Shoulder Joint

Shoulder Joint
DR.HARDIP BARAIYA
Learning Object
 Type and variety
 Articular surfaces
 Ligament
 Relations
 Blood supply
 Movement
 Applied anatomy
How to Discribe a joint
 Defination
 Type of joint
 Variety of joint
 Articular surfaces
 Ligament
 Relation
 Blood supply
 Nerve supply
 Movement(muscle producing movement)
 Applied anatomy
Shoulder joint :-
 Defination
 -shoulder joint is formed by articulation of the scapula

(glenoid cavity) and head of the hemurus.
 Glenohumeral joint
Shoulder joint
 The shoulder is made up of two joints, the acromioclavicular

joint and the glenohumeral joint. The acromioclavicular joint
is where the acromion, part of the shoulder blade (scapula)
and the collar bone (clavicle) meet. The glenohumeral joint is
where the ball (humeral head) and the socket (the glenoid)
meet.
Type of joint
 Synovial joint
 Polyaxial joint
Variety of joint
 Ball and socket variety

Articular surfaces
 Distal articular surface

- head of hemurus (convex surface)
- Distal articular surface covered with hyaline cartilge.
 Proximal articular surface

- Glenoid Cavity (concavity of glenoid fossa )
- Glenoid fossa of the scapula
- Proximal articular surface covered with hyaline cartilge.
Shoulder joint – weak joint
 Glenoid fossa is too small and shallow

 To hold the head of the hemurus in this place
 The head is four time the size of glenoid cavity
 Structurally it is a weak joint.
WHAT IS LIGAMENT…?
 Ligaments are bands of tissue that help hold bones, joints

and organs in place.
 You can take several steps to protect your ligaments.
However, ligament sprains are very common, especially in the
ankle, knee, wrist, back and neck.
Ligament
 CAPSULAR LIGAMENT
 GLENOHUMERAL LIGAMENT
 CORACOHUMERAL LIGAMENT
 TRANSVERSE HUMERAL LIGAMENT
 CORACO ACROMIAL LIGAMENT
 GLENOID LABRUM
CAPSULAR LIGAMENT
 Extends between anatomical neck of humerus and glenoid

cavity.
Capsular ligament
GLENOHUMERAL LIGAMENT
 Anterior thickening of fibrous capsule

 • Defect causes anterior dislocation of shoulder joint.
CORACOHUMERAL LIGAMENT
 Extends between coracoid process of scapula and greater

tubercle of humerus.
TRANSVERSE HUMERAL LIGAMENT
 Streches between tops of greater and lesser tuberosities.
LEGEND
PHYSIO
CORACO ACROMIAL LIGAMENT
 Extends between coracoid process and acromial process of

scapula.
 Preventions superior dislocation of shoulder joint.
GLENOID LABRUM
 Fibrocartilage - Surrounds the margin of glenoid cavity.

 Deepens glenoid cavity.
Relation
 SUPERIOR:
 • Coraco acromial arch
 • Supraspinatus tendon
 • Subacromial bursa
 • Deltoid
 INFERIOR:
 • Long head of triceps brachii
 • Axillary nerve
 • Posterior circumflex humeral vessels
 ANTERIOR:
 • Subscapularis
 • Coracobrachialis
 • Short head of biceps brachii
 • Deltoid
 POSTERIOR:
 • Infraspinatus
 • Teres minor
 • Deltoi
WHAT IS BURSAE…?
 Bursa, and bursas or bursae for the plural form, is an

