articular surface is called the notch notch, which is related to the humerus tackle. There are protrusions at the upper back and lower front of the notch, which are called eagle mouth and coronoid process respectively. The articular surface of the outer side of the coronoid process is called the radial notch, which is related to the radial head. The rough bulge before and below the coronoid process is called the ulna. The lower end of the ulna is called the ulna head, and its anterior, outer, and posterior sides have circular articular surfaces and ulnar notch-related sections of the radius. The ulna head has a downward protuberance called the ulnar styloid process.
(4) Hand bones: divided into wrist bones, metacarpals and phalanges.
The carpalbones of the carpal are composed of 8 small short bones, arranged in two rows, each row has 4 pieces. From the radial side to the ulnar side, the proximal column is in order the scaphoid bone, lunar bone, triangular bone, and pea bone; the distal column is in order large polygonal bone, small polygonal bone, skull bone, and hook bone.
There are 5 metacarpalbones in the metacarpal bone, from the radial side to the ulnar side.
There are 14 phalangesoffingers in the phalanx, there are 2 phalanxes in the thumb, and 3 in each other. Proximal to distal are the proximal phalanx, middle phalanx, and distal phalanx.
(3) Lower extremity bone The lower extremity bone includes the lower extremity band bone and free lower extremity bone, with a total of 62 on both sides.
1. There is one hip bone on each side of the lower extremity.
Hip hipbone is an irregular flat bone that is located in the pelvis and forms the side wall of the pelvis. There is a deep socket on the outside of the hip bone called the acetabulum, which is associated with the femoral head. There is a large hole in the anterior inferior part of the hip bone called the obturator. The hip bones in early childhood consist of the sacrum above and below, the ischium below and below, and the pubic bone below and below. After 15 years of age, the three bones fused into a hip bone. The epiphysis of the upper edge of the sacrum is called the iliac crest. 5 to 7 cm behind the anterior superior iliac spine, the outward protrusion of the iliac crest is called the condylar tubercle. There is a thick and rough ischial tubercle at the lower part of the ischium. The medial part of the pubic bone has a forward protrusion called the pubic tubercle.
2. Free lower extremity bones include the femur, patella, tibia, fibula, and foot. With the exception of the sacrum and the sacrum of the foot, all are long bones.
(1) Femur femur: It is located in the thigh and is the longest bone of the human body. Its length occupies about 1/4 of its height and is divided into one body and two ends. The upper end has a spherical femoral head, which is associated with the acetabulum. The thinner part below the head is called the femoral neck. There are two ridges at the junction of the neck and body. The square ridges on the upper and outer sides are large trochanters, and the lower trochanters are small trochanters. The large trochanter is an important body surface sign that can be reached on the body surface.
The femoral body is slightly convex forward, and the posterior epiphysis is called the thick line, which continues to the gluteal muscle tuber.
There are two swellings at the lower end of the femur, called the medial condyle and lateral condyle. The most prominent parts of the medial and lateral condyles are called the medial epicondyle and lateral epicondyle, which are bony landmarks that can be felt on the body surface.
(2) Patella patella: It is the largest sesamoid in the whole body. It is located in the quadriceps tendon, with a wide upper and lower tip. The position of the sacrum is superficial, and fractures can occur due to direct impact of external forces.
(3) Tibia tibia: It is located on the inner side of the lower leg and is the bone that is the main load-bearing part of the lower leg. Therefore, it is thicker and can be divided into one body and two ends. There are 2 swellings at the upper end, which are called medial condyle and lateral condyle. There is a tibial tuberosity at the upper end of the tibia and in front of the body transition. The tibial body is triangular in shape, and its front edge and medial surface are close to the skin. The bulge of the medial side of the lower end of the tibia is called the medial malleolus.
(4) Fibula fibula: It is located on the lateral part of the lower leg and can be divided into one body and two ends. The upper end is slightly enlarged and is called the fibula head, which is related to the tibia. The tapering under the head is called the fibula neck, which is superficially subcutaneous and is an important bony sign. The lower end of the fibula is enlarged to the lateral ankle.
(5) Foot bone: It can be divided into patella, patella and phalanges.
Sacral tarsalbones belong to short bones, a total of 7 pieces, namely the talus, calcaneus, scapula, scaphoid bone and 3 wedge bones (medial wedge bone, middle wedge bone and lateral wedge bone).
There are 5 metatarsalbones in the patella, which are called 1-5th patella in order from the inside to the outside. The outward protrusion of the 5th bone base is called the 5th metatarsal tuberosity, which is easily accessible on the body surface, and is an important bony landmark.
There are 14 phalangesoftoes of the phalanges, the number and name of which are the same as the phalanges.
