Bones & Joints of the Shoulder

The bones of the shoulder consist of the humerus (the upper arm bone), the scapula
(the shoulder blade), and the clavicle (the collar bone).

The clavicle is the only bony attachment between the trunk and the upper limb. It
forms the front portion of the shoulder girdle and is palpable along its entire length
with a gentle S-shaped contour.The clavicle articulates at one end with the sternum
(chest bone) and with the acromion of the scapula at the other. This articulation
between the acromial end of the clavicle and the acromion of the scapula forms the
roof of the shoulder.

The scapula is a large, flat triangular bone with three processes called the acromion,
spine and coracoid process . It forms the back portion of the shoulder girdle. The
spine (which is located at the back of the scapula) and the acromion can be readily
palpated on a patient.
The flat blade of the scapula glides along the back of the chest allowing for
extended movement of the arm. The coracoid process is a thick curved structure
that projects from the scapula and is the attachment point of ligaments and
muscles.
The scapula is also marked by a shallow, somewhat comma-shaped glenoid cavity ,
which articulates with the head of the humerus.
The top end of the humerus consists of the head, the neck, the greater and lesser
tubercles, and the shaft. The head is half-spherical in shape and projects into the
glenoid cavity. The neck lies between the head and the greater and lesser tubercles.
The greater and lesser tubercles are prominent landmarks on the humerus and
serve as attachment sites for the rotator cuff muscles.
There are four joints making up the 'shoulder joint':

The shoulder joint itself known as the Glenohumeral joint, (is a ball and socket
articulation between the head of the humerus and the glenoid cavity of the scapula)

The acromioclavicular (AC) joint (where the clavicle meets the acromion of the
scapula)

The sternoclavicular (SC) joint (where the clavicle meets the chest bone [sternum])

The scapulothoracic joint (where the scapula meets with the ribs at the back of the
chest)
Note how the ball ( head ) of the humerus fits into a shallow socket on the scapula
called the glenoid . One can see that this ball does not fit into the glenoid cup at all;
this allows for the wide range of movement provided by the shoulder, at the cost of
skeletal stability. Joint stability is provided instead by the rotator cuff muscles ,
related bony processes and glenohumeral ligaments.
Shoulder Ligaments

ligaments are soft tissue structures that connect bones to bones. There are several important ligaments in
the shoulder.

Glenohumeral ligaments (GHL):

A joint capsule is a watertight sac that surrounds a joint. In the shoulder, the joint capsule is formed by a
group of ligaments that connect the humerus to the glenoid. These ligaments are the main source of
stability for the shoulder. They are thesuperior, middle and inferior glenohumeral ligaments. They help
hold the shoulder in place and keep it from dislocating .

Coraco-acromial ligament (CAL):

Another ligament links the coracoid to the acromion - coracoacromial ligament(CAL). This ligament can
thicken and cause Impingement Syndrome

Coraco-clavicular ligaments (CCL):

These two ligaments (trapezoid and conoid ligaments) attach the clavicle coracoid process of the scapula.
These tiny ligaments (with the acomioclavicular joint) play an important role in keeping the scapula attached
to the clavicle and thus keeping your shoulder 'square'. They carry a massive load and are extremely
strong.
A fall on the point of the shoulder can rupture these ligaments with dislocation of the AC Joint .

Transverse Humeral ligament (THL) :Holds the tendon of the long head of biceps brachii muscle in the
groove between the greater and lesser tubercle on thehumerus (intertubercular sulcus).
Shoulder Tendons

tendons are extensions of muscles that attach muscles to bone. Muscles move the bones by pulling on
the tendons.

Rotator Cuff
The rotator cuff tendons are a group of four tendons that connect the deepest layer of muscles to
the humerus. They are the tendons of the rotator cuff muscles.
These are (from front to back):

1. subscapularis

2. supraspinatus

3. infraspinatus

4. teres minor
The supraspinatus is the most commonly affected tendon, both by overuse and trauma. It is the
muscle that lifts your arm out to the side (a very important movement for most daily taks). Injury to
the tendon can result in a Rotator Cuff Tear. Overuse can lead to Subacromial Impingement.

Biceps tendons
The biceps muscle has two tendons at the shoulder, called the Long Head and Short Head.

The Long Head of Biceps (LHB) is a very important tendon that travels through the shoulder joint
(glenohumeral joint). The biceps tendon begins at the top of the shoulder socket (the glenoid) and then
passes across the front of the shoulder to connect to the biceps muscle. (The biceps is the muscle that
weightlifters are always showing off).
 De prezentat:

-cele 3 oase (omoplat, humerus si clavicula)

-cele 3 articulatii (legatura intre aceste oase) : art. Acromio-

clavicular, Coraco-acromiala si scapulo-humerala!

-structura unei articulatii -: elemente de structura

-ligamentele

-tendoanele

-musculatura

-miscari in articulatii

-patologie