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Shoulder joint, Sterno-clavicular
joint, Acromio-clavicular joint
Dr. Mohammed mahmoud Mosaed
Sternoclavicular Joint
• Articulation: between the sternal end of the clavicle, the manubrium sterni, and
the first costal...
Ligaments: The capsule is reinforced by the strong sternoclavicular ligaments (anterior
and posterior), interclavicular li...
Sternoclavicular joint
Movements and relations
• Forward and backward movement of the
clavicle takes place in the medial
compartment. Elevation a...
Acromioclavicular Joint
• Articulation: This occurs between the acromion of the scapula and the
lateral end of the clavicl...
• Ligaments: Superior and inferior acromioclavicular ligaments reinforce
the capsule;
• Accessory ligament: The very stron...
Movements and relations
• A gliding movement takes place when the scapula
rotates or when the clavicle is elevated or
depr...
Shoulder Joint
• Articulation: This occurs between the rounded
head of the humerus and the shallow, pear-shaped
glenoid ca...
• Capsule: This surrounds the joint and is
attached medially to the margin of the
glenoid cavity outside the labrum;
later...
Ligaments of shoulder joint
• Ligaments:
• The glenohumeral ligaments
are three weak bands of
fibrous tissue that strength...
• Accessory ligaments: The coracoacromial
ligament extends between the coracoid process
and the acromion. Its function is ...
• Nerve supply: The axillary and suprascapular
nerves.
Movements of the shoulder joint
• The shoulder joint has a wide range of movement
• The following movements are possible:
...
Important Relations
• Anteriorly: The subscapularis muscle and the axillary
vessels and brachial plexus.
• Posteriorly: Th...
Stability of the Shoulder Joint
• The shallowness of the glenoid fossa of the scapula
and the lack of support provided by ...
Shoulder joint,  sterno clavicular joint, acromio-clavicular joint (2)
Shoulder joint,  sterno clavicular joint, acromio-clavicular joint (2)
Shoulder joint,  sterno clavicular joint, acromio-clavicular joint (2)
Shoulder joint,  sterno clavicular joint, acromio-clavicular joint (2)
Shoulder joint,  sterno clavicular joint, acromio-clavicular joint (2)
Shoulder joint,  sterno clavicular joint, acromio-clavicular joint (2)
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Shoulder joint, sterno clavicular joint, acromio-clavicular joint (2)

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Anatomy of the joints of the upper limb

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Shoulder joint, sterno clavicular joint, acromio-clavicular joint (2)

