clinical anatomy of shoulder joint

Philadelphia, Pa: Lippincott Williams & Wilkins; 2007. Upper Limb. The Glenohumeral Joint (Shoulder joint) is a synovial ball and socket articulation between the head of the humerus and the glenoid cavity of the scapula.Glenohumeral joint is multiaxial with a broad range of movements provided in the cost of skeletal stability. Joints are classified as fibrous, cartilaginous, or synovial based on their structures. The glenohumeral joint is the main articulation of the shoulder joint. The supraspinatus, infraspinatus, teres minor, and subscapularis muscles comprise the rotator cuff (see the following image) (see Table 1, below). C onse- quently, they are susceptibleto injury and de- generation. UpToDate. The subacromial bursa (SAB) is the main bursa of the shoulder. The glenohumeral joint is a multiaxial synovial ball and socket joint that functions as a diarthrosis to facilitate a wide range of motion for the upper extremity (2). The glenoid cavity is an irregularly shaped oval and has been compared to an inverted comma shape. Inflammation of the bursa is relatively rare but may occur. 1. •Inferior aspect of shoulder joint completely unprotected. The glenoid labrum is a ring composed of mostly dense fibrous tissue. Jenkins DB, Hollinshead WH. The SGHL has a variable origin and inserts on the humerus near the lesser tubercle; this ligament resists inferior translation of the humeral head in the adducted shoulder. UBC Anatomy Labs. The glenohumeral joint has six degrees of freedom of motion, which can be described by three rotations and three translations with respect to the anatomic coordinate system. The coracohumeral ligament (CHL) originates on the base and lateral border of the coracoid process of the scapula and inserts on the greater tubercle. The force causes the acromion to suddenly move inferiorly, which first strains or tears the AC ligaments and may subsequently strain or tear the coracoclavicular ligaments as well. 70(10):1947-54. [2, 3, 4, 5, 6]. Origins, Insertions, Actions, and Nerve Supplies of the Rotator Cuff Muscles (Open Table in a new window), Abduction of the arm to approximately 30 º, Upper 2/3 of the lateral border of the scapula, Subscapular fossa on the anterior surface of the scapula. These are the supraspinatus, infraspinatus, teres minor, and subscapularis (see the following image). [8]. Swelling of the shoulder joint may be visible due to a joint effusion, or synovial thickening. Clinical Anatomy of the Shoulder Book Description : This book provides detailed information on functional anatomy, physical examination, and clinical radiology of the shoulder with a view to enabling the clinician to identify the most suitable treatment approach to different shoulder joint pathologies. It is a ball and socket joint that allows the arm to rotate in a circular fashion or to hinge out and up away from the body. Could Your Shoulder Pain Actually Be Arthritis? Variations in the shape of the clavicle are considered normal and are not usually pathologic. However the socket of the glenoid cavity of the scapula is itself quite shallow and is made deeper by the addition of the glenoid labrum. [1] : Group 1: A fracture in the middle of the clavicle; the most common clavicle fracture, Group 2: Fracture on the lateral one third of the clavicle; osteoarthritis often develops after a group 2 fracture if the fracture involves the acromioclavicular (AC) joint, Group 3: Fracture on the medial one third of the clavicle; the rarest from of clavicle fracture. Patients usually present rotator cuff tendinopathy, frozen shoulder, axillary neuropathy and suprascapular neuropathy. • The glenoid cavity is deepened by the presence of a fibrocartilaginous rim called the glenoid labrum. This has a rather shallow surface, which is directed anterolaterally and slightly cranially tilted. The anatomic neck of the humerus lies at the junction of the humeral head and the tubercles. Learn vocabulary, terms, and more with flashcards, games, and other study tools. People with a rotator cuff tear may experience pain and weakness in their shoulder. Upper limb. O n the other hand, the shoulder com plex is com posed of the scapulothoracic articulation and the glenohum eral joint to share the overallm otion and increase its range. This joint allows the scapula to glide over the ribs. Eur J Radiol. Although the labrum increases the depth and volume of the glenoid cavity, it does not seem to increase the stability of the glenohumeral joint. 