The shoulder joint, or glenohumeral joint, is a ball and socket joint between the head of the humerus and the glenoid cavity of the scapula. It is stabilized by ligaments like the capsular ligament and glenohumeral ligaments, with additional support from the rotator cuff muscles, labrum, and long head of the biceps. The joint contains the subscapular, subacromial, and infraspinatus bursae. It allows flexion, extension, abduction, adduction, and rotation powered by muscles like the deltoid, pectoralis major, and supraspinatus. The shoulder is prone to dislocations

1. Shoulder Joints
Dr. Prabhakar Yadav
Assistant Professor
Department of Human Anatomy
B.P. Koirala Institute of Health

2. Objectives:
 To know the type of joint
 Articular surfaces of the joint
 Ligaments of the joints
 Bursa related to the joints
 Factors providing the stability of joint
 Blood supply & Nerve supply
 Relation of the joint
 Movements & Muscle bringing the movements
 Applied Anatomy

3. GLENOHUMERAL JOINT:
Most common joint to dislocate & to undergo recurrent
dislocations
TYPE OF JOINT:
ARTICULAR SURFACES:

5. LIGAMENTS:
1. Capsular ligament (joint capsule):
• Thin fibrous layer of the joint capsule
surrounds glenohumeral joint.
• Very loose & permits free movements.
• Least supported inferiorly
Medial attachment-
Lateral attachment-
Reinforced anteriorly by:
2. Glenohumeral ligament (Superior, middle & Inferior)
defect exists between superior & middle glenohumeral ligaments,
in anterior dislocation of the shoulder joint.

6. synovial membrane:
synovial cavity of the joint presents the following features:
(a) It forms tubular sheath around the tendon of biceps Brachii,
(b) It communicates with subscapular and infraspinatus bursae, around the joint.

7. Three apertures in the joint capsule:

8. 3. Coracohumeral ligament:
4. Transverse humeral ligament:
ACCESSORY LIGAMENTS
1. Coracoacromial ligament:
2. Coracoacromial arch:
 formed by –
 forms a protective arch for the head of humerus above and
prevents its superior displacement above the glenoid cavity.
• supraspinatus muscle passes under the arch
• subacromial bursa lies between the arch superiorly & tendon of
supraspinatus and greater tubercle of humerus inferiorly-facilitates
movement of supraspinatus tendon.

9. BURSAE RELATED TO THE JOINT
1. Subscapular bursa: lies between-
2. Subacromial bursa: lies between-
 largest synovial bursa in the body
 facilitates movements of supraspinatus tendon under the coracoacromial arch.
3. Infraspinatus bursa: lies between-

10. Relation of the JOINT

11. Blood Supply:

12. Nerve Supply: 1. Axillary Nerve
2. Musculocutaneous nerve
3. Suprascapular nerve

13. Factors providing stability of the joint:
1. Glenoid labrum
2. Long head of biceps tendon
3. Rotator cuff( Musculotendinous cuff)
4. Coracoacromial arch (secondary socket of the
glenohumeral joint )

14. ROTATOR CUFF (MUSCULOTENDINOUS CUFF): Fibrous sheath formed by four flattened tendons that blend with each other &
with capsule of shoulder joint and strengthen it
Function: grasp relatively large head of humerus and hold it against smaller, shallow glenoid cavity
• Cuff gives strength to capsule of joint all around except inferiorly

15. MOVEMENTS AT SHOULDER JOINT: are considered in relation to scapula.
• Flexion & Extension: takes place in a plane parallel to surface of glenoid cavity
• Abduction& Adduction: takes place at right angle to the plane of flexion and extension
• Medial & lateral rotation:
• Circumduction:

22. Movements Main muscles (prime movers) Accessory muscles (synergists)
Flexion • Pectoralis major (clavicular part)
• Deltoid (anterior fibres)
• Biceps brachii (short head)
• Coracobrachialis
Extension • Deltoid (posterior fibres)
• Latissimus dorsi
• Teres major
• Long head of triceps
• Sternocostal head of pectoralis major
Adduction • Pectoralis major (sternocostal part)
• Latissimus dorsi
• Teres major
• Coracobrachialis
• Short head of biceps
• Long head of triceps
Abduction • Supraspinatus 0-15O
• Deltoid (lateral fibres) 15-90O
• Serratus anterior 90-180O
• Upper and lower fibres of trapezius90-180O
Medial rotation • Pectoralis major
• Latissimus dorsi
• Deltoid (anterior fibres)
• Teres major
• Subscapularis
Lateral rotation • Deltoid (posterior fibres) • Infraspinatus
• Teres minor

23. Mechanism of Abduction:
Total range of abduction is 180°.
Abduction up to 90°occurs at glenohumeral joint.
From 90° to 120° occur only if humerus is rotated laterally.
From 120° to 180° can occur if scapula rotates forwards on the chest wall

24. Range of motion (ROM) of various movements

25. Dislocation of the shoulder joint:
Mostly occurs inferiorly, often injures the axillary nerve
Dislocation caused by: excessive extension & lateral rotation of humerus.
Presents as: (a) Loss of rounded contour of the shoulder
(b) Prominence of shoulder tip

26. Dislocation of the shoulder joint:
Anterior or Posterior dislocation:
humeral head descended anterior or posterior to infraglenoid tubercle & long head of triceps.

29. Frozen shoulder (adhesive capsulitis):
Occurs due to shrinkage of the joint capsuleis condition
Age Group: 40–60 years of age.
characterized by: pain & uniform limitation of all movements of shoulder joint.
There are no radiological changes in the joint.

30. subacromial bursitis:
calcific supraspinatus tendinitis
pain occurs during 60°–120° of abduction (painful arc
syndrome).
Dawbarn’s sign:

31. Type of joint:
Articular surfaces of the joint:
Ligaments of the joints: Capsular ligament (joint capsule); Glenohumeral ligaments; Coracohumeral ligament;
Transverse humeral ligament; Coracoacromial ligament:
Bursa related to the joints: Subscapular bursa; Subacromial bursa; Infraspinatus bursa
Factors providing the stability of joint: Glenoid labrum; Long head of biceps tendon;
Rotator cuff( Musculotendinous cuff); Coracoacromial arch
Blood supply & Nerve supply
Relation of the joint
Movements & Muscle bringing the movements