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By: Nathan, Melissa, Shanik. Shoulder Joint (Glenohumeral Joint) . Surface Anatomy . Anterior axillary fold. Manubrium. Posterior axillary fold. Anterior axillary line. Surface Anatomy. Clavicle. Clavicular Deltoid origin. Clavipectoral triangle. Clavicular Pectoralis

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surface anatomy
Surface Anatomy

Anterior axillary fold

Manubrium

Posterior axillary fold

Anterior axillary line

slide3

Surface Anatomy

Clavicle

Clavicular Deltoid origin

Clavipectoral triangle

Clavicular Pectoralis

Major origin

Sternocostal head of

Pectoralis Major

surface anatomy4
Surface Anatomy

Descending Trapezius

Middle Trapezius

Anterior Deltoid

Acromial Deltoid origin

Middle Deltoid

Posterior Deltoid

Ascending Trapezius

Scapular Spine Deltoid origin

Triangle of Auscultation

classes of joints
Classes of Joints

There are three classes of joints in the body which are called:

  • Fibrous
  • Cartilaginous
  • Synovial

The shoulder is a Synovial Joint

types of synovial joints
Types of Synovial Joints

There are six types of synovial joints that occur in the body:

  • Plane or griddle Joints
  • Saddle Joints
  • Hinge Joints
  • Pivot Joints
  • Ball-and-socket Joints
  • Ellipsoid joints

The shoulder is a ball-and-socket joint which allow for ROM in most directions

types of synovial joints7
Types of Synovial Joints

Plane Joint Saddle Joint

Ball-and-Socket Joint

movements of the shoulder
Movements of the Shoulder
  • The shoulder joint can do most ROM:
  • Flexion
  • Extension
  • Abduction
  • Adduction
  • Rotation
  • Circumduction
synovial membrane
Synovial Membrane
  • Synovial joints are lined with a membranes called synovial membrane that secretes synovial fluid into the joint for :
  • Lubrication
  • Nourishes
  • Smooth movements
  • Filling all empty spaces
articular cartilage
Articular Cartilage
  • Bone ends in the synovial joint are covered by hyaline cartilage called Articular Cartilage for smooth gliding movements
  • The humeral head articulates with the glenoid cavity of the scapula
articular capsule
Articular Capsule

The articular cartilage is surrounded by a joint capsule made of:

  • Synovial Membrane
  • Fibrous Layer

Helps hold the bones together and allows for movement to happen

layers of capsule
Layers of Capsule
  • Fibrous layer aids in covering periosteum of the bone and helps with strength and stability of the joint
  • Synovial membrane covers the internal portion of the joint and secretes synovial fluid

Capsule

Membrane

Fluid

Articular Cartilage

cartilage of shoulder
Cartilage of Shoulder

Because glenoid cavity is shallow, the head of humerus needs help to articulate with the cavity (Articular Cartilage on surface)

GlenoidLabruim –

ring of fibrocartilaginous material that attaches to the margin of the glenoid cavity

FL

GC

SM

GL

FL- Fibrous Layer, GC- Glenoid Cavity,

SM- Synovial Membrane, GL- GlenoidLabruim

bursae
Bursae
  • In some synovial joints, bursae are found
  • Extension of a synovial membrane that form into a sac
  • Filled with synovial fluid
  • Help cushion or protect tendons from rubbing against bones
bursae of the shoulder
Bursae of the Shoulder
  • Subacromial bursa or Subdeltoid bursa
    • Located between acromion, deltoid, and coracoacromial ligament
    • Helps with movement of supraspinatus tendon
subscapular bursa
Subscapular Bursa
  • Subscapular bursa or subcoracoid bursa
    • Located between the tendon of the subscapularis muscle and the neck and corocoidproccess of scapula
    • Protects and reduces friction between the tendon where it passes inferior to the coracoid process and over the neck of the scapula
ligaments of the shoulder
Ligaments of the Shoulder

Ligaments are fibrous tissue that connects bones to other bones. They are sometimes called articular ligaments

  • Coracohumeral
  • Transverse humeral
  • Coniod
  • Acromioclavicular
  • Glenohumeral
  • Coracoclavicular
  • Superior transverse scapular
location of ligaments
Location of Ligaments
  • Acromiolclavicular ligament: Extends from the acromion to the clavicle
  • Coracoclavicular ligament: Anchors the clavicle to the coracoid process of scapula

