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Joints of the Shoulder Region
Glenohumeral Joint Sternoclavicular Joint Acromioclavicular Joint
Terms in this set (41)
Classify the Glenohumeral Joint
Synovial, multi-axial, ball and socket
Identify the range of movement for the Glenohumeral Joint
Flexion - Extension around the transverse axis on the saggital plane, Abduction - Adduction on anteroposter axis on coronal plane and Internal (medial) rotation - External (lateral rotation), on a longitudinal axis in the transverse plane.
Name the articular surfaces of the Glenohumeral Joint.
Humerus and Glenoid Fossa
What provides protection for the Glenoid Fossa from the Humerus?
What is the Glenoid Labrum?
A fibrous structure around the Glenoid Fossa.
What is the function of the Glenoid Fossa?
Less deep than the convexity of the humeral head it facilitates mobility, the glenoid fossa increases glenoid concavity and provides attachment for the joint capsule, ligaments and muscles.
What is the Joint Capsule in the Glenohumeral Joint?
Fibrous cylindrical sleeve between the subscapular and the intertubercular groove.
What is the structure and function of the Joint Capsule?
It is a thin lax, loose bag that attaches to the glenoid labrum. It is attached inferiorly onto the medial shaft of the humerus to allow for move movement within the joint.
The Joint Capsule is supported by what?
The rotator cuff tendons and the glenohumeral and coracohumeral ligaments.
What does the Joint Capsule Communicate with?
Subscapular Bursa and Intertubercular Groove.
What is the synovial membane of the Glenohumeral Joint?
Lines the joint capsule and bony surfaces inside the joint capsule which are not covered by articular cartilage.
What are the ligaments of the Glenohumeral joint?
Coracohumeral and the Transverse Humeral and Coracromial and Glenohumeral.
Classify and state the mechanical function of the coracromial ligament.
Extracapsular ligament. Runs from the coracoid process to the acromim. Prevents superior dislocation of the humerus.
Classify and state the mechanical function of the coracohumeral ligament.
Partly capsular, partly extracapsular. Runs from the coracoid process to the humerus. Prevents lateral and therefore inferior dislocation of the humerus.
Classify and state the mechanical function of the transverse humeral ligament.
Capsular. Runs horizontal across the coracohumeral ligament and connects the lesser and greater tubercle of the humerus. Keeps the long head of the biceps brachi in the intertubercular groove.
Classify and state the mechanical function of the glenohumeral ligament.
Capsular. There are 3 longitudinal bands of fibres that reinforce the joint capsule.
Superior - prevents lateral and therefore inferior dislocation of the humerus, limits external rotation.
Middle - Limits external rotations.
Inferior - Prevents anterior dislocation of humerus when fully flexed/abducted.
Anterior dislocation where the inferior glenohumeral joint would be damaged.
Describe the precise position that the glenoid fossa faces with the upper limb is in the anatomical position and explain the significance of this alignment.
Glenoid fossa is position on the superior-lateral end of the scapula, facing anteriorly and slightly superiorly due to the orientation of the humeral head. This alignment is significant so that the scapular can move and allow a large range of movement at the shoulder.
What are the movements of the scapular?
Elevation - Depression in the coronal plane, in elevation the glenoid fossa comes to face increasingly upward Protraction - Retraction in the saggital plane, in protraction the glenoid faces increasingly forward and in retraction the glenoid fossa faces more lateral. Lateral (upward) Rotation - Medial (downward) rotation angle range of 60 degrees.
Describe the relationship of the subacromial and subscapular bursae with the cavity of the glenohumeral joint:
Subarcomial bursa - prevent friction between bony projections of the scapula, corcaid process and acromium and it's joint capsule and ligaments. It seperates the coracomial arch and deltoid from the superiorlateral part of the GHJ.
Subscapular bursa - prevents friction between subscapularis and bony projections of the scapula and the RC muscles. Attaches to the articular margins of the humerus and scapula forming the subscapular bursa.