(IV) Skull There are 29 skulls (6 of which are ossicles), which are divided into two parts: the skull and the skull. The brain is located in the posterior upper part of the skull, and surrounds the cranial cavity, which houses the brain. The facial skull is the anterior lower part of the skull, forming the contour of the face, and participates in forming the oral cavity, nasal cavity, and orbit.
1. There are 8 skulls in the brain, including a frontal bone located in the anterior upper part of the skull, a occipital bone in the rear, a sphenoid bone in the middle of the skull base, a ethmoid bone between the two orbitals, and 2 parietal bones above it. 2 temporal bones on the side.
2. There are 15 facial skulls, one each for the vomera, mandible, and hyoid; two each for the maxilla, nasal bone, lacrimal bone, sacrum, lower turbinate and sacrum.
Maxilla2, located in the center of the facial skull. There is a large air-containing cavity in the bone called the maxillary sinus. The lower edge of the maxillary bone is free and there is an alveolar cavity that accommodates the maxillary root.
The mandiblel block of the mandible, located below the maxilla, can be divided into one body and two branches. The lower jaw body is centrally located and is in the shape of a horseshoe. The upper edge of the lower jaw body is provided with an alveolar receiving the root of the lower jaw. The mandibular branch protrudes upward from two protrusions, the anterior process is called the coronoid process, the posterior process is called the condyle, and the upper end of the condyle is called the mandible head, which is related to the mandibular fossa of the temporal bone.
3 Overall view of the skull (1) Skull cap: There is a transverse coronal suture between the frontal bone and the parietal bone, there is a sagittal suture between the left and right parietal bones, and a herringbone suture between the parietal bone and the occipital bone. There is an arched bulge above the upper orbital edge called the eyebrow arch.
(2) Skull base: It can be divided into inner face and outer face.
The inner surface of the skull base supports the brain, and three sockets are arranged stepwise from front to back, which are called anterior cranial fossa, middle cranial fossa and posterior cranial fossa. There are many holes, fissures, and tubes in each litter, and most of them open outside the skull.
There is a maxillary alveolar and hard palate bone plate in the front part outside the skull base. Above the posterior edge of the bone plate there are 2 posterior nostrils separated by vomera. The center of the back of the skull base has a large occipital foramen, and there are oval bulges on both sides of it called occipital condyles. There is a jugular foramen on the outer side of the occipital ridge, and there is an elongated osteoprosthesis called a styloid process on the outside of the foramen, and a mastoid process of the temporal bone on the outer side of the foramen. The hole between the styloid process and the mastoid process is called the papillary foramen.
(3) The front of the skull: It is composed of most of the facial skull and part of the brain skull, and together forms the orbital and bony nasal cavity.
The orbit orbit accommodates the eyeball and its ancillary structures, and has a four-sided pyramid shape, with the tip pointing inward and passing through the optic canal into the cranial cavity. Bottom forward and outward, its upper and lower edges are called the upper orbital edge and the lower orbital edge, respectively. The supraorbital notch (or supraorbital foramen) at the junction of the middle and inner 1/3 of the upper orbital rim, and the suborbital foramen below the midpoint of the lower orbital rim.
Bonynasalcavity is located in the center of the facial skull and is divided into left and right halves by the bonynasal septum. There are three curly bone fragments on the outer side of the nasal cavity, which are called the upper turbinate, the middle turbinate and the lower turbinate. The lower turbinate is an independent bone mass, and the upper and middle turbinates are part of the ethmoid bone. The space under each turbinate is called the upper, middle, and lower nasal passages.
There are 4 pairs of paranasal sinuses, including the frontal sinus, maxillary sinus, ethmoid sinus, and sphenoid sinus, all of which communicate with the nasal cavity. The frontal sinus is located in the frontal bone and opens in the middle nasal passage. The maxillary sinus is the largest and is located in the maxillary bone on both sides of the nasal cavity. It is open in the middle nasal passage. Because the sinus mouth is higher than the bottom of the sinus, it is not easy to drain in the upright position. The ethmoid sinus is located in the ethmoid bone and can be divided into anterior, middle and posterior groups. The anterior and middle groups open in the middle nasal passage and the posterior group opens in the upper nasal passage. The sphenoid sinus is located in the sphenoid bone and opens in the sphenoethmoidal recess above the upper turbinate.
(4) The side of the skull: There is an external ear door in front of the mastoid, and it enters the external ear canal inward. In front of the external ear door, there is a bow-shaped bone called the zygomatic arch, which can be touched on the body surface. The depression above the zygomatic arch is called the temporal fossa and houses the temporal muscles. In the temporal fossa, the junction of the frontal, apical, temporal, and sphenoid bones is called the pterygoid. The bone here is relatively weak, and the anterior branch of the middle meningeal artery passes on its inner surface. Therefore, when the wing point is fractured, it is easy to damage the artery, causing intracranial hematoma, which can be life threatening.