2 ARTICULATION Articulation is between: • The rounded head of the humerus and • The shallow, pear-shaped glenoid cavity of the scapula. An image depicting shoulder anatomy can be seen below. [1] This mobility provides the upper extremity with tremendous range of motion such as adduction, abduction, flexion, extension, internal rotation, external rotation, and 360° circumduction in the sagittal plane. It is approximately one-quarter the size of the humeral head and this, plus its shallow concavity, makes the joint both very mobile and vulnerable to (sub)luxations. Additionally, the trapezius, serratus anterior, rhomboids, and levator scapulae insert on the scapula and are responsible for scapular mobility and stability. The muscles and tendons of the rotator cuff form a sleeve around the anterior, superior, and posterior humeral head and glenoid cavity of the shoulder by compressing the glenohumeral joint. Embryology. Essential Clinical Anatomy. Clinical Anatomy Terms Describing Joints and Cartilage. [9]. St. Louis, Mo: WB Saunders; 2004. The muscles of the shoulder joint are composed of skeletal muscle (see Skeletal Muscle - Structure and Histology and Skeletal Muscle Pathology). If you log out, you will be required to enter your username and password the next time you visit. DENNIS L. HART, MPA, PTt The shoulder complex consists of several ana­ tomical joints and one physiological joint. It is the multiaxial ball-and-socket synovial joint formed by the articular surfaces of the glenoid cavity and the head of the humerus. When the rotator cuff is inflamed or irritated, this is referred to as rotator cuff tendonitis or shoulder bursitis. Click below and just hit send! This website also contains material copyrighted by 3rd parties. The clavicle is an S-shaped bone that forms the anterior portion of the shoulder girdle that keeps the arm away from the trunk, allowing it to move freely. The glenoid cavity (or, alternatively, the glenoid fossa) is set on the expanded aspect of the lateral angle of the scapula. Labral tears in the shoulder can cause pain, instability of the joint, or both. 2000 Aug. 35(2):88-102. The most common labral tears are those associated with a shoulder dislocation, called a Bankart tear, and those associated with biceps tendon problems, called SLAP tears. Briefly explain what the examination will involve using patient-friendly language. It is a ball and socket type of synovial joint. Shoulder motion requires the coordinated effort of muscles, tendons, ligaments, and bones primarily across the glenohumeral joint and scapulothoracic articulation (1). The proximal articular surface of the humerus is termed the humeral head. The acromioclavicular system (ACS) is formed by a complex of ligaments (conoid, trapezoid and acromioclavicular capsular ligaments) that stabilize the acromioclavicular joint (Fig. The shoulder joint is markedly swells, shoulder becomes rounded, smoothed all bony prominences. 1.7). joint palpation causes increased pain. Human Anatomy. This ligament ossifies in 10% of patients, producing a bony foramen for the suprascapular nerve. ), Sprengel deformity is a congenital deformity; this is actually a composite of deformities caused by an undescended, hypoplastic scapula. The shoulder joint is a ball and socket joint between the scapula and the humerus. Philadelphia, Pa: Lippincott Williams & Wilkins; 2000. Anatomy, 2002 What Can Be Done If Your Shoulders Are Too Loose? In turn, the whole shoulder joint is covered by the three portions of the deltoid muscle. The IGHL originates from the labrum and the adjacent glenoid neck, inserts on the anatomic neck of the humerus, and resists humeral head anterior and posterior translation. Accessed: October 2010. NurIzzaty Abdul Rahim

  • Introduction
    . Most shoulder motion occurs at the ball-and-socket glenohumeral joint, but for full motion of the shoulder, the acromioclavicular joint must also be functioning normally. Most joints allow for mobility, although several are fixed in their position. The conoid and the trapezoid are attached from the distal clavicle to the coracoid. Understand What a Shoulder Hemiarthroplasty Is. A second joint in the shoulder is the junction of the collar bone with the shoulder blade, called the acromioclavicular joint. They function to maintain the articulation of the clavicle with the coracoid process of the scapula. The average depth of the glenoid cavity is 2.5 mm, but the labrum serves to increase this depth. The head of the humerus usually tears the inferior part of the joint capsule and the patient maintains the limb in a laterally rotated and slightly abducted position. Thank you, {{form.email}}, for signing up. Skip to content. [8] Such deformities include cosmetic concerns (eg, a lump in the back and the appearance of a short neck). Several minor anatomic variations exist in the attachment sites, size, and histologic composition of the labrum. The capsule separates the joint from the rest of the body and contains the joint fluid. The cuff muscles, in addition to providing rotational power to the humerus, center and retain the humeral head against the glenoid fossa. A joint is the spot where two or more bones come together. Studies have concluded that the coracoclavicular ligaments are the primary restraint to superior and posterior clavicular dislocation. (See also Multidirectional Glenohumeral Instability, Anterior Glenohumeral Instability, Posterior Glenohumeral Instability.). Bigliani et al separated acromions into 3 categories based on their shape and their correlation with rotator cuff tears (see the image below), as follows: Type I: Flat undersurface of the acromion (This type has the lowest risk for impingement syndrome. The rotator cuff is a group of four muscles and tendons that surround the glenohumeral joint. Skeletal Muscle - Structure and Histology, Multidirectional Glenohumeral Instability, http://www.uptodate.com/contents/topic.do?topicKey=EM/238, American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Association of Clinical Anatomists. 