Problem Solving Questions: Shoulder

Certainly! Here are the details for the bony structure of the scapula:
Surfaces of the Scapula:

The scapula has two main surfaces:

a. Costal (or Anterior) Surface: The relatively flat surface of the scapula that lies against the rib cage.
b. Dorsal (or Posterior) Surface: The back surface of the scapula, which faces away from the rib cage.
Angles of the Scapula: The scapula has three angles:

Superior Angle: The uppermost angle of the scapula.

Inferior Angle: The lowest angle of the scapula.
Lateral Angle (also called the Glenoid Angle): The lateral edge of the scapula between the superior and inferior
angles.
Borders of the Scapula:

Superior Border: The upper border of the scapula.

Medial (or Vertebral) Border: The inner border of the scapula, closer to the vertebral column.
Lateral (or Axillary) Border: The outer border of the scapula, closer to the armpit.
Processes of the Scapula:

Coracoid Process: It's a hook-like projection extending anteriorly from the superior border of the scapula,
serving as an attachment site for muscles and ligaments.
Acromion Process: It's an extension of the scapular spine that articulates with the clavicle.
Structure separating the Suprascapular and Infrascapular Fossae:

The spine of the scapula separates the Suprascapular Fossa (above the spine) from the Infrascapular Fossa
(below the spine).
Coracoid Process Location: The coracoid process is located at the superior border of the scapula, projecting
anteriorly towards the clavicle.

Location Indications:

Lateral Angle: This is the lateral edge of the scapula, which includes the glenoid cavity.
Neck of the Scapula: It's the narrow region connecting the body of the scapula to the acromion process.
Glenoid Cavity: A shallow, socket-like structure on the lateral angle of the scapula, articulating with the head of
the humerus.
Supraglenoid Tubercle: It's a bony projection superior to the glenoid cavity.
Infraglenoid Tubercle: A bony projection inferior to the glenoid cavity.
Articulation of the Glenoid Cavity: The glenoid cavity articulates with the head of the humerus, forming the
shoulder joint (glenohumeral joint).

glenohumeral joint:
Classification of the Joint:

The glenohumeral joint is a synovial ball-and-socket joint.

Articulating Surfaces:

The glenohumeral joint involves the articulation between two main surfaces:
a. Glenoid Cavity (Glenoid Fossa): This is the shallow, socket-like depression on the lateral angle of the
scapula.
b. Head of the Humerus: It's the rounded, ball-shaped structure at the proximal end of the humerus bone.
Description of Articulating Surfaces:
Glenoid Cavity (Fossa):

The glenoid cavity is shallow and relatively small compared to the humeral head.
It's part of the scapula and is lined with articular cartilage to facilitate smooth movement.
The glenoid cavity's shallow nature allows for a wide range of motion at the shoulder joint but sacrifices some
stability.
Head of the Humerus:

The head of the humerus is spherical and larger than the glenoid cavity.
It's covered with articular cartilage, which aids in reducing friction during movement within the joint.
This spherical shape allows for a wide range of movement in multiple directions, providing mobility to the
shoulder joint.
The ball-and-socket nature of the glenohumeral joint allows for significant mobility and a wide range of
movements such as flexion, extension, abduction, adduction, internal rotation, and external rotation of the arm.
However, the joint's increased mobility makes it inherently less stable compared to other joints, like the hip
joint, which has a deeper socket. Ligaments, tendons, muscles, and the surrounding structures play a crucial role
in providing stability to the joint.

Certainly! Here are the details regarding ligaments associated with the glenohumeral joint:

Ligaments of the Glenohumeral Joint:

Coracohumeral Ligament
Transverse Humeral Ligament
Glenohumeral Ligaments
Superior Glenohumeral Ligament
Middle Glenohumeral Ligament
Inferior Glenohumeral Ligament (comprises three parts: anterior band, posterior band, and axillary pouch)
Ligaments Reinforcing the Capsule:

The joint capsule of the glenohumeral joint is reinforced by the following ligaments:
Superior Glenohumeral Ligament: Thickens the upper part of the capsule.
Middle Glenohumeral Ligament: Strengthens the central part of the capsule.
Inferior Glenohumeral Ligament: Reinforces the lower part of the capsule and is the primary stabilizer against
dislocation.
Attachments of the Coracohumeral Ligament:

The coracohumeral ligament attaches:

Superiorly: To the coracoid process of the scapula.
Inferiorly: To the greater tubercle of the humerus.
Attachments and Function of the Transverse Humeral Ligament:

Attachments: The transverse humeral ligament extends between the lesser and greater tubercles of the humerus.
Function: It forms a canal (bicipital groove or intertubercular sulcus) through which the tendon of the long head
of the biceps brachii muscle passes.
Glenohumeral Ligaments and Their Attachments:

Superior Glenohumeral Ligament (SGHL):

