Anatomy of Shoulder Joint Complex

ANATOMY OF SHOULDER
JOINT COMPLEX
DR. SAJNA ROY

JUNIOR RESIDENT
PMR – GMC, KOZHIKODE.
STERNO CLAVICULAR JOINT
• Saddle Type
• Medial & Lateral

Compartments
• Articular Disc
• Joint Capsule
• Ligaments
• Ligaments
– Intrinsic
• Anterior Sterno-Clavicular
• Posterior Sterno-Clavicular
– Extrinsic
• Inter-Clavicular
• Costo-Clavicular
• Joint Stability-articular disc &

ligaments
• Nerve Supply
– Supraclavicular Nerve
– Nerve to Subclavius
• Blood Supply
– Internal Thoracic A(br of

subclavian)
– Suprascapular A(br of
thyrocervical trunk of subclavian)
ACROMIO CLAVICULAR JOINT
• Synovial
• Articulation
• Joint Capsule
• Ligaments
• Movements
• Ligaments
– Intrinsic
• Acromio-Clavicular
– Extrinsic
• Coraco-Clavicular
– Trapezoid
– Conoid
• 15 – 20 degree movement at AC Joint

permits positioning of the Glenoid Cavity
– for arm movements
• Nerve Supply
– Suprascapular Nerve
• Blood Supply
– Thoraco-Acromial A(br of second

part of Axillary A)
– Suprascapular A
GLENO HUMERAL JOINT
• Ball & Socket Joint
• Articulation
• Glenoid Labrum
• Capsule
• Synovial Membrane
• Bursae
– That communicate with the joint cavity
• Subtendinous Bursa of the Subscapularis
– That do not communicate with the joint cavity
• Subacromial/Subdeltoid Bursa
• Between Acromial & Skin
• Between Joint Capsule & Coracoid Process
• In relation to Coracobrachialis, T. Major, Long head of Triceps,

L. dorsi
• Ligaments
– Intrinsic
• Gleno humeral
– Superior
– Middle
– Inferior
• Coraco humeral
• Transverse humeral
– Extrinsic
• Coraco-Acromial
• Nerve Supply
– Posterior Cord of brachial plexus

– Suprascapular Nerve
– Lateral Pectoral Nerve
• Blood Supply
– Anterior Circumflex Humeral(br of axillary

A)
– Posterior Circumflex Humeral
– Suprascapular A
ANTERIOR AXIO-APPENDICULAR
MUSCLES
MUSCLE ORIIN INSERTION NS
ANT SURFACE OF MED ½ OF
CLAVICLE MED & LAT
ANT SURFACE OF LAT LIP OF INTER-
PECTORALIS PECTORAL
STERNUM,1ST 7 COSTAL TUBERCULAR
MAJOR CARTILAGES,STERNAL END OF SULCUS
NERVES
6TH RIB, EXT.OBLIQUE (C5,C6,C7,C8,T1)
APONEUROSIS
ANT SURFACE & SUP
PECTORALIS BORDERS OF 3-5 RIBS & CORACOID MED PECTORAL N
MINOR Deep fascia overlying PROCESS (C7,C8,T1)
corresponding ICS
Groove on inf
JN btw first rib & costal N to subclavius
SUBCLAVIUS cartilage
surface of middle
(C5,C6)
i/3rd of clavicle
Lat surfaces of upper 8-9
Costal surface of
SERRATUS ribs & Deep fascia Long thoracic N
med scapular
ANTERIOR overlying corresponding
border
(C5,C6,C7)
ICS
EXTRINSIC SHOULDER MUSCLES/POSTERIOR
AXIO-APPENDICULAR MUSCLES
MUSCLE ORIGIN INSERTION NS
• Sup. Nuchal line
Sup.edge of crest of
•External occipital
scapular spine CN 11( MOTOR)
protruberance
TRAPEZIUS •Med margin of lig.nuchae
Acromion Sensory-ant rami of
Post.border of lat 1/3rd C3,C4
•Spinous process of c7-t12
of clavicle
vertebrae
•Iliac crest
•Thoracolumbar fascia
Floor of intertubercular Thoracodorsal N
L.DORSI •Inf. 3-4 ribs
sulcus (C6, C7, C8)
•Spinous process of lower 6
thoracic vertebrae
Post surface of med
LEVATOR
C1-c4 transverse process scapular border from C3, C4, C5
SCAPULAE the sup angle
o Post surface of med

scapular border at the
oC7, t1-spinous process
root
Lower end of lig.nuchae
• Post surface of med
RHOMBOIDS scapular border from
C4, C5
•T2-T5 spinous process &
the root to inf scapular
supraspinous ligs.
angle
SCAPULO-HUMERAL/INTRINSIC
SHOULDER MUSCLES
MUSCLE ORIGIN INSERTION NS
•Inf edge of crest

of scapular spine
•Acromion-lat Deltoid Axillary N
DELTOID
margin tuberosity (C5,C6)
•Ant border of lat
1/3rd of clavicle
Elongate oval area Med lip of Lower