4 Neonatal skull The neonatal skull is not fully developed. There is a gap between each skull. It is closed by connective tissue membrane and is called cranial crest. The largest ridge is at the intersection of the sagittal suture and the coronal suture. It is diamond-shaped and is called the anterior ridge (frontal ridge). At the intersection of the sagittal and herringbone stitches, there is a triangular posterior condyle (pillow), which is closed about 3 months after birth. The anterior palate is often used as a clinical examination site for infant developmental conditions and intracranial pressure changes.
Myology I. General Skeletal muscle is the dynamic part of the motor system. Under the control of the nervous system, the skeletal muscle contracts, pulling the bone to produce movement. There are more than 600 human skeletal muscles, which are widely distributed, accounting for about 40% of body weight. Regardless of the size, each skeletal muscle has a certain shape, structure, and function, and has a rich distribution of blood vessels and lymphatic vessels, which are subject to a certain innervation.
(I) The shape of muscles and the shapes of structural muscles can be broadly divided into four types: long muscle, short muscle, broad muscle and orbicularis muscle according to their appearance. Long muscles are more common in the extremities. When contracted, the muscles shorten significantly and cause large movements. Some long muscles have more than two initial heads. According to their number, they are called biceps, triceps, and quadriceps; short The muscles are mostly distributed in the deep layer of the trunk, with obvious segmentation, and the amplitude of movement is small during contraction; the broad muscles are flat and thin, mostly distributed in the chest and abdominal wall. In addition to exercising the trunk, they also protect and support the internal organs. Orbicularis muscle is mostly annular, located around holes and fissures, closing the fissures when contracted.
Each skeletal muscle consists of two parts, the abdomen and the tendon. The muscular abdomen is mostly located in the middle part of the muscle and is mainly composed of a large number of striated muscle fibers. It is red, soft and has contractility. The tendons are mostly located at the two ends of the muscle abdomen, attached to the surface of the bone, and are mainly composed of dense connective tissue. They are white, tough, and have no contractility, but they can resist great traction.
(B) the starting and stopping and functioning of the muscle The muscle is generally attached to the bone at two ends and spans one or more joints in the middle. When muscles contract, they move the bones and produce movement. When muscles contract, the position of one bone is usually relatively fixed and the position of the other bone is relatively moved. The attachment point of the muscle on the fixed bone is usually called the starting point or fixed point, and the attachment point on the moving bone is called the dead point or moving point. Generally, the attachment point near the midline of the body or the proximal end of the limb is the starting point, and vice versa.
Muscles have two functions: one is the static effect, that is, the muscle has a certain tension to maintain a certain posture between various parts of the body, such as standing motions in sitting, sitting and gymnastics; the other is the dynamic effect, that is, the muscle Has a certain contraction force, enabling the body to complete various actions, such as reaching for objects, walking and running.
(III) Auxiliary structures of muscles The auxiliary structures of muscles are fascia, synovial sac, and tendon sheath. These structures are formed by the transformation of connective tissue around muscles under the influence of muscle movement. These structures have protection and assist muscle movement. Role.
1. Fascia Fascia is located on the surface of the muscle and is divided into two types: superficial fascia and deep fascia.
(1) Superficial fascia superficialfascia: also known as subcutaneous fascia, which is located under the skin and consists of loose connective tissue, which contains fat (subcutaneous fat), superficial veins, cutaneous nerves, superficial lymph nodes and lymphatic vessels. Clinically, it is injected subcutaneously, that is, the drug solution is injected into the superficial fascia.
(2) Deepfascia: Also known as the inherent fascia, it is located on the deep side of the fascia. It consists of dense connective tissue, which is spread throughout the body and continuous with each other. The deep fascia covers each muscle and penetrates into the muscle layers. Between them, the fascial sheath and fascial space of each muscle is formed. In addition, the deep fascia also surrounds blood vessels and nerves to form vascular nerve sheaths, and wraps the glands to form the glands' envelopes.
2. Synovial bursa synovialbursa is a closed connective tissue flat sac with a small amount of synovial fluid. Its size ranges from a few millimeters to a few centimeters in diameter, and some communicate with the joint cavity, while others exist independently. Mostly located between the tendon and the bone surface, it can reduce the friction between the two and promote the flexibility of tendon movement. Synovial sacs form synovitis when they are chronically injured and infected.
3 Tendinoussheath is a sheath tube that surrounds long tendons, and is mostly located in areas where the hands and feet are relatively frictional, such as the wrists, ankles, the palms of the fingers, and the toe plantar side. The tendon sheath consists of an outer tendon fibrous sheath (fibrous layer) and an inner tendon synovial sheath (synovial layer). The tendon sheath restrains the tendon and reduces friction between the tendon and the bone surface. Tenosynovitis, which is common clinically, is locally nodular in swelling, causing local pain and limited movement.