By: Nathan, Melissa, Shanik

Anterior axillary fold
Posterior axillary fold
Anterior axillary line
Manubrium

Clavicular Deltoid origin
Clavipectoral triangle
Clavicle
Clavicular Pectoralis
Major origin
Sternocostal head of
Pectoralis Major

Descending Trapezius
Anterior Deltoid
Middle Deltoid
Posterior Deltoid
Ascending Trapezius
Middle Trapezius
Acromial Deltoid origin
Scapular Spine Deltoid origin
Triangle of Auscultation

There are three classes of joints in the body which are called:



Fibrous
Cartilaginous
Synovial
The shoulder is a Synovial Joint

There are six types of synovial joints that occur in the body:



Plane or griddle Joints
Saddle Joints
Hinge Joints


Pivot Joints
Ball-and-socket Joints
 Ellipsoid joints
The shoulder is a ball-and-socket joint which allow for ROM in most directions

Ball-and-Socket Joint
Plane Joint Saddle Joint

 The shoulder joint can do most ROM:






Flexion
Extension
Abduction
Adduction
Rotation
Circumduction






Synovial joints are lined with a membranes called synovial membrane that secretes synovial fluid into the joint for :
Lubrication
Nourishes
Smooth movements
Filling all empty spaces

 Bone ends in the synovial joint are covered by hyaline cartilage called Articular
Cartilage for smooth gliding movements
 The humeral head articulates with the glenoid cavity of the scapula

The articular cartilage is surrounded by a joint capsule made of:


Synovial Membrane
Fibrous Layer
Helps hold the bones together and allows for movement to happen



Fibrous layer aids in covering periosteum of the bone and helps with strength and stability of the joint
Synovial membrane covers the internal portion of the joint and secretes synovial fluid
Capsule
Membrane
Fluid
Articular Cartilage

FL
GC
SM
GL
Because glenoid cavity is shallow, the head of humerus needs help to articulate with the cavity
(Articular Cartilage on surface)
Glenoid Labruim – ring of fibrocartilaginous material that attaches to the margin of the glenoid cavity
FL- Fibrous Layer, GC- Glenoid Cavity,
SM- Synovial Membrane, GL- Glenoid
Labruim





In some synovial joints, bursae are found
Extension of a synovial membrane that form into a sac
Filled with synovial fluid
Help cushion or protect tendons from rubbing against bones

 Subacromial bursa or
Subdeltoid bursa
 Located between acromion, deltoid, and coracoacromial ligament
 Helps with movement of supraspinatus tendon

 Subscapular bursa or subcoracoid bursa
 Located between the tendon of the subscapularis muscle and the neck and corocoid proccess of scapula
 Protects and reduces friction between the tendon where it passes inferior to the coracoid process and over the neck of the scapula

Ligaments are fibrous tissue that connects bones to other bones. They are sometimes called articular ligaments


Coracohumeral
Transverse humeral





Coniod
Acromioclavicular
Glenohumeral
Coracoclavicular
Superior transverse scapular







Acromiolclavicular ligament: Extends from the acromion to the clavicle
Coracoclavicular ligament: Anchors the clavicle to the coracoid process of scapula
- Conoid: Attaches to the root of the coracoid process, base attaches to the inferior surface of the conoid tubercle of the clavicle
Glenohumeral ligaments: Part of the fibrous layer of the capsule. Consists of superior, middle, and inferior ligaments. All originate from the humerus to margin of glenoid cavity
Coracohumeral ligament: Root of the coracoid process to humeral neck
Transverse Humeral ligament: Broad fibrous band from greater to lesser tubercle. Holds the tendon from the long head of the biceps brachii muscle
Superior transverse scapular ligament:
Attached by end of the coracoid process and inserts into the medial end of the scapular notch
4
5
1
3
2
6

Upper trapezius
Lower trapezius

Trapezius
Innervation: Spinal accessory nerve
Vascularization: Transverse cervical artery
Upper
Action: Scapular elevation and upward rotation
Middle
A: Scapular retraction
Lower
A: Scapular depression and upward rotation
Serratus anterior
I: Long Thoracic Nerve
V: Lateral Thoracic Artery
A: Scapular protraction and upward rotation
Rhomboideus Major and Minor
I: Dorsal scapular nerve
V: Dorsal scapular artery
A: Scapular retraction and downward rotation Levator Scapulae
I: 3rd and 4th Cervical nerves
V: Dorsal Scapular Artery
A: Scapular elevation and downward rotation

Supraspinatus
Deltoid
T1
Latissimus Dorsi
Supraspinatus
Infraspinatus
Teres Minor
Teres Major

Deltoids
I: Axillary Nerve
V: Posterior circumflex artery
Anterior
A: Shoulder flexion, medial rotation, horizontal adduction
Middle
A: Shoulder abduction
Posterior
A: Shoulder extension, hyperextension, lateral rotation, horizontal abduction
Latissimus dorsi
I: Thoracodorsal nerve
V: Deep scapular artery
A: Shoulder extension, adduction, medial rotation, hyperextension
Teres Major
I: Subscapular Nerve
V: Circumflex scapular artery
A: Shoulder extension, adduction, medial rotation

Clavicle
Pectoralis Major
Anterior Deltoid
Manubrium
Subscapularis
Coracobrachialis

Pectoralis Major
I: Lateral and Medial pectoral nerve
V: Lateral Thoracic artery
A: Shoulder adduction, medial rotation, horizontal adduction
Pectoralis Minor
I: Medial pectoral nerve
V: Axillary artery
A: Scapular depression, protraction, and downward rotation
Coracobrachialis
I: Musculocutaneous nerves C6, C7
V: Brachial artery
A: Weakly adducts the shoulder joint
Origin: Coracoid process
Insertion: Medial aspect of humerus

The Rotator Cuff is made up of four muscles, Supraspinatus,
Infraspinatus, Teres Minor and Subscapularis. The “SITS” muscles
The tendons of these four muscles merge with the joint capsule of the shoulder as they pass it to insert on the tubercles of the humerus. This insertion forms a partial sleeve around the proximal end of the humerus.
The Rotator Cuff reinforces the joint capsule and holds the head of the humerus in the glenoid cavity.

Supraspinatus
I: Subscapular nerve
V: Subscapular artery
A: Shoulder abduction
Infraspinatus
I: Subscapular nerve
V: Subscapular artery
A: Lateral rotation, horizontal abduction
Subscapularis
I: Subscapular nerve
V: Subscapular artery
A: Medial rotation
Teres Minor
I: Axillary nerve
V: Circumflex scapular artery
A: Lateral rotation, horizontal abduction

• Common in sports and recreation.
•Joint is not protected ventrally
•Supraspinatus is easily torn with: pitching (baseball) falls (skiing) hard blows from the side (hockey)