1. Shoulder Anatomy

2. Shoulder Anatomy - bones • Scapula • Clavicle • Humerus • greater tubercle

3. Scapula Supraspinous fossa Infraspinous fossa Subscapular fossa Axillary border Inferior angle

20. Humerus

21. Joints of the shoulder Sternoclavicular (SC) Joint Acromioclavicular (AC) Joint Glenohumeral (GH) Joint Scapulothoracic Articulation Shoulder Anatomy

22. Sternoclavicular (SC) Joint • Synovial Joint - double gliding joint • side to side & front to back • Ligaments • Anterior SC • Posterior SC • Interclavicular • Costoclavicular

23. SC Movements • moves in many directions (but only in small amounts) • Protraction • Retraction • Elevation • Depression

25. SC Joint Function • Absorbs forces • Distributes forces • Allows movement of clavicle

26. Shoulder Anatomy - joints • Acromioclavicular Injury – “Separated Shoulder”

27. Acromioclavicular joint (AC) Support a. Capsule - dense but weak b. Acromioclavicular ligaments • Superior and inferior c. Coracoclavicular ligaments • Trapezoid- Lateral • Conoid -Medial

28. AC Joint

29. A-C Ligament: strengthens A-C joint along with fibers from trapezius Coracoclavicular Ligament: anchors Clavicle to coracoid process; strongest ligament binding the clavicle to scapula Acromioclavicular Joint

30. Two Parts Conoid ligament (medial) Trapezoid (lateral) A-C Separation 1-Stretch A-C 2-Complete tear of A-C; partial tear of C-C 3-Complete tear of A-C; complete tear of C-C Coracoclavicular Ligament

31. Shoulder Anatomy - joints • Scapulothoracic • muscular attachments only • The scapula meets the rib cage!

32. Scapulothoracic Articulation • Movements: • Protraction • Retraction • Elevation • Depression • Upward Rotation • Downward Rotation

33. Shoulder Anatomy - joints • Glenohumeral • ball and socket • lacks bony stability (small glenoid, large humerus) • provides motion • glenoid labrum (fibrocartilage) • rotator cuff (muscular stability)

34. ROTATOR CUFF

35. Glenohumeral (GH) Joint • “True Shoulder Joint” • Synovial Joint - Ball and Socket • Glenoid fossa & labrum with Humeral Head • 3 Major Ligaments: • Coracohumeral - coracoid to greater tubercle (strong) • 3 GH bands - thickenings of articular capsule • Transverse Humeral - greater to lesser tubercle

36. Glenoid Cavity (shallow) Glenoid labrum (soft cartilaginous rim that adds depth and stability) Glenohumeral Stability

37. GH Joint Support • Capsule • Ligaments • Anterior – Glenohumeral • Superior - Coracohumeral • Coracoacromial arch • Bursae • Subacromial • Subdeltoid • Subscapular bursa

38. Coracohumeral ligament Glenohumeral ligaments

39. Anterior Capsule Posterior Capsule Glenohumeral ligaments Superior Middle Inferior Glenohumeral Stability

40. GH Movements • Sacrifices stability for mobility • Flexion • Extension • Abduction • Adduction • Internal Rotation • External Rotation

41. Upper Arm & Shoulder Muscles deltoid brachialis triceps brachii teres major teres minor

42. supraspinatus Rotator Cuff Muscles infraspinatus teres minor subscapularis