4.6 Define and Demonstrate movements at the shoulder joint and movements of the scapula
Shoulder -The glenoid fossa does not coincide with one of the cardinal planes of the body due to 45 degree inclination. But presuming it sat parallel to the coronal plane actions include
o Flexion and extension occur around a transverse axis
o Abduction and adduction occur around a anteroposterior axis
o Medial and lateral rotation occur around the longitudinal axis of the humerus.
o Protraction of the shoulder occurs in the sagittal plane and makes the glenoid fossa face more directly forwards. Retraction makes the glenoid fossa face more directly laterally. These two extreme positions of the scapula form an angle of 40-45o and the angle between the clavicle and shoulder decreases to 60o in full protraction and increases to approx 70o in full retraction - figures (a) and (b)
o Elevation and depression of the shoulder occurs in the coronal plane and has a linear range of 10-12cm however there is rotation so that in elevation the glenoid fossa comes to face increasingly upwards. In depression the fossa faces increasingly downwards - figure (c)
o Medial and lateral rotation has a total angular range of up to 60o and involves displacement of the inferior angle of the scapula by 10-12cm - figure (d)
Describe the relationship between the scapula and clavicular movements.
Scapula lateral rotation produces posterior rotation of clavicle at the sternoclavicular joint. The clavicle works as a strut to push the scapular laterally in rotation so that your muscles don't have to.
i) During abduction or flexion of the arm, the clavicle rotates about its long axis so that the anterior surface is increasing directed upwards.
ii) Towards the end of the range of rotation of the scapula against the clavicle, the coracoclavicular ligament becomes taut and transmits the rotating force to the clavicle whose rotation then accounts for the scapular rotation on the chest wall.
iii) Any impairment of the clavicle to rotate at either the sternoclavicular or acromioclavicular joints will interfere with the free movement of the shoulder blade and the upper limb as a whole.
Functions of the clavicle and state the implications of its crank like shape for shoulder function.
The function of the clavicle is to work as a strut, although it is not rigid but slightly mobile to aid assistance in the movement of the scapula. The scapula is attached at the more accentuated S end to enhance the range of movement with rotation.
Classify the Sternoclavicular Joint.
Synovial, Multiaxial, Plane
What are the articular surfaces of the the sternoclavicular joint?
Sternal end of the clavicle
Clavicular Notch of the Sternum
Costal cartilage of Rib 1
What is the joint capsule of the of the sternoclavicular joint?
Stong, reinforced by capsular ligaments. Capsule surrounds whole joint like a sleeve attaching to articular margins of the clavicle and sternum.
What is the synovial membrane of the sternoclavicular joint?
2 synovial membranes, that spread synovial fluid.
What is the articular disc inside the sternoclavicular joint?
intra-articulated disc - vertical dividing joint cavity, medial and lateral.
What is the function of the articular disc?
Shock absorber, acts as a pivot about which elevation and depression occur, prevents superior dislocation of the clavicle.
What are the ligaments of the sternoclavicular joint?
Classify and state the mechanical function of the sternoclavicular ligament?
Capsular. Anterior sternoclavicular limits retraction. Posterior sternoclavicular limits protraction.
Classify and state the mechanical function of the costoclavicular ligament?
Situated between the first rib and the clavicle. Extracapsular. Strong, dense band of fibres.
Prevents superior dislocation, limits protraction and retraction.
Classify the Acromioclavicular Joint
Synovial, multiaxial, plane
What are the articular surfaces of the the acromioclavicular joint?
Anterior, medial acromium & acromial end of clavicle.
What is the joint capsule of the of the acromioclavicular joint?
Loose and reinforced by capsular ligaments.
What is the synovial membrane of the acromioclavicular joint?
The synovial membrane lines the inner surface of the capsule attaching to the margins of the articular surface.
What are the ligaments of the acromioclavicular joint?
Coracoclavicular - conoid and trapezoid parts. Situated medial to the acromioclavicular joint angling the lateral end of the clavicle to the coracoid process.
Describe the conoid part of the coracoclavicular ligament.
Vertical, and posterior medial.
Prevents superior dislocation of clavicle.
Limits protraction of scapula
Provides axial rotation of the clavicle.
Describe the trapezoid part of the coracoclavicular ligament.
Limits retraction of the scapula.
Prevents lateral dislocation of scapula.
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