TERES MAJOR on post surface of intertubercular subscapular N
inf scapular angle sulcus (C5-C7)
ROTATOR CUFF
ROTATOR CUFF
Muscle Origin Insertion Nerve Supply
Medial 2/3rd of Superior most
Suprascapular N
Supraspinatus Supraspinous facet of the
(C5,C6)
fossa greater tubercle
Middle facet on
Medial 2/3rd of the post surface Suprascapular N
Infraspinatus Infraspinous fossa of the greater (C5,C6)
tubercle
Upper 2/3rd of a
flattened strip of Inferior facet on
bone on the the post surface
Teres Minor Axillary N (C5,C6)
dorsal scapula, of the greater
adjacent to the tubercle
lateral border
Medial 2/3rd of Upper & lower

Subscapularis subscapularis Lesser tubercle subscapular N
fossa (c5,c6,c7)
Movement Primary Muscles Accessory Muscles
Pectoralis Major, Coracobrachialis,
Flexion
Deltoid Biceps
Teres Major, L. Dorsi,

Extension Deltoid
Long Head of Triceps
Abduction Deltoid Supraspinatus
Pectoralis Major, Teres Major,

Adduction
L. Dorsi Long Head of Triceps
Teres Major, L. Dorsi,

Medial Rotation Subscapularis Pectoralis Major,
Deltiod (clavicular)
Teres Minor,
Lateral Rotation Infraspinatus
Deltoid (spinal)
Joint stability
Tensors of joint capsule

Coracoacromial arch
Shunt muscles
• Resist downward location
• Deltoid,long head of triceps,
coracobrachialis, short head of biceps
SCAPULO THORACIC JOINT
Movements Muscles
Trapezius (Upper Fibres), Levator Scapulae,
Elevation
Rhomboids
Trapezius (Lower Fibres), Serratus Anterior,
Depression
P. Minor
Serratus Anterior, P. Minor
Protraction
Retraction Trapezius (Middle Fibres) , Rhomboids
Lateral Rotation Trapezius (Upper Fibres), Serratus Anterior
Medial Rotation Levator Scapulae, Rhomboids, P. Minor, L. Dorsi

Scapulo-Humeral Rhythm
THANK YOU
References:-
1. GRAY’S ANATOMY FOR STUDENTS ( 4th EDITION )
2. KEITH L MOORE – CLINICALLY ORIENTED ANATOMY

( 7th EDITION )

Anatomy of Shoulder Joint Complex

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ANATOMY OF SHOULDER

DR. SAJNA ROY

• Medial & Lateral

• Joint Stability-articular disc &

– Internal Thoracic A(br of

• 15 – 20 degree movement at AC Joint

– Thoraco-Acromial A(br of second

– That communicate with the joint cavity

• Subtendinous Bursa of the Subscapularis

– That do not communicate with the joint cavity

• Between Acromial & Skin

• Between Joint Capsule & Coracoid Process

• In relation to Coracobrachialis, T. Major, Long head of Triceps,

– Posterior Cord of brachial plexus

– Anterior Circumflex Humeral(br of axillary

o Post surface of med

MUSCLE ORIGIN INSERTION NS

•Inf edge of crest

Elongate oval area Med lip of Lower

Medial 2/3rd of Upper & lower

Teres Major, L. Dorsi,

Abduction Deltoid Supraspinatus

Pectoralis Major, Teres Major,

Teres Major, L. Dorsi,

Tensors of joint capsule

Retraction Trapezius (Middle Fibres) , Rhomboids

Lateral Rotation Trapezius (Upper Fibres), Serratus Anterior

Medial Rotation Levator Scapulae, Rhomboids, P. Minor, L. Dorsi

1. GRAY’S ANATOMY FOR STUDENTS ( 4th EDITION )

2. KEITH L MOORE – CLINICALLY ORIENTED ANATOMY

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