), Type II: Curved undersurface of the acromion, Type III: Hooked undersurface of the acromion (This type has the highest correlation with subacromial pathology. DENNIS L. HART, MPA, PTt The shoulder complex consists of several ana tomical joints and one physiological joint. Furthermore, the shoulder allows for scapular protraction, retraction, elevation, and depression. Search. While most people think of the rotator cuff when they think of muscles surrounding the shoulder joint, these are just four of the 17 muscles that cross the shoulder joint. Studies have concluded that the coracoclavicular ligaments are the primary restraint to superior and posterior clavicular dislocation. These are the clavicle and scapula. People with a rotator cuff tear may experience pain and weakness in their shoulder. Hollinshead's Functional Anatomy of the Limbs and Back. 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. Anatomy and Biomechanics: The glenohumeral joint provides the largest range of motion among all diarthrodial joints but also has the greatest propensity for instability. Thomas R Gest, PhD is a member of the following medical societies: American Association of Clinical AnatomistsDisclosure: Nothing to disclose. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The labrum is a rim of cartilage that surrounds the socket of the shoulder joint. The glenoid cavity (or, alternatively, the glenoid fossa) is set on the expanded aspect of the lateral angle of the scapula. [10]. [7] The glenoid labrum, a fibrocartilaginous ring attached to the outer rim of the glenoid cavity, provides additional depth and stability. Rockwood C, Matsen F, eds. Human Anatomy. 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. The articulations between the bones make up the shoulder joints. Bigliani LU, Morrison DS, April EW. UpToDate. Additionally, the trapezius, serratus anterior, rhomboids, and levator scapulae insert on the scapula and are responsible for scapular mobility and stability. 2002 These muscles help to control the movements of the shoulder blade (the scapula), and this movement is critical to normal shoulder function. 1899211-overview 2004 Nov 15. The subacromial bursa (SAB) is the main bursa of the shoulder. Confirm the patient’s name and date of birth. This rim of fibrocartilage is the glenoid labrum. Satvik Munshi, MD Instructor, Department of Physical Medicine and Rehabilitation, Louisiana State University Health Sciences Center The notch is bridged by the superior transverse scapular ligament. Being their insertions so close to the axis of motion, i.e. [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. The rotator cuff is a group of four muscles and tendons that surround the glenohumeral joint. Allman FL Jr. Fractures and ligamentous injuries of the clavicle and its articulation. Philadelphia, Pa: WB Saunders; 1998. [8] An anterior dislocation is likely to occur when the arm is abducted, extended, and externally rotated. The acromioclavicular system (ACS) is formed by a complex of ligaments (conoid, trapezoid and acromioclavicular capsular ligaments) that stabilize the acromioclavicular joint (Fig. Philadelphia, Pa: Lippincott Williams & Wilkins; 2007. An understanding of the intricate network of bony, ligamentous, muscular, and neurovascular anatomy is required in order to properly identify and diagnose shoulder pathology. The rotator cuff muscles are important in movements of the ball-and-socket shoulder joint. By Matthew Hoffman, MD. It facilitates normal movement and is also commonly involved in shoulder disorders. A joint is the spot where two or more bones come together. The cuff muscles, in addition to providing rotational power to the humerus, center and retain the humeral head against the glenoid fossa. It is a ball and socket type of synovial joint. Wash your hands. Eur J Radiol. See the images below. The supraspinatus, infraspinatus, teres minor, and subscapularis muscles comprise the rotator cuff (see the following image) (see Table 1, below). The AC joint is frequently injured in athletes. The muscles of the shoulder joint are composed of skeletal muscle (see Skeletal Muscle - Structure and Histology and Skeletal Muscle Pathology). Ryan V, Brown H, Minns lowe CJ, Lewis JS. The shoulder is made up of three bones- the clavicle, the scapula, and the humerus as well as associated muscles, ligaments, and tendons. The average depth of the glenoid cavity is 2.5 mm, but the labrum serves to increase this depth. Clinical Examination of the Shoulder. Ellenbecker TS. The subacromial bursa lies on the superior aspect of the supraspinatus tendon (see the images below). Pelvis. 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. Philadelphia, Pa: Lippincott Williams & Wilkins; 2000. [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. In turn, the whole shoulder joint is covered by the three portions of the deltoid muscle. 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. The shoulder joint is the main joint of the shoulder. As… Skip to content. Different Bones of Your Shoulder Can Be Fractured, The pathophysiology associated with primary (idiopathic) frozen shoulder: A systematic review. Pass My Clinical Examination. 1986. The acromioclavicular (AC) joint is the only articulation between the clavicle and scapula. 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 surgical neck of the humerus is distal to the tubercles. Introduce yourself to the patient including your name and role. Radiological Atlas. 1909254-overview 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 scapular notch varies in size and shape. This is the only skeletal connection between the axial skeleton and the upper extremity. Two bones comprise the shoulder girdle. 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