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…!