important lubricated fluid-filled thin sac located between
bone and surrounding soft tissue, bones and tendons,
and/or muscles around joints, and are useful to the human
body by reducing tension and negative effects of wear-and-
tear at points of friction .
BURSAE
 SUBSCAPULAR BURSA:
 • Lies below subscapular tendon.
 • Communicates with joint cavity.
Bursae conti…
SUBACROMIAL BURSA:
 • Lies between Coraco-acromial ligament above and
supraspinatus below.
 • Largest bursa and continues below deltoid as sub-deltoidal
bursa.
 INFRASPINATUS BURSA:
 • Lies below infraspinatus tendon.
 • Communicates with joint cavity.
ROTATOR CUFF (MUSCULOTENDINOUS CUFF)
 FORMATION:
 • Formed by tendons of muscles surrounding shoulder joint
 Superior – Supraspinatus
 Posterior -Infraspinatus;
Teres minor
 Interior - Subscapularis
Rotator cuff conti….
 • Most important factor
providing support to shoulder
joint.
 • Deficient inferiorly (Inferior
dislocation of joint is more
common).
Blood supply
 Anterior circumflex humeral artery

 postrior circumflex humeral artery
 Suprascapular artery
 Circumflex scapular brance of subscapular artery
 Brachial artery
Nerve supply
 Axillary nerve (posterior division)

 Suprascapular nerve
 Lateral pectoral nerve
MOVEMENTS MUSCLES INVOLVED
Pectoralis Major
FLEXION Deltoid (Anterior fibres)
Biceps brachii
EXTENSION Latissimus dorsi

Deltoid (Posterior fibres)
Pectoralis major
ADDUCTION Latissimus dorsi
Teres major
ABDUCTION 0 -15° Supraspinatus

15 - 90° Deltoid (Lateral fibres)
90 - 180° Serratus anterior, Trapezius
MEDIAL ROTATION Subscapularis

Deltoid (Anterior fibres)
LATERAL ROTATION Infraspinatus

Teres minor
Deltoid (Posterior fibres)
Movement conti….
Movement conti….
 NOTE:-
 • Deltoid muscle forms all relations for shoulder joint except inferiorly.
 • Deltoid causes all movements at shoulder joint except adduction.
 CIRCUMDUCTION - Combination of all movements of shoulder joint.
 SCAPULOHUMERAL RHYTHM –
 • Abduction of shoulder joint is accompanied by lateral rotation of scapula.
 • Scapula and humerus move in ratio 1:2
 • For every 15° abduction, scapular movement is 5° and humeral movement is 10°.
Clinical anatomy
 DISLOCATION OF SHOULDER JOINT

 • More common -Inferior dislocation
 • Rotator cuff deficit inferiorly.
 • Causes injury of axillary nerve - Deltoid and teres minor
palsy.
Clinical antomy conti…
 PAINFUL ARC SYNDROME / IMPINGEMENT SYNDROME

 • Most common cause - Supraspinatus injury; Subacromial
bursitis
 • Painful abduction
L.P
Clinical antomy conti…
 FROZEN SHOULDER
 • Inflammation of rotator cuff tendons
 • Painful movements
Thank Y0u…..

Shoulder Joint

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Shoulder Joint

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Shoulder Joint

 -shoulder joint is formed by articulation of the scapula

 The shoulder is made up of two joints, the acromioclavicular

 Ball and socket variety

 Distal articular surface

 Proximal articular surface

 Glenoid fossa is too small and shallow

 Ligaments are bands of tissue that help hold bones, joints

 Extends between anatomical neck of humerus and glenoid

 Anterior thickening of fibrous capsule

 Extends between coracoid process of scapula and greater

 Streches between tops of greater and lesser tuberosities.

 Extends between coracoid process and acromial process of

 Fibrocartilage - Surrounds the margin of glenoid cavity.

 Bursa, and bursas or bursae for the plural form, is an

 Anterior circumflex humeral artery

 Axillary nerve (posterior division)

EXTENSION Latissimus dorsi

ABDUCTION 0 -15° Supraspinatus

MEDIAL ROTATION Subscapularis

LATERAL ROTATION Infraspinatus

 CIRCUMDUCTION - Combination of all movements of shoulder joint.

 DISLOCATION OF SHOULDER JOINT

 PAINFUL ARC SYNDROME / IMPINGEMENT SYNDROME

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