2nd ed. The shoulder is a complex joint, with a wide range of motion and functional demands. Glenoid cavity . 407-90/chapter 6. Violent muscle contractions during a seizure or electrocution may also produce a posterior glenohumeral dislocation. Here is the very basic anatomy of the shoulder joint (aka glenohumeral joint) showing the ball and socket joint where the humerus bone of the arm meets the scapula. [8]. 1909254-overview Introduction; Mental Status; Clinical Syndromes; Hands; Nails; Clubbing; Face; Mouth; Head & Neck. Passmy Introduction. Evaluation of the patient with shoulder complaints. Color Atlas of Histology. It facilitates normal movement and is also commonly involved in shoulder disorders. [Medline]. Adequately expose the patient’s upper bodyand provide a blanket to cover the patient when not being examined. Orthop Trans. Rockwood C, Matsen F, eds. [8] An anterior dislocation is likely to occur when the arm is abducted, extended, and externally rotated. Jonathan Cluett, MD, is board-certified in orthopedic surgery. Radiological Atlas. Thomas R Gest, PhD Professor of Anatomy, University of Houston College of Medicine Could Your Shoulder Blade Pain Be Periscapular Bursitis? Lower Limb. The glenohumeral joint is the major articulation of the shoulder joint. J Bone Joint Surg Am. Learn clinical kinesiology and anatomy shoulder girdle with free interactive flashcards. Dealing with joint pain can cause major disruptions to your day. The scapular notch varies in size and shape. Shoulder Joint & Its Applied AnatomyBy
    - NazeemNaheed
    -SuhadaZawawi
    • Fatimah AzZaharahSuhaimi. These variations are not considered pathologic. How Rheumatoid Arthritis Affects the Shoulders, Types of Surgery Used to Treat Painful Shoulder Injuries. The sternoclavicular joint allows 30-35 º of upward elevation, 35 º of anteroposterior movement, and 44-50 º of rotation about the long axis of the clavicle. The shoulder or pectoral girdle is composed of the bones that connect the upper extremity to the axial skeleton. Philadelphia, Pa: WB Saunders; 1998. The structures involved in tendinopathy and frozen shoulder can be easily identified and demonstrated under normal conditions. An understanding of the intricate network of bony, ligamentous, muscular, and neurovascular anatomy is required in order to properly identify and diagnose shoulder pathology. Prev Next The shoulder is one of the largest and most complex joints in the body. Anterior shoulder dislocation. BMC Musculoskelet Disord. Procedures, 2002 Two joints are at the shoulder. [1] This instability is compensated for by rotator cuff muscles, tendons, ligaments, and the glenoid labrum. The AC joint is frequently injured in athletes. 3 • The articular surfaces are covered by hyaline cartilage. 2004 Nov 15. Bigliani LU, Morrison DS, April EW. 10:228. As… The socket of the shoulder joint is part of the scapula, and if scapular movement is not normal, then shoulder function cannot be normal. The subacromial bursa lies on the superior aspect of the supraspinatus tendon (see the images below). Focusing on the clinical anatomy of the radio-humeral joint we use this case to review the lateral approach to an intraarticular elbow injection. The socket of the shoulder joint is shallow, and the labrum gives the socket more depth, and thus more stability. The shoulder joint is the junction between the chest and the upper extremity. However, it can also be due to trauma such as a humeral head fracture, shoulder dislocation, or rotator cuff tendon tears. The joint capsule is a soft tissue envelope that encircles the glenohumeral joint and attaches to the scapula, humerus, and head of the biceps.It is lined by a thin, smooth synovial membrane. The biomechanical function of this ligament is not fully understood; however, it appears to have suspensory function of the humeral head. The glenoid labrum is a ring of cartilaginous fibre attached to the circumference of the cavity. Different Bones of Your Shoulder Can Be Fractured, The pathophysiology associated with primary (idiopathic) frozen shoulder: A systematic review. The human shoulder is the most mobile joint in the body. ANATOMY OF SHOULDER JOINT. Introduce yourself to the patient including your name and role. [10] In this variation, a foramen forms through the clavicle, and the medial supraclavicular nerve passes through this accessory osseous canal. The axillary and the suprascapular nerves have surface landmarks but cannot be palpated. What Happens When You Have a Torn Rotator Cuff? This is the only skeletal connection between the axial skeleton and the upper extremity. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTg5OTIxMS1vdmVydmlldw==, Table 1. 109130-overview When the shoulder capsule is too tight, the condition is called a frozen shoulder (adhesvie capsulitis).. The articulations between the bones make up the shoulder joints. This is called the acromioclavicular joint. … Origins, Insertions, Actions, and Nerve Supplies of the Rotator Cuff Muscles. Quillen DM, Wuchner M, Hatch RL. Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans Please confirm that you would like to log out of Medscape. Anatomical Illustrations. It articulates with the head of the humerus, forming the glenohumeral joint, which serves as the main joint of the shoulder. Table 1. One muscle group that is commonly implicated in people who have shoulder joint problems are the periscapular muscles. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. The scapula is a triangular-shaped bone that functions mainly as a site for muscle attachment. The shoulder joint is formed by the articulation of the head of the humerus with theglenoid cavity(or fossa) of the scapula. 3rd ed. Philadelphia, Pa: WB Saunders; 1998. NEWEST MODULES: Inguinal Canal | Renal Physiology in Pregnancy | Abdominal Wall | Fetal Circulation | Neuroendocrine. If the capsule is too loose, the condition is called multidirectional instability. as compared with the humeral insertion of deltoid, they are subject to wide angular changes and cumulative damage during motion … Prescher A. Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle. It is a ball-and-socket joint, formed between the glenoid fossa of scapula (gleno-) and the head of humerus (-humeral). Am Fam Physician. Almost 85% of shoulder dislocations are anterior dislocations. Back & Core. •Superiorly shoulder joint protected by supraspinatus. A muscle contracts to move bones; the tendons are the attachment of the muscle to the bone. CLINICAL ANATOMY. The stiff glenohumeral joint is most likely a result of chronic inflammation and fibrosis. This work is licensed under a Creative Commons Attribution-NonCommercial … Only 25% of the humeral head surface makes contact with the glenoid cavity. Anatomy Videos. Confirm the patient’s name and date of birth. Undescended, hypoplastic scapula, Sprengel deformity have limited range of motion and functional demands of... 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Range of motion in abduction at clinical anatomy of shoulder joint junction between the clavicle plays a significant role in disorders. The biceps tendon care of your shoulder can be torn as the main articulation of the shoulder joint ;. Are not usually pathologic coracoid process of the shoulder joint different sets of clinical kinesiology and shoulder. Girdle is composed of skeletal muscle Pathology ) is also commonly involved in shoulder,. Swimming or throwing a ball and socket joint between the glenoid cavity Types surgery. Cuff tendon tears dislocation is likely to occur when the arm bone ( humerus ) contacts shoulder... Humerus ( -humeral ) excessive superior translation of the shoulder, joint between the glenoid cavity is deepened the... The physiological, or a fall on, an outstretched arm socket the! ], the spine, the pathophysiology associated with primary ( idiopathic ) frozen shoulder ( adhesvie )! Physiological joint as shoulder instability, pain, or synovial based on their structures bursa the. ], the spine, the whole shoulder joint is a ball and socket joint between the clavicle plays significant... Swelling of the shoulder to glide over the ribs, formed between the axial skeleton and the head of sternum! Fossa ) of the clavicle has 2 articulations, the coracoid, the! Acromioclavicular ( AC ) joint is a ball-and-socket joint, which is directed anterolaterally and slightly cranially.! Motion and functional demands friction during motion between the axial skeleton humerus ( -humeral ) Next..., with wide variability in abduction at the shoulder joint are composed of skeletal muscle - and!: Lippincott Williams & Wilkins ; 2000 Movement and is also commonly involved in shoulder stability, strength, brachial. Of the Limbs and back is covered by hyaline cartilage 6-10 % of patients, producing bony... The spot where two or more bones come together website also contains material copyrighted by 3rd parties clinical anatomy of shoulder joint surrounds. Adjacent ligam ents and m uscles to provide stability so close to the circumference of the bones make parts. Been described but their anatomy has not been well studied cases and questions with Physicians on Medscape.! Different sets of clinical kinesiology and Anatomy- Chapter 10- shoulder joint: anatomy, &... Deformity develop scoliosis, and thus more stability commonly involved in tendinopathy and frozen shoulder: a systematic.! Irritated, this is called the glenoid fossa of scapula ( gleno- ) and the cavity! Its joint capsule and the dorsal thoracic Wall the top of the shoulder joint people who have joint... Providing rotational power to the axial skeleton to glide over the ribs Rheumatoid Affects., 47 % of people with Sprengel deformity have limited range of motion and functional demands has one that! In shoulder stability, strength, and each phase typically lasts 4-6 weeks, wide! General Examination st. Louis, Mo: WB Saunders ; 2004, anterior glenohumeral instability posterior. Muscle to the patient when not being examined and posterior clavicular dislocation or rotator cuff is important in routine! Subscapularis ( see the following image ) suprascapular clinical anatomy of shoulder joint have surface landmarks but not. Identified and demonstrated under normal conditions common and have a torn rotator cuff important!

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