- Conoid: Attaches to the root of the coracoid process, base attaches to the inferior surface of the conoid tubercle of the clavicle

  • Glenohumeral ligaments: Part of the fibrous layer of the capsule. Consists of superior, middle, and inferior ligaments. All originate from the humerus to margin of glenoid cavity
  • Coracohumeral ligament: Root of the coracoid process to humeral neck
  • Transverse Humeral ligament: Broad fibrous band from greater to lesser tubercle. Holds the tendon from the long head of the biceps brachii muscle
  • Superior transverse scapular ligament: Attached by end of the coracoid process and inserts into the medial end of the scapular notch

1

2

4

6

5

3

posterior musculature
Posterior Musculature

Posterior Musculature

Upper trapezius

Levator scapulae

Levator scapulae

Middle Trapezius

Middle Trapezius

Rhomboid Minor

Rhomboid Minor

Infraspinatus

Infraspinatus

Rhomboid Major

Rhomboid Major

Posterior Deltoid

Posterior Deltoid

Teres Minor

Teres Minor

Teres Major

Teres Major

Serratus anterior

Serratus anterior

Lower trapezius

slide20

Posterior Musculature

Trapezius

Innervation: Spinal accessory nerve

Vascularization: Transverse cervical artery

Upper

Action: Scapular elevation and upward rotation

Middle

A: Scapular retraction

Lower

A: Scapular depression and upward rotation

Levator Scapulae

I: 3rd and 4th Cervical nerves

V: Dorsal Scapular Artery

A: Scapular elevation and downward rotation

Serratus anterior

I: Long Thoracic Nerve

V: Lateral Thoracic Artery

A: Scapular protraction and upward rotation

Rhomboideus Major and Minor

I: Dorsal scapular nerve

V: Dorsal scapular artery

A: Scapular retraction and downward rotation

posterior musculature21
Posterior Musculature

T1

Supraspinatus

Supraspinatus

Infraspinatus

Deltoid

Teres Minor

Teres Major

Latissimus Dorsi

musculature
Musculature

Deltoids

I: Axillary Nerve

V: Posterior circumflex artery

Anterior

A: Shoulder flexion, medial rotation, horizontal adduction

Middle

A: Shoulder abduction

Posterior

A: Shoulder extension, hyperextension, lateral rotation, horizontal abduction

Latissimusdorsi

I: Thoracodorsal nerve

V: Deep scapular artery

A: Shoulder extension, adduction,

medial rotation, hyperextension

Teres Major

I: Subscapular Nerve

V: Circumflex scapular artery

A: Shoulder extension, adduction,

medial rotation

anterior view of musculature
Anterior view of Musculature

Manubrium

Clavicle

Subscapularis

Pectoralis Major

Coracobrachialis

Anterior Deltoid

musculature24
Musculature

Pectoralis Major

I: Lateral and Medial pectoral nerve

V: Lateral Thoracic artery

A: Shoulder adduction, medial rotation, horizontal adduction

Pectoralis Minor

I: Medial pectoral nerve

V: Axillary artery

A: Scapular depression, protraction, and downward rotation

Coracobrachialis

I: Musculocutaneous nerves C6, C7

V: Brachial artery

A: Weakly adducts the shoulder joint

Origin: Coracoid process

Insertion: Medial aspect of humerus

rotator cuff
Rotator Cuff

The Rotator Cuff is made up of four muscles, Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. The “SITS” muscles

The tendons of these four muscles merge with the joint capsule of the shoulder as they pass it to insert on the tubercles of the humerus. This insertion forms a partial sleeve around the proximal end of the humerus.

The Rotator Cuff reinforces the joint capsule and holds the head of the humerus in the glenoid cavity.

muscles of the rotator cuff
Muscles of the Rotator Cuff

Subscapularis

I: Subscapular nerve

V: Subscapular artery

A: Medial rotation

Teres Minor

I: Axillary nerve

V: Circumflex scapular artery

A: Lateral rotation, horizontal abduction

Supraspinatus

I: Subscapular nerve

V: Subscapular artery

A: Shoulder abduction

Infraspinatus

I: Subscapular nerve

V: Subscapular artery

A: Lateral rotation, horizontal abduction

rotator cuff tear
Rotator Cuff Tear

Rotator Cuff Tear

•Common in sports and recreation.

•Joint is not protected ventrally

•Supraspinatus is easily torn with:

pitching (baseball)

falls (skiing)

hard blows from the side (hockey)