?Rotator cuff
?Relations /nerve & blood supply
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?Movements & muscles producing them
?Dislocations /nerve injuries
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Articulation - Rounded head of humerus &Shallow , glenoid cavity of scapula.
Glenoid
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cavity? Articular surfaces are covered by articular - hyaline cartilage.
? Glenoid cavity is deepened by fibro cartilaginous rim called glenoid labrum.
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Synovial membrane
?lines fibrous capsule & attached to
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margins of the cartilage covering thearticular surfaces.
?forms a tubular sheath around the
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tendon of the long head of biceps brachii.?It extends through anterior wall of
capsule to form subscapularis bursa
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beneath subscapularis muscle.Synovial membrane
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Musculotendinious/Rotator cuff?Supraspinatus ? superiorly
?Infraspinatus & Teres minor- posteriorly
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?Subscapularis ? anteriorly?Long head of triceps ? inferiorly ( axillary n &
post circumflex humeral artery ? lax and least
supported) ?
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?most common dislocations ? Inferiorly axillary n
palsy ?loss of abduction
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NERVE SUPPLY of Shoulder joint
NERVE SUPPLY of Shoulder joint
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1. axillary n 2. suprascapular n &3. lateral pectoral nerve.
Shoulder joint - spaces
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Quadrangular space
Triangular space
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?Sup - teres minor?Sup ? teres major
?Inf - teres major
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?Medially- long head
?Medially - long head of of triceps
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triceps?Laterally ?
?Laterally ? lateral head triceps(humerus)
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of triceps (humerus)
?
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?Contents ? in spiralContents ? axillary
groove Radial nerve
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nerve & posterior
circumflex humeral
& profunda brachii
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artery
artery
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Shoulder Joint -Upper Limb
Dr Brijendra Singh
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Prof & Head
Department of Anatomy
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AIIMS RishikeshShoulder joint -movements:
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? Flexion?
Abduction
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?
Lateral
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? Extension?
Circumduction
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rotation
?
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Medialrotation
Flexion - 90?
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1. Deltoid - ant2. Pectoralis major
3. Biceps brachii
4. Coracobrachialis
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Extension is - 45??Deltoid post
?Latissimus dorsi
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?Teres majorAbduction:
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?Initiated - supraspinatus 0 to 18?19 120 - middle fibers of deltoid.
?Subscapularis
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?Infraspinatus
?Teres minor
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?Above 90 by rotation of scapula?Trapezius & Serratus Anterior
?Supraspinatus: initiates abduction(0 to 15) and
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holds the head of the humerus against glenoid
fossa of scapula;
?Latter function of supraspinatus allows deltoid
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muscle to contract and abduct humerus at
shoulder joint.
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Adduction:Normally upper limb
can be swung 45?
across front of chest.
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?pectoralis major?latissimus dorsi
?teres major
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?teres minor
Lateral rotation
Is about 40 - 45?.
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POST -?infraspinatus
?teres minor
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?posterior fibers of
the deltoid muscle
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19Medial rotation:
?Normal medial rotation is
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about 55?.
?performed by : muscles
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attached at BG - ANT?pectoralis major
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?Subscapularis?latissimus dorsi
?teres major
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?anterior fibers of deltoid.
Circumduction:
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This is a movementin which distal end
of humerus moves
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in circular motion
while proximal end
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remains stable.?It is -
1.Flexion,
2.Abduction,
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3.Extension &4.Adduction
Successively
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2.
the axillary
nerve
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3.
the posterior
circumflex humeral
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vesselsInferiorly:
1.
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the long head of
the triceps muscle
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Stability of the shoulder joint?This joint is unstable because of :
? shallowness of glenoid fossa
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? weak ligaments?Its strength almost entirely depends on tone of
rotator cuff muscles.
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?Tendons of these muscles are fused to
underlying capsule of shoulder joint.
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?Least supported part of joint lies in inferiorlocation, where it is unprotected by muscles.
Wrist drop
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? A subglenoid displacement of the head of the humerus into the quadrangular
space can cause damage to the axillary nerve.
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? This is indicated by paralysis of the deltoid muscle and loss of skin sensationover the lower half of the deltoid.
? Downward displacement of the humerus can also stretch and damage the
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radial nerve.
?A subglenoid displacement of head of
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humerus into quadrangular space can
cause damage to axillary nerve.
?This is indicated by paralysis of the
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deltoid muscle and loss of skin
sensation over lower half of the deltoid.
?Downward displacement of humerus
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can also stretch and damage radial
nerve.
Shoulder pain
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27
Branches from 1st part of subclavian artery
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? suprascapular artery,
(branch from 1st part of
subclavian artery)
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distributed to supraspinousand infraspinous fossae of
scapula.
? superficial cervical artery,
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which gives off a deep
branch that runs down
medial border of scapula.
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Branches from 3rd part of axillary artery? subscapular artery and its
circumflex scapular branch
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supply subscapular andinfraspinous fossae of scapula.
? anterior & posterior circumflex
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humeral artery.? Both circumflex arteries form
an anastomosing circle around
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surgical neck of the humerus.