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Glenohumeral Joint Jessica Vila & Carrie A. Hoch
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Ligaments Anterior view
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Bursae subacromial bursa subdeltoid bursa subcoracoid bursa
subscapular bursa
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Cartilage and Articular Capsule
glenoid labruim synovial membrane articular cartilage glenoid labruim synovial membrane fibrous layer Anterior/sliced view
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intertubercular sulcus
Humerus anatomical neck head anatomical neck greater tubercle surgical neck lesser tubercle intertubercular sulcus surgical neck deltoid tuberosity
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Scapula ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ Anterior view
superior angle ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ subscapular fossa ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ Anterior view Posterior view inferior angle
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Clavicle ⏎ ⏎
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Rotator Cuff Muscles supraspinatus Rotator cuff teres minor
infraspinatus subscapularis
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Clinical Issues Common rotator cuff injuries:
Tendinitis = tendons are inflamed due to overuse or overload Bursitis = bursa become irritated or inflamed Strain or tear = can result from tendinitis or stress
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Rotator Cuff Cont. Common causes:
Normal wear & tear - leads to breakdown of collagen in tendons and muscles Poor posture - muscle or tendons can become pinched under clavicle Falling - breaking fall w/ arm or falling onto arm can bruise or tear tendon or muscles
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Common Causes Cont. Lifting or pulling – can strain or tear tendons or muscles Repetitive stress – repetitive overhead movement can result in inflammation and tearing in tendons or muscles
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Risk Factors Age - most common in people > 40
Athletes - pitchers, tennis players Construction trades – painters, carpenters Weak shoulder muscles
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Surface Anatomy Essential Clinical Anatomy p. 428
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acromial part of deltoid middle part of trapezius spinal part of deltoid ascending part of trapezius triangle of auscultation
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descending part of trapezius clavipectoral triangle clavicle clavicular part of deltoid clavicular head of pectoralis major
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manubrium sternocostal head pectoralis major posterior axillary fold anterior axillary fold
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Accessory Nerve XI, Cervical & Brachial Plexus
⏎ Cervical plexus C1-C4 ⏎
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Nerves ✪ Brachial Plexus C5-T1 ✪ ✪ ✪ ✪ ✪ ✪ ✪ ✪ ✪ ✪
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Brachial Plexus ✪ ✪
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Arteries ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ Deep Scapular artery????
circumflex scapular a. ✓ ✓ Deep Scapular artery????
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Veins
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Anterior Deltoid Origin: Lateral third of clavicle
Insertion: Deltoid tuberosity Action: Shoulder flexion, Medial Rotation, Horizontal ADDuction Innervation: Axillary Nerve Vascular supply: Posterior Circumflex artery
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Middle Deltoid Origin: Acromion process Insertion: Deltoid Tuberosity
Action: Shoulder ABDuction Innervation: Axillary nerve Vascular supply: Posterior circumflex artery Middle Deltoid
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Posterior Deltoid Origin: Spine of Scapula
Insertion: Deltoid Tuberosity Action: Shoulder extension, hyperextension, lateral rotation and horizontal ABDuction Innervation: Axillary Nerve Vascular Supply: Posterior Circumflex artery
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Pectoralis Major (clavicular and sternal portions)
Origin: Medial third of clavicle, sternum, costal cartilages of the first six ribs Insertion: Lateral lip of bicipital groove of humerus Action: Shoulder ADDuction, medial rotation and horizontal ADDuction Innervation: Lateral and medial pectoral nerve Vascular Supply: Lateral thoracic artery
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1.)Teres Minor 2.) Teres Major 1 2 Origin: Axillary border of scapula
Insertion: Greater tubercle of Humerus Action: Shoulder Lateral rotation horizontal and horizontal ABDuction Innervation: Axillary nerve Vascular supply: Circumflex scapular artery 2.) Teres Major Origin: Axillary border of scapula (near the inferior angle) Insertion: Crest below lesser tubercle next to the latissimus dorsi muscle attachment Action: Shoulder extension, ADDuction and medial rotation Innervation: Subscapular nerve 1 2
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Latissimus Dorsi Origin: Lower three ribs, Spinous processes of T7 through L5( via dorsolumbar fascia), posterior surface of sacrum and iliac crest. Insertion: Medial lip of bicipital groove of humerus Action: Shoulder extension, ADDuction, medial rotation and hyperextension Innervation: Thorocodorsal nerve Vascular supply: DEEP scapular nerve
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1.) Subscapularis Origin: Subscapular fossa of the scapula
Insertion: Lesser tubercle of the humerus Action: Shoulder medial rotation Innervation: Subscapular nerve Vascular supply: Subscapular artery 1 2 3
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2.)Supraspinatus Origin: Supraspinous fossa of the scapula Action: Shoulder ABDuction
1 2 3 3.)Infraspinatus Origin: Infraspinous fossa of scapula Action: Shoulder Lateral rotation horizontal and ABDduction The Supraspinatus and Infraspinaus have the same: Insertion : Greater tubercle of the Humerus Innervation : Suprascapular nerve Vascular Subscapular artery
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Trapezius 1 2 3 Upper Trapezius Middle Trapezius Lower Trapezius
Origin: Occipital bone, nuchal ligament Insertion: Outer third of clavicle, acromion process Action: Scapular elevation and upward rotation Middle Trapezius Origin: Spinous process of C7 through T3 Insertion: Scapular Spine Action: Scapular depression Lower Trapezius Origin: Spinous processes of middle and lower thoracic vertebrae Insertion: Base of scapular spine Action: Scapular depression and upward rotation Innervation of all Three: Spinal accessory (cranial nerve XI) Vascular supply of all Three: Transverse cervical artery 1 2 3
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Levator Scapulae Origin: Transverse process of first four cervical vertbrae Insertion: Vertebral border of scapula between the superior angle and spine Action: Scapular elevation and downward rotation Innervation: Third and fourth cervical nerve Vascular supply: Dorsal scapular artery
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Pectoralis minor Origin: Anterior Surface, third through fifth ribs
Insertion: Coracoid process of the scapula Action: With ribs fixed: draws the scapula forward(ABDucts) and rotates scapula downward against the thoracic wall With scapula fixed: elevated the rib cage Innervation: Medial pectoral nerve Vascular supply: Axillary artery
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Serratus Anterior Origin: Lateral surface of the upper eight ribs
Insertion: The anterior surface of vertebral border of the scapula Action: Scapular protraction and upward rotation Innervation: Long thoracic nerve Vascular supply: Lateral thoracic artery
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The RHOMBOIDES!!! 1.) Rhomboideus minor 2.) Rhomboideus MAJOR: 1 2
Origin: Spinous processes of C7 through T1 Insertion: Vertebral border of scapula at the spine process 1 2 2.) Rhomboideus MAJOR: Origin: Spinous processes of T2 through T5 Insertion: Vertebral border of scapula between the spine and inferior angle The Rhomboideus major and the Rhomboideus major have the same: Action: Scapular retraction and downward rotation Innervation: Dorsal scapular nerve Vascular supply: Dorsal scapular artery
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Coracobrachialis Origin: Coracoid process
Insertion: Medial aspect of humerus Action: Weakly ADDucts shoulder joint Innervation: Musculocutaneous nerves, C6 and C7 Vascular Supply: Brachial Artery
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Study Reference
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Study Reference
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