Shoulder Girdle Joints

Dr. M Farrukh Shahzad

BSPT, PPDPT
Isra University,
Islamabad Campus

SHOULDER GIRDLE

Girdle means a belt, shoulder girdle encircle the shoulder

region like a belt encircle the waist region or else where.
It consist of the clavicle and the scapula. It connects the
upper limb to the axial skeleton. Anteriorly, the clavicle
reaches the sternum and articulates with it at the
sternoclavicular joint. The clavicle and the scapula are
united to each other at the acromioclavicular joint. The
scapula is not connected to the axial skeleton directly, but
is attached to it through muscles. There are two joints in
one shoulder girdle.
Sternoclavicular joint.
Acromioclavicular joint.

STERNOCLAVICULAR JOINT

Articulation: This occurs between the sternal

end of the clavicle, the manubrium sterni, and
the first costal cartilage.
Type: Synovial double-plane joint/compound
and complex
Capsule: This surrounds the joint and is
attached to the margins of the articular
surfaces.
Ligaments: The capsule is reinforced in front
of and behind the joint by the strong
sternoclavicular ligaments

CONTINUED

Articular disc: The main bond of this joint. This flat

fibrocartilaginous disc lies within the joint and divides the
joint's interior into two compartments. Inferiorly, the disc is
attached to the sternum and the first costal cartilage at their
junction. Anteriorly and posteriorly the disc is attached to the
capsule.

CONTINUED

Accessory ligaments: There are two other

ligaments associated with this joint. The
costoclavicular ligament and the interclavicular
ligament.
The costoclavicular ligament is a strong
ligament that runs from the junction of the first
rib with the first costal cartilage to the inferior
surface of the sternal end of the clavicle.
The interclavicular ligament passes between
the sternal ends of the right and left clavicle.

CONTINUED

Nerve supply: The supraclavicular nerve and the nerve to

the subclavius muscle.
Blood supply. Internal thoracic and supra scapular
arteries.
Important Relations
Anteriorly: The skin and some fibers of the
sternocleidomastoid and pectoralis major muscles
Posteriorly: The sternohyoid muscle; the brachiocephalic
artery; , the left brachiocephalic vein and the left common
carotid artery

SC JOINT

ACROMIOCLAVICULAR JOINT

Articulation: This occurs between the acromion

of the scapula and the lateral end of the clavicle
Type: Synovial plane joint
Capsule: This surrounds the joint and is attached
to the margins of the articular surfaces
Ligaments: Superior and inferior
acromioclavicular ligaments reinforce the
capsule;

CONTINUED

Accessory ligament: The very strong

coracoclavicular ligament extends from the
coracoid process to the undersurface of the
clavicle( two parts). It is largely responsible for
suspending the weight of the scapula and the
upper limb from the clavicle.
Nerve supply: The suprascapular nerve
Blood supply: The suprascapular arteries.

CONTINUED

Important Relations
Anteriorly: The deltoid muscle
Posteriorly: The trapezius muscle
Superiorly: The skin

AC JOINT

MOVEMENTS AT
THE SHOULDER
GIRDLE
Movements at the joints of the girdle are always
associated with the movements of the
scapula. The various movements are;
1. Elevation
2. Depression
3. Protraction
4. Retraction
5. Forward rotation of scapula
6. Backward rotation of scapula

LIGAMENTS OF SCAPULA

Coracoacromial ligament.. triangular ligament extents

between acromion and the coracoid.
Suprascapular ligament
Spinoglenoid ligament

SHOULDER JOINT

Articulation: This occurs

between the rounded head
of the humerus and the
shallow, pear-shaped
glenoid cavity of the
scapula. The articular
surfaces are covered by
hyaline articular cartilage,
and the glenoid cavity is
deepened by the presence
of a fibrocartilaginous rim
called the glenoid labrum.

CONTINUED

Type: Synovial ball-and-socket joint

Capsule: This surrounds the joint and is attached
medially to the margin of the glenoid cavity
outside the labrum; laterally it is attached to the
anatomic neck of the humerus. The capsule is
thin and lax, allowing a wide range of movement.
It is strengthened by fibrous slips from the
tendons of the subscapularis, supraspinatus,
infraspinatus, and teres minor muscles (the
rotator cuff muscles).

CONTINUED

CONTINUED

Synovial membrane: This lines the capsule and is attached

to the margins of the cartilage covering the articular
surfaces. It forms a tubular sheath around the tendon of the
long head of the biceps brachii. It extends through the
anterior wall of the capsule to form the subscapularis bursa
beneath the subscapularis muscle.

CONTINUED

Ligaments:
The glenohumeral ligaments are three weak bands of fibrous tissue
that strengthen the front of the capsule. The transverse humeral
ligament strengthens the capsule and bridges the gap between the two
tuberosities.
The coracohumeral ligament strengthens the capsule above and
stretches from the root of the coracoid process to the greater tuberosity
of the humerus.
Accessory ligaments:
The coracoacromial ligament extends between the coracoid process
and the acromion. Its function is to protect the superior aspect of the
joint.
Transverse humeral ligament. It bridges the upper part of the
bicipital groove of the humerus, the tendon of the long head of bicep
brachii passes deep to the tendon.

BURSAE RELATED TO
SHOULDER JOINT

There are many bursae related to the glenohumeral joint, the

most important of them are;
Subacromial (subdeltoid) bursa.
Subscapularis bursa.
Infraspinatus bursa.
Subcoracoid bursa.

RELATIONS

Anteriorly: The subscapularis muscle, coracobrachialis,

short head of biceps and deltoid.
Posteriorly: The infraspinatus and teres minor and deltoid
muscles
Superiorly: The supraspinatus muscle, Subacromial
bursa, coracoacromial arch, and deltoid muscle
Inferiorly: The long head of the triceps muscle, the
axillary nerve, and the posterior circumflex humeral
vessels
The tendon of the long head of the biceps muscle passes
through the joint and emerges beneath the transverse
ligament

BLOOD AND NERVE SUPPLY

Blood supply. (PASS)

Posterior circumflex artery
Anterior circumflex artery
Suprascapular artery
Subscapular artery.
Nerve supply. (MAS).
Musculocutaneous nerve
Axillary nerve.
Suprascapular nerve.

MOVEMENTS/
MUSCLES
PRODUCING
THESE
Flexion
MOVEMENTS.
Extension
Abduction. Complex movement.
Adduction
Lateral rotation
Medial rotation

SHOULDER JOINT
HAS SACRIFICED
STABILITY FOR
MOBILITY..?

Factors responsible for the mobility of

shoulder joint.
Greater head of humerus.
Loose capsule.
Concurrent movements at shoulder girdle joints.
Factors responsible for the stability of
shoulder joint.
The coracoacromial arch
The rotator cuff
Glenoidal labrum.

THANKS!

Best whishes.!