Glenohumeral Joint Jessica Vila & Carrie A. Hoch.
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Transcript of Glenohumeral Joint Jessica Vila & Carrie A. Hoch.
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Glenohumeral JointJessica Vila
&
Carrie A. Hoch
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Ligaments
Anterior view
http://www.mlcmarlins.com.au/content/training/coaching_clinic/shoulders/shoulders.htm
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Bursae
subscapular bursa
subacromial bursa subdeltoid bursa
subcoracoid bursa
http://www.aidmybursa.com/shoulder-bursitis.php
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Cartilage and Articular Capsule
glenoid labruim
glenoid labruim
articular cartilage
synovial membrane
fibrous layer
Anterior/sliced view
synovial membrane
http://home.comcast.net/~pegglestoncbsd/skeletal.htm
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Humerus
head
surgical neckgreater tubercle
lesser tubercle
anatomical neckanatomical neck
intertubercular sulcus
surgical neck
deltoid tuberosity
http://www.medicalook.com/human_anatomy/organs/Brachium.html
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Scapula✗
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subscapularfossa
superior angle✗
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inferior angle✗Anterior view Posterior view
http://thesebonesofmine.wordpress.com/category/scapula/
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Clavicle
⏎
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http://legacy.owensboro.kctcs.edu/gcaplan/anat/Notes/API%20Notes%20H%20Skeletal%20Arm.htm
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Rotator Cuff Muscles
subscapularis infraspinatus
teres minor
supraspinatus
Rotator cuff
http://www.rci.rutgers.edu/~uzwiak/AnatPhys/Blood_Vessels.html
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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
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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
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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
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Risk Factors
• Age - most common in people > 40
• Athletes - pitchers, tennis players
• Construction trades – painters, carpenters
• Weak shoulder muscles
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Surface AnatomyEssential Clinical Anatomy p. 428
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acromial part of deltoid
spinal part of deltoid
triangle ofauscultation
middle part of trapezius
ascending partof trapezius
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clavicular head ofpectoralis major
clavipectoraltriangle clavicle
descending partof trapezius
clavicular part of deltoid
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posterior axillary
fold
manubrium
sternocostal headpectoralis major
anterioraxillary
fold
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Accessory Nerve XI, Cervical & Brachial Plexus
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Cerv
ical
ple
xus
C1-C
4
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http://www.netteranatomy.com/ImageLibrary/
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Nerves✪✪
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✪ Brachial PlexusC5-T1
http://www.nerveblocks.net/tutorium/?lang=en_EN&main=1&sub=1§ion=content
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Brachial Plexus
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http://www.netteranatomy.com/ImageLibrary/
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Arteries✓
✓
✓
✓
✓
✓
✓
✓
✓
Deep Scapular artery????
circumflex scapular a.✓
http://www6.ufrgs.br/favet/imunovet/molecular_immunology/circulation.html
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Veins
http://www.rci.rutgers.edu/~uzwiak/AnatPhys/Blood_Vessels.html
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Anterior DeltoidOrigin: Lateral third of clavicle
Insertion: Deltoid tuberosity
Action: Shoulder flexion, Medial Rotation, Horizontal ADDuction
Innervation: Axillary Nerve
Vascular supply: Posterior Circumflex artery
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Middle DeltoidOrigin: Acromion process
Insertion: Deltoid Tuberosity
Action: Shoulder ABDuction
Innervation: Axillary nerve
Vascular supply: Posterior circumflex artery
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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
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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
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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) 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
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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
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1.) Subscapularis
Origin: Subscapular fossa of the scapula
Insertion: Lesser tubercle of the humerus
Action: Shoulder medial rotation
Innervation: Subscapular nerve
Vascular supply: Subscapular artery
http://thewinger.com/2009/subscapularis
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2.)Supraspinatus
Origin: Supraspinous fossa of the scapula
Action: Shoulder ABDuction
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
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TrapeziusUpper Trapezius
Origin: Occipital bone, nuchal ligament
Insertion: Outer third of clavicle, acromion process
Action: Scapular elevation and upward rotation
Middle Trapezius
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
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Levator ScapulaeOrigin: 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
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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 wallWith scapula fixed: elevated the rib cage
Innervation: Medial pectoral nerve
Vascular supply: Axillary artery
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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
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The RHOMBOIDES!!!
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1.) Rhomboideus minor
Origin: Spinous processes of C7 through T1
Insertion: Vertebral border of scapula at the spine process2.) 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
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Coracobrachialis
Origin: Coracoid process
Insertion: Medial aspect of humerus
Action: Weakly ADDucts shoulder joint
Innervation: Musculocutaneous nerves, C6 and C7
Vascular Supply: Brachial Artery
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Study Reference
http://www.rocmd.com/conditions-treated/shoulder
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Study Referencehttp://www.netteranatomy.com/ImageLibrary/
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!Who is this handsome man?