Glenohumeral Joint
Jessica Vila
&
Carrie A. Hoch
Ligaments
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Anterior view
http://www.mlcmarlins.com.au/content/training/coaching_clinic/shoulders/shoulders.htm
Bursae
 subacromial bursa
 subdeltoid bursa
 subcoracoid bursa
 subscapular bursa
http://www.aidmybursa.com/shoulder-bursitis.php
Cartilage and Articular Capsule
glenoid labruim 
 synovial membrane
articular cartilage 
glenoid labruim 
synovial membrane 
fibrous layer 
Anterior/sliced view
http://home.comcast.net/~pegglestoncbsd/skeletal.htm
Humerus
anatomical neck
greater tubercle
lesser tubercle
head
anatomical neck
surgical neck
intertubercular sulcus
surgical neck
deltoid tuberosity
http://www.medicalook.com/human_anatomy/organs/Brachium.html
Scapula
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superior angle
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subscapular
fossa
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Anterior view
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inferior angle
Posterior view
http://thesebonesofmine.wordpress.com/category/scapula/
Clavicle
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http://legacy.owensboro.kctcs.edu/gcaplan/anat/Notes/API%20Notes%20H%20Skeletal%20Arm.htm
Rotator Cuff Muscles
supraspinatus
Rotator cuff
teres
minor
subscapularis
infraspinatus
http://www.rci.rutgers.edu/~uzwiak/AnatPhys/Blood_Vessels.html
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
http://www.mayoclinic.com/health/rotator-cuff-injury/DS00192
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
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
Risk Factors
• Age - most common in people > 40
• Athletes - pitchers, tennis players
• Construction trades – painters, carpenters
• Weak shoulder muscles
Surface Anatomy
Essential Clinical Anatomy p. 428
acromial part
of deltoid
spinal part
of deltoid
triangle of
auscultation
middle part
of trapezius
ascending part
of trapezius
descending part
of trapezius
clavipectoral
triangle
clavicular part
of deltoid
clavicle
clavicular head of
pectoralis major
manubrium
sternocostal head
pectoralis major
posterior
axillary
fold
anterior
axillary
fold
Accessory Nerve XI,
Cervical & Brachial Plexus
Cervical plexus C1-C4
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http://www.netteranatomy.com/ImageLibrary/
Nerves
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✪ Brachial Plexus
C5-T1
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http://www.nerveblocks.net/tutorium/?lang=en_EN&main=1&sub=1&section=content
Brachial Plexus
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http://www.netteranatomy.com/ImageLibrary/
Arteries
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circumflex scapular a.
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Deep Scapular artery????
http://www6.ufrgs.br/favet/imunovet/molecular_immunology/circulation.html
Veins
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http://www.rci.rutgers.edu/~uzwiak/AnatPhys/Blood_Vessels.html
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
Middle Deltoid
Origin: Acromion process
Insertion: Deltoid Tuberosity
Action: Shoulder ABDuction
Innervation: Axillary nerve
Vascular supply: Posterior
circumflex artery
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
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
1.)Teres Minor
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)
1
Insertion: Crest below lesser tubercle
next to the latissimus dorsi muscle
attachment
Action: Shoulder extension,
ADDuction and medial rotation
Innervation: Subscapular nerve
Vascular supply: Circumflex scapular artery
2
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
1.) Subscapularis
Origin: Subscapular fossa of the scapula
2
Insertion: Lesser tubercle of the humerus
Action: Shoulder medial rotation
Innervation: Subscapular nerve
1
3
Vascular supply: Subscapular artery
http://thewinger.com/2009/subscapularis
2.)Supraspinatus
Origin: Supraspinous fossa of the
scapula
2
Action: Shoulder ABDuction
1
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
3
Trapezius
Upper Trapezius
Origin: Occipital bone, nuchal ligament
Insertion: Outer third of clavicle, acromion process
1
Action: Scapular elevation and upward rotation
Middle Trapezius
2
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
3
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
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
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
The
RHOMBOIDES!!!
1.) Rhomboideus minor
Origin: Spinous processes of C7 through T1
Insertion: Vertebral border of scapula at the
spine process
1
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
2
Coracobrachialis
Origin: Coracoid process
Insertion: Medial aspect of humerus
Action: Weakly ADDucts shoulder joint
Innervation: Musculocutaneous nerves, C6 and C7
Vascular Supply: Brachial Artery
Study Reference
http://www.rocmd.com/conditions-treated/shoulder
Study Reference
http://www.netteranatomy.com/ImageLibrary
/
!
Who is this handsome man?