Contents
1. INTRODUCTION
2. GLENO-HUMERAL JOINT
3. ACROMIO-CLAVICULAR JOINT
4. STERNO-CLAVICULAR JOINT
5. SCAPULOTHORACIC JOINT
6. STABILITY OF SHOULDER JOINT
7. CLINICAL CONDITION:FROZEN
SHOULDER
SHOULDER JOINT COMPLEX
INTRODUCTION:
The shoulder complex, composed of the clavicle, scapula and humerus is an intricately designed combinations of joints the
links the upper extremity to the thorax.
The articular structures of the shoulder complex are designed primarily for mobility,allowing us to move and position the
hand through a wide range of space.
ARTICULATIONS:
The ‘shoulder joint complex’ consists of four basic articulations-
1. Glenohumeral joint.
2. Acromioclavicular joint.
3. Sternoclavicular joint.
4. Scapulothoracic articulation/scapulothoracic linkage
1.Glenohumeral Joint
Features:
• It is a joint between the head of humerus and glenoid
cavity of the scapula.
• The shoulder joint is a ball-and-socket type of synovial
joint.
• It has greater mobility than any other joint in the body.
Articular surface :formed by articulation of large
round head of humerus with the relatively
shallow glenoid cavity of the scapula.
Glenoid Labrum: The total available articular surface of
the glenoid fossa is enhanced by the glenoid labrum.
Glenohumeral Joint
Ligaments: capsular ligament (joint capsule)
Coracohumeral ligament
Glenohumeral ligament
Transverse humeral ligament
Accessory ligaments: coracoacromial ligament & Coracoacromial arch
Bursae:
Subscapular
Subacromial (subdeltoid)
Infraspinatus
Blood Supply: anterior & posterior circumflex humeral vessels
Suprascapular & Subscapular vessels
Nerve Supply: 1 Axillary nerve 2.Musculocutaneous nerve 3. Suprascapular nerve
Glenohumeral Joint
2.Acromioclavicular joint
Features:
It is a plane synovial joint ,with flat articular surfaces which
are approximately the same in size.
Articulating Surfaces:
The acromioclavicular joint consists of the articulation
between the lateral end of the clavicle and a small facet on the
acromion of the scapula. The joint cavity is subdivided by an
incomplete wedge-shaped articular disc.
Ligaments: 1. Acromioclavicular ligament:
2. Coracoclavicular ligament:
two parts: (a) conoid and
(b)trapezoid
Acromioclavicular ligament
Blood supply: Suprascapular and thoraco-acromial arteries.
Nerve supply: Lateral supraclavicular nerve
Muscles:
• descending and transverse parts of the trapezius muscle
• Pectoralis minor
• serratus anterior
• levator scapulae
• rhomboids
3.Sternoclavicular joint
Features:
• The sternoclavicular joint is a saddle type of
the synovial joint.
• It serves as the only structural attachment of
the shoulder complex and upper extremity to the axial
skeleton.
Articulating surfaces:
• between the manubrium of the sternum and the clavicle
bone.
• The articulation between the first rib costal cartilage
Sternoclavicular joint
Ligaments:Anterior and posterior sternoclavicular ligaments
Interclavicular ligament
Costoclavicular ligament
Blood supply: Internal thoracic and suprascapular arteries.
Nerve supply: Medial supraclavicular nerve.
MUSCLES: Deltoid Pectoralis major
Trapezius Sternocleidomastoid
Subclavius muscle Scalene muscles
4.Scapulothoracic linkage
Features: The scapulothoracic articulation is not a true
articulation, but a functional linkage between the
ventral aspect of the scapula and lateral aspect of the
thoracic wall. The linkage is provided by serratus
anterior muscle.
Articular surfaces: formed by the articulation of the
scapula with the thorax. It is not a true anatomic joint.
No ligaments present.
Stabilized by the synchronized actions of 3 muscles:
trapezius, serratus anterior.
Medial stabilizers are: levator scapulae and rhomboid
muscles
SHOULDER JOINT
STABILITY
Good Shoulder Stability enables to: carry out
strong, controlled and precise arm and
hand movements over a length of time.
Stability of Shoulder Joint
G
1. long head of
biceps tendon
2. Coracoacromial
arch
3. Rotator cuff
muscles 4.Glenoid
Labrum
Stability of Shoulder Joint
FACTORS PROVIDING STABILITY OF SHOULDER
The factors providing stability to Shoulder joint are:
1. Rotator cuff (musculotendinous cuff) :The rotator cuff is formed by blending together of tendons of subscapularis, supraspinatus,
infraspinatus and teres minor around the joint capsule.
2. Coracoacromial arch: The coracoacromial arch forms, the secondary socket of the glenohumeral joint and protects the joint from the above
and prevents the upward dislocation of the head of humerus.
3. Long head of biceps tendon: The long head of biceps brachii, passes above the head of humerus intracapsular, hence prevents its upward
displacement.
4. Glenoid labrum: The glenoid labrum provides protection by deepening the shallow glenoid cavity
CLINICAL CONDITON:FROZEN
SHOULDER
Frozen shoulder, also called adhesive capsulitis,
causes pain and stiffness in the shoulder.
Over time, the shoulder becomes very hard to move.
People with frozen shoulder have limited range of
motion both actively and passively.
FROZEN SHOULDER
Causes:
One of the most common causes of frozen shoulder is the immobility
that may result during recovery from a shoulder injury, broken arm
or a stroke
.
Symptoms
Pain from frozen shoulder is usually dull or aching. It is typically worse early
in the course of the disease and when you move your arm. The pain is usually
located over the outer shoulder area and sometimes the upper arm.
. Treatment
Frozen shoulder generally gets better over time, although it may take up to 3 years.
The focus of treatment is to control pain and restore motion and strength through
physical therapy.
FROZEN SHOULDER
Nonsurgical Treatment
Most people with frozen shoulder improve with relatively simple treatments to control pain and restore
motion.
1.Non-steroidal anti-inflammatory medicines
2.Physical therapy: Specific exercises will help restore motion. These may be done under the supervision of a
physical therapist. Therapy includes stretching or range of motion exercises for the shoulder.
Surgical Treatment
If your symptoms are not relieved by therapy and other conservative methods, you and your doctor may
discuss surgery
1.Shoulder arthroscopy.
2.Manipulation under anesthesia.
RESOURCES
WEBSITES:
● https://www.thespineandrehabgroup.com/frozen-shoulder-adhesive-capsulitis
● https://www.physio-pedia.com/Shoulder#:~:text=Shoulder%20%2D%20Physiopedia%20Introduction%20The%20sho
ulder,known%20as%20the%20Scapulothoracic%20(ST)
BOOKS:
Joint Structure And Function:
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