HUBS1105 Glenohumeral joint and Muscles of the Shoulder Region Lectures (combined) 11/3/19

SHOULDER = GLENOHUMERAL JOINT

 Synovial, ball and socket or spheroidal joint

- Synovial joint MUST have synovial fluid, is a ball and socket therefore has hyaline cartridge
 Multiaxial
 Dislocation common
 Glenoid fossa is made congruent (congruence  refers to the joint surface formed from perfect encasing of two
interacting part) due to the presence of a ring cartridge = the glenoid labarum
 Head of humorous articulates (a joint an area where two bones are attached for the purpose of motion of
body parts. An  articulation, or joint, is usually formed of fibrous connective tissue and cartilage) with the
glenoid labarum
 Fibrous capsule fused with rotator cuff (rotator cuff is a group of muscles and their tendons that act to
stabilize the shoulder = supraspinatus muscle, the  infraspinatus muscle,  teres minor muscle, and
the  subscapularis  muscle)
 Joint of body that’s trading off stability for dexterity and mobility we require
 Capsule allows a large range of movement -weakest inferiorly
 Coracoacromial arch/ ligament: +ve and -ve role in shoulder

 Bursae -subscapular & subacromial –function??

Laterally medially or posteriorly from the head is tubercles on the humorous

Joining the head to the two tubercles is where the neck is, this neck is where it fuses. Heading towards the diaphysis
is the surgical neck (nicknamed this due to common in surgery for fractures, weakest point)
Roughening occurs along the deltoid tuberosity
Head of humorous fits into glenoid cavity
GLENOID LABRUM

 Labarum = lip
 Fibrocartilage rim
 Had a much bigger head than the tiny socket, but this is for its
movement

SHOULDER BONES AND BUMPS (MUST MEMORISE)

HUMOROUS

- Important features of Humorous: Many muscle attachments, common for osteoporosis

- Surgical neck is nicknamed this due to it being the most common fracture site
GLENOHUMERAL JOINT
Overlying the capsule and the sheath surrounding the long head of biceps and tendon
In an x-ray shows as an empty space

- Subscapular: The subscapularis is a large triangular muscle which fills the subscapular fossa and inserts into
the lesser tubercle of the humours and the front of the capsule of the shoulder-joint
- Subacromial: The subacromial space is the space between the acromion of the scapula and the head of the
humours in which the supraspinatus muscle works

DISLOCATIONS
Capsule of shoulder joint is weakest inferiorly
Usually in position of extension, abduction, and lateral rotation
Instability post dislocation is common

GLENOHUMERAL JOINT MOVEMENTS

 Movements: Flexion, extension, abduction, adduction, rotation, circumduction

- flexion and extension happen in sagittal plane
- Abduction and adduction. Medial rotation, lateral rotation
- Circumduction: generic term for combination of movements and planes
 Stability:
- Increased mobility = less stability
- Ligaments & rotator cuff muscles become all important

PLANES/AXIS

Rotational movement happens on a transverse plane (imagine a hand

flat on a table turning at the wrist)

Medial rotation, DIRECTION HUMEROUS IS GOING AND SPINNING –

hand is a manifestation of that spinning

SCAPULOHUMERAL RHYTHM
Scapula and humorous move in a 1:2 ratio (e.g. scapula move 60 degrees, humorous moves 120) occurs by
glenohumeral joint movement
Muscles of Shoulder region: 8 muscles, 4 of which are rotator cuff muscles

GLENOHUMERAL JOINT PRIME MOVEMENTS

LIST THESE FROM SLIDE make summary!

*Supraspinatus initiates abduction when arm is adducted at the side - After approximately 15 degrees of abduction
deltoid begins to act (fibres at back help to extend you) (Good example as an initiator for a movement)

Two groups
a. Moves pictorial girdle
b. Moves humorous

MUSCLES MOVING SHOULDER JOINT

Notes on these…

- TERES MAJOR
NOT a cuff rotator muscle

- DELTOID
Broad origin along clavicle and acromion, multiple fibres extending, insertion at deltoid tuberosity of humorous
A complex convergent muscle which comes to a point with multiple bellies

- PECTORALIAS MAJOR
large origin along ribs and sternum, small insertion on humorous
A convergent muscle – gives ability to use humorous in variety of positions, however primary an adductor (moving
in)
Fibres overlay and cross over

- LATISSIMUS DORSI
Muscles bringing us back into extension to abduct us
action: medial rotation of shoulder, consider rock climbing/ swimming
Big and flat muscle, similar to trapezius in its thickness
Receives nerve supply from neck region
- near by is TERES MAJOR smaller similar muscle aiding in the same movements

Both insert on tubercle Only one to join to lesser tubercle

TERES MINOR IS ROTATOR, TERES MAJOR IS NOT

SSIT trick
3 on back, 1 on front (insertion)

BURSA- prevents insertion point wearing out against the bone

Very complex joint- Subacromial arch, bursa and rotator cuff muscles
Case study answers – what’s going on with supraspinatus? Inflamed bursa or torn tissue?

Practice questions
a) Must be on scapula because it moves this (C and d are origins not insertions)

c) muscle contraction with an increase I length describes an eccentric muscle contraction

d) subscapularis