Feb 15, 2016
Shoulder Girdle Joints
Dr. M Farrukh ShahzadBSPT, PPDPT
Isra University, Islamabad Campus
2
Girdle means a belt, shoulder girdle encircle the shoulder region like a belt encircle the waist region or else where. It consist of the clavicle and the scapula. It connects the upper limb to the axial skeleton. Anteriorly, the clavicle
reaches the sternum and articulates with it at the sternoclavicular joint. The clavicle and the scapula are united to each other at the acromioclavicular joint. The
scapula is not connected to the axial skeleton directly, but is attached to it through muscles. There are two joints in
one shoulder girdle. Sternoclavicular joint.Acromioclavicular joint.
SHOULDER GIRDLE
• Articulation: This occurs between the sternal end of the clavicle, the manubrium sterni, and the first costal cartilage.
• Type: Synovial double-plane joint/compound and complex
• Capsule: This surrounds the joint and is attached to the margins of the articular surfaces.
• Ligaments: The capsule is reinforced in front of and behind the joint by the strong sternoclavicular ligaments
STERNOCLAVICULAR JOINT
Articular disc: The main bond of this joint. This flat fibrocartilaginous disc lies within the joint and divides the
joint's interior into two compartments. Inferiorly, the disc is attached to the sternum and the first costal cartilage at their junction. Anteriorly and posteriorly the disc is attached to the
capsule.
CONTINUED
Accessory ligaments: There are two other ligaments associated with this joint. The
costoclavicular ligament and the interclavicular ligament.
The costoclavicular ligament is a strong ligament that runs from the junction of the first rib with the first costal cartilage to the inferior
surface of the sternal end of the clavicle.The interclavicular ligament passes between
the sternal ends of the right and left clavicle.
CONTINUED
Nerve supply: The supraclavicular nerve and the nerve to the subclavius muscle.
Blood supply. Internal thoracic and supra scapular arteries.
Important RelationsAnteriorly: The skin and some fibers of the
sternocleidomastoid and pectoralis major musclesPosteriorly: The sternohyoid muscle; the brachiocephalic artery; , the left brachiocephalic vein and the left common
carotid artery
CONTINUED
SC JOINT
Articulation: This occurs between the acromion of the scapula and the lateral end of the clavicle
Type: Synovial plane jointCapsule: This surrounds the joint and is attached
to the margins of the articular surfacesLigaments: Superior and inferior
acromioclavicular ligaments reinforce the capsule;
ACROMIOCLAVICULAR JOINT
Accessory ligament: The very strong coracoclavicular ligament extends from the coracoid process to the undersurface of the
clavicle( two parts). It is largely responsible for suspending the weight of the scapula and the
upper limb from the clavicle. Nerve supply: The suprascapular nerve
Blood supply: The suprascapular arteries.
CONTINUED
Important RelationsAnteriorly: The deltoid muscle
Posteriorly: The trapezius muscle
Superiorly: The skin
CONTINUED
AC JOINT
Movements at the joints of the girdle are always associated with the movements of the scapula. The various movements are;
1. Elevation2. Depression3. Protraction4. Retraction
5. Forward rotation of scapula6. Backward rotation of scapula
MOVEMENTS AT THE SHOULDER
GIRDLE
Coracoacromial ligament.. triangular ligament extents between acromion and the coracoid.
Suprascapular ligamentSpinoglenoid ligament
LIGAMENTS OF SCAPULA
SHOULDER JOINT
Articulation: This occurs between the rounded head
of the humerus and the shallow, pear-shaped glenoid cavity of the
scapula. The articular surfaces are covered by
hyaline articular cartilage, and the glenoid cavity is
deepened by the presence of a fibrocartilaginous rim called the glenoid labrum.
Type: Synovial ball-and-socket jointCapsule: This surrounds the joint and is attached
medially to the margin of the glenoid cavity outside the labrum; laterally it is attached to the
anatomic neck of the humerus. The capsule is thin and lax, allowing a wide range of movement.
It is strengthened by fibrous slips from the tendons of the subscapularis, supraspinatus, infraspinatus, and teres minor muscles (the
rotator cuff muscles).
CONTINUED
CONTINUED
Synovial membrane: This lines the capsule and is attached to the margins of the cartilage covering the articular
surfaces. It forms a tubular sheath around the tendon of the long head of the biceps brachii. It extends through the
anterior wall of the capsule to form the subscapularis bursa beneath the subscapularis muscle.
CONTINUED
Ligaments: The glenohumeral ligaments are three weak bands of fibrous tissue
that strengthen the front of the capsule. The transverse humeral ligament strengthens the capsule and bridges the gap between the two
tuberosities.The coracohumeral ligament strengthens the capsule above and
stretches from the root of the coracoid process to the greater tuberosity of the humerus.
Accessory ligaments: The coracoacromial ligament extends between the coracoid process and the acromion. Its function is to protect the superior aspect of the
joint.Transverse humeral ligament. It bridges the upper part of the
bicipital groove of the humerus, the tendon of the long head of bicep brachii passes deep to the tendon.
CONTINUED
There are many bursae related to the glenohumeral joint, the most important of them are;
Subacromial (subdeltoid) bursa.Subscapularis bursa.Infraspinatus bursa.Subcoracoid bursa.
BURSAE RELATED TO SHOULDER JOINT
Anteriorly: The subscapularis muscle, coracobrachialis, short head of biceps and deltoid.
Posteriorly: The infraspinatus and teres minor and deltoid muscles
Superiorly: The supraspinatus muscle, Subacromial bursa, coracoacromial arch, and deltoid muscle
Inferiorly: The long head of the triceps muscle, the axillary nerve, and the posterior circumflex humeral
vesselsThe tendon of the long head of the biceps muscle passes through the joint and emerges beneath the transverse
ligament
RELATIONS
Blood supply. (PASS)Posterior circumflex arteryAnterior circumflex artery
Suprascapular arterySubscapular artery.
Nerve supply. (MAS).Musculocutaneous nerve
Axillary nerve.Suprascapular nerve.
BLOOD AND NERVE SUPPLY
Flexion Extension
Abduction. Complex movement.Adduction
Lateral rotationMedial rotation
MOVEMENTS/ MUSCLES
PRODUCING THESE
MOVEMENTS.
Factors responsible for the mobility of shoulder joint.
Greater head of humerus.Loose capsule.
Concurrent movements at shoulder girdle joints.Factors responsible for the stability of
shoulder joint.The coracoacromial arch
The rotator cuff Glenoidal labrum.
SHOULDER JOINT HAS SACRIFICED STABILITY FOR
MOBILITY..?
Best whishes….!
THANKS…!