Attaches from the superior aspect of the glenoid cavity to the lesser tubercle of the humerus.
Middle Glenohumeral Ligament (MGHL):
Attaches from the anterior glenoid labrum to the lesser tubercle of the humerus.
Inferior Glenohumeral Ligament (IGHL):
Comprises three bands:
Anterior Band: Attaches from the anterior glenoid labrum to the anatomical neck of the humerus.
Posterior Band: Extends from the posterior glenoid labrum to the humerus.
Axillary Pouch: An expansion of the inferior glenohumeral ligament that provides stability in extreme ranges of
motion.
Main Movements at the Shoulder Joint:
Flexion
Extension
Abduction
Adduction
Internal Rotation
External Rotation
Axis and Plane of Shoulder Joint Movements:

Flexion/Extension: Sagittal Axis in the Sagittal Plane

Abduction/Adduction: Frontal Axis in the Frontal Plane
Internal/External Rotation: Vertical (Longitudinal) Axis in the Transverse Plane
Muscles Responsible for Shoulder Movements:

Flexion: Anterior deltoid, pectoralis major

Extension: Latissimus dorsi, posterior deltoid, teres major
Abduction: Supraspinatus, deltoid
Adduction: Pectoralis major, latissimus dorsi, teres major
Internal Rotation: Subscapularis, pectoralis major, latissimus dorsi
External Rotation: Infraspinatus, teres minor
Origin and Insertion of Muscles for Shoulder Movements:

For example, the origin and insertion of the deltoid muscle:

Origin: Clavicle, acromion process, spine of the scapula
Insertion: Deltoid tuberosity of the humerus
Rotator Cuff Muscles and Their Origins/Insertions:

Supraspinatus:
Origin: Supraspinous fossa of the scapula
Insertion: Greater tubercle of the humerus
Infraspinatus:
Origin: Infraspinous fossa of the scapula
Insertion: Greater tubercle of the humerus
Teres Minor:
Origin: Lateral border of the scapula
Insertion: Greater tubercle of the humerus
Subscapularis:
Origin: Subscapular fossa of the scapula
Insertion: Lesser tubercle of the humerus
Additional Structures Necessary for Normal Arm Range of Motion:

The scapula (shoulder blade) and the clavicle (collarbone) must move along with the humerus to achieve a full
range of arm movements.
Complex Responsible for Shoulder Movements:

This collective motion involving the humerus, scapula, and clavicle is referred to as the "Shoulder Complex" or
"Shoulder Girdle."
Bones Involved in the Shoulder Complex:

Humerus, Scapula, Clavicle

Joints Involved in the Shoulder Complex:

Glenohumeral Joint (between humerus and glenoid cavity of the scapula)

Acromioclavicular Joint (between acromion process of the scapula and clavicle)
Sternoclavicular Joint (between sternum and clavicle)
Scapulothoracic Articulation (not a true joint, but the movement between the scapula and rib cage)
special features of the shoulder joint:
Intra-capsular Tendon:

The long head of the biceps brachii tendon is intra-capsular as it passes through the shoulder joint within the
joint capsule.
Attachments of the Capsule:

The capsule attaches to the rim of the glenoid cavity (glenoid labrum) and the anatomical neck of the humerus.
Lining of the Capsule:

The inner lining of the joint capsule is lined with synovial membrane, which secretes synovial fluid, lubricating
the joint and reducing friction.
Tissue Forming the Capsule:

The capsule of the shoulder joint is primarily formed by dense, fibrous connective tissue.
Loosest Area of the Capsule in Relation to the Joint:

The inferior part of the capsule is the loosest. This laxity allows for the extensive movements of the shoulder
joint, including abduction and rotation.
Tendons Blending with the Capsule and Their Relationships:

Six tendons blend with the joint capsule:

Supraspinatus tendon blends superiorly.
Infraspinatus and Teres minor blend posteriorly.
Subscapularis blends anteriorly.
Long head of the biceps brachii tendon blends anteriorly.
Biceps pulley (transverse humeral ligament) blends with the anterior capsule but doesn't fuse with it.
Tendon Supporting the Capsule Inferiorly but Not Blending with it:

The long head of the triceps brachii supports the inferior aspect of the capsule but does not blend with it.
Glenoid Labrum:

Attachment: The glenoid labrum is a fibrocartilaginous structure that attaches to the rim of the glenoid cavity
(shoulder socket).
Structure: It's a ring-shaped structure that deepens the glenoid cavity, adding stability to the shoulder joint.
Functions: The glenoid labrum provides additional support to the joint, enhances stability, and helps maintain
the congruency of the joint.
Bursa between Supraspinatus Tendon and Acromion Process:

The subacromial bursa lies between the supraspinatus tendon and the acromion process. This bursa helps reduce
friction and provides cushioning between these structures during movement.