  1. 1. Shoulder joint, Sterno-clavicular joint, Acromio-clavicular joint Dr. Mohammed mahmoud Mosaed
  2. 2. Sternoclavicular Joint • Articulation: between the sternal end of the clavicle, the manubrium sterni, and the first costal cartilage . • Type: Synovial double-plane joint • Capsule: This surrounds the joint and is attached to the margins of the articular surfaces. Synovial membrane: This lines the capsule and is attached to the margins of the cartilage covering the articular surfaces • Ligaments: The capsule is reinforced by the strong sternoclavicular ligaments (anterior and posterior), interclavicular ligament • Accessory ligament: The costoclavicular ligament is a strong ligament that runs from the junction of the first rib with the first costal cartilage to the inferior surface of the sternal end of the clavicle • Articular disc: This flat fibrocartilaginous disc lies within the joint and divides the joint's interior into two compartments. Its circumference is attached to the interior of the capsule, but it is also strongly attached to the superior margin of the articular surface of the clavicle above and to the first costal cartilage below. • Nerve supply: The supraclavicular nerve and the nerve to the subclavius muscle • Vascular supply by branches from the internal thoracic and suprascapular arteries.
  3. 3. Ligaments: The capsule is reinforced by the strong sternoclavicular ligaments (anterior and posterior), interclavicular ligament Accessory ligament: The costoclavicular ligament is a strong ligament that runs from the junction of the first rib with the first costal cartilage to the inferior surface of the sternal end of the clavicle
  4. 4. Sternoclavicular joint
  5. 5. Movements and relations • Forward and backward movement of the clavicle takes place in the medial compartment. Elevation and depression of the clavicle take place in the lateral compartment. • Muscles Producing Movement • The forward movement of the clavicle is produced by the serratus anterior muscle. • The backward movement is produced by the trapezius and rhomboid muscles. • Elevation of the clavicle is produced by the trapezius, sternocleidomastoid, levator scapulae, and rhomboid muscles. • Depression of the clavicle is produced by the pectoralis minor and the subclavius muscles
  6. 6. Acromioclavicular Joint • Articulation: This occurs between the acromion of the scapula and the lateral end of the clavicle . • Type: Synovial plane joint • Capsule: This surrounds the joint and is attached to the margins of the articular surfaces • Ligaments: Superior and inferior acromioclavicular ligaments reinforce the capsule; • Accessory ligament: The very strong coracoclavicular ligament extends from the coracoid process to the undersurface of the clavicle. It has trapezoid and conoid parts; It is largely responsible for suspending the weight of the scapula and the upper limb from the clavicle. • Articular disc from the capsule, a wedge-shaped fibrocartilaginous disc projects into the joint cavity from above . • Synovial membrane: This lines the capsule and is attached to the margins of the cartilage covering the articular surfaces. • Nerve supply: The suprascapular nerve • Vascular supply from the suprascapular and thoracoacromial arteries
  7. 7. • Ligaments: Superior and inferior acromioclavicular ligaments reinforce the capsule; • Accessory ligament: The very strong coracoclavicular ligament extends from the coracoid process to the undersurface of the clavicle. It has trapezoid and conoid parts; It is largely responsible for suspending the weight of the scapula and the upper limb from the clavicle.
  8. 8. Movements and relations • A gliding movement takes place when the scapula rotates or when the clavicle is elevated or depressed. • Important Relations • Anteriorly: The deltoid muscle • Posteriorly: The trapezius muscle • Superiorly: The skin
  9. 9. Shoulder Joint • Articulation: This occurs between the rounded head of the humerus and the shallow, pear-shaped glenoid cavity of the scapula. • The articular surfaces are covered by hyaline articular cartilage, and the glenoid cavity is deepened by the presence of a fibrocartilaginous rim called the glenoid labrum. • Type: Synovial ball-and-socket joint
  10. 10. • Capsule: This surrounds the joint and is attached medially to the margin of the glenoid cavity outside the labrum; laterally it is attached to the anatomic neck of the humerus. The capsule is thin and lax, allowing a wide range of movement. • It is strengthened by fibrous slips from the tendons of the subscapularis, supraspinatus, infraspinatus, and teres minor muscles (the rotator cuff muscles). • Synovial membrane: This lines the capsule and is attached to the margins of the cartilage covering the articular surfaces . It forms a tubular sheath around the tendon of the long head of the biceps brachii. It extends through the anterior wall of the capsule to form the subscapularis bursa beneath the subscapularis muscle.
  11. 11. Ligaments of shoulder joint • Ligaments: • The glenohumeral ligaments are three weak bands of fibrous tissue that strengthen the front of the capsule. • The transverse humeral ligament strengthens the capsule and bridges the gap between the two tuberosities. • The coracohumeral ligament strengthens the capsule above and stretches from the root of the coracoid process to the greater tuberosity of the humerus .
  12. 12. • Accessory ligaments: The coracoacromial ligament extends between the coracoid process and the acromion. Its function is to protect the superior aspect of the joint.
  13. 13. • Nerve supply: The axillary and suprascapular nerves.
  14. 14. Movements of the shoulder joint • The shoulder joint has a wide range of movement • The following movements are possible: • Flexion: by the anterior fibers of the deltoid, pectoralis major (clavicular head), biceps, and coracobrachialis muscles. • Extension: by the posterior fibers of the deltoid, latissimus dorsi, and teres major muscles. • Abduction: by supraspinatus to 18⁰ and deltoid to 90⁰ • Adduction: by the pectoralis major, latissimus dorsi, teres major, and teres minor muscles. • Lateral rotation: by the infraspinatus, the teres minor, and the posterior fibers of the deltoid muscle. • Medial rotation: by the subscapularis, the latissimus dorsi, the teres major, and the anterior fibers of the deltoid muscle. • Circumduction: This is a combination of the above movements
  15. 15. Important Relations • Anteriorly: The subscapularis muscle and the axillary vessels and brachial plexus. • Posteriorly: The infraspinatus and teres minor muscles. • Superiorly: The supraspinatus muscle, subacromial bursa, coracoacromial ligament, and deltoid muscle. • Inferiorly: The long head of the triceps muscle, the axillary nerve, and the posterior circumflex humeral vessels. • The tendon of the long head of the biceps muscle passes through the joint and emerges beneath the transverse ligament.
  16. 16. Stability of the Shoulder Joint • The shallowness of the glenoid fossa of the scapula and the lack of support provided by weak ligaments make this joint an unstable structure. • Its strength almost entirely depends on the tone of the short muscles that bind the upper end of the humerus to the scapula namely, the subscapularis in front, the supraspinatus above, and the infraspinatus and teres minor behind. The tendons of these muscles are fused to the underlying capsule of the shoulder joint. Together, these tendons form the rotator cuff. • The least supported part of the joint lies in the inferior location, where it is unprotected by muscles.

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