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THE SHOULDER GIRDLE
ANATOMY
Lecture Notes By: John Lorenz Beleno, RM, RN, MD

SHOULDER REGION
> In a broad sense it includes not only the rounded contour between the arm and the body but also the
pectoral region, region of the back around the shoulder blade and the axilla
...
__________
2
...

- Jackson Hawkin’s test
> Lesser tubercle
Muscle attached: Subscapularis
* Intertubercular groove (Bicipital Groove)
Crest of the lesser tubercle (medial lip)
Crest of the greater tubercle ( lateral lip)

* see page 1 for the skeletal illustration ☺

JOINTS and LIGAMENTS

JOINTS
TRUE: ( composed of capsule, articular cartilages and synovial fluid)
> Glenohumeral: most important joint of the body
> Sternoclavicular
> Acromioclavicular
> Costovertebral
> Costosternal
FALSE (Functional): (no capsule, no synovial fluid)
> Scapulocostal
> Suprahumeral
> (+) Biceps mechanism: gliding of tendon in relation to intertubercular groove
* BICIPITAL TENDINITIS: inflammation of the long head of tendon
GLENOHUMERAL
- triaxial
LIGAMENTS
> Coracohumeral
> Glenohumeral
- Superior
- Middle
- Inferior
* Foramen of WEITBRECHT : outpouching between the superior and middle part of the Glenohumeral
* Foramen of ROUVIER : outpouching between the middle and inferior part of the Glenohumeral

GLENOHUMERAL JOINT
> formed by the ball shaped head of humerus and shallow concave glenoid fossa
- Most striking feature is marked discrepancy in the shape of both
- Head: angular value of 153 degrees
- Glenoid fossa: 75 degrees (shallower, larger radius)
* STABILITY OF THE GH
> Negative atmospheric pressure
> Upward direction of glenoid
> Presence of glenoid labrum- makes fossa deeper
> Ligaments
> GH muscle

STERNOCLAVICULAR JOINT
- only joint attachment of the upper extremities to the trunk
TYPE:
> sellar (saddle)
DEGREES OF FREEDOM OF MOTION:
> triaxial

* LIGAMENTS
> Anterior: prevents upward and lateral displacement
> Posterior: same as anterior
> Costoclavicular: same as anterior, fulcrum
> Interclavicular: prevents lateral displacement

ACROMIOCLAVICULAR JOINT
Type: arthrodial
Degree of freedom of motion: nonaxial
LIGAMENTS
- superior
- inferior
- coracoclavicular
> CONOID: mp,
- prevents medial displacement
- limits dorsal rotation
> TRAPEZOID: la,
- prevents medial displacement
- limits ventral rotation
SCAPULOCOSTAL (SCAPULOTHORACIC)
* False (functional) joint
* 2 types of motion
- translatory: sidewards, backwards
- rotatory
> Protraction: forward movement of scapula
> Retraction: backward movement of scapula
SUPRAHUMERAL
* False (functional) joint
* aka supraspinatus tunnel, subacromial space
FUNCTIONS:
- a protective articulation between the humeral head and coracoacromial arch
- prevents trauma from above to the GH joint or to the head of the humerus

- also prevents upward dislocation of the humerus
* PAIN SENSITIVE STRUCTURES:
- Subacromial bursa
- Subcoracoid bursa
- Supraspinatus muscle and tendon
- Superior portion of the glenohumeral capsule
- Portion of the biceps tendon
- Interposed loose connective tissue

MUSCLES OF THE SHOULDER REGION
* Three Groups
Muscles from the trunk to shoulder girdle (7)
Muscles from shoulder girdle to humerus (9)
Muscles from trunk to humerus (2)

THE SHOULDER GIRDLE
ANATOMY

Muscles from the trunk to shoulder girdle
* TRAPEZIUS
* SERRATUS ANTERIOR
* LEVATOR SCAPULA
* RHOMBOID MAJOR
* RHOMBOID MINOR
* PECTORALIS MINOR
* SUBCLAVIUS
Muscles from shoulder girdle to humerus
* DELTOID
* SUPRASPINATUS
* INFRASPINATUS
* TERES MINOR
* SUBSCAPULARIS

> Musculotendinous Cuff: prime mover
> Short Rotators:
Infraspinatous and Teres Minor
- external rotation
Subascapularis
- internal rotation
* TERES MAJOR
* CORACOBRACHIALIS
* BICEPS BRACHII
* TRICEPS BRACHII

Muscles from trunk to humerus
* LATISSIMUS DORSI
* PECTORALIS MAJOR

DR
...

Clavicle, medial margin
acromion

Elevates
scapula; rotates
scapula upward, draws
head to same
side and turns
face to opposite
side

Spinal accessory (CN XI), C3
and c4 as sensory

Middle fibers

Spinous process
T1-T6

Posterior border spine of
scapula

Retracts scapula

Same

Lower fibers

Spinous processes
T7-T12

Tubercle spine
of scapula

Depresses
Same
scapula; rotates
scapula upward

SERRATUS
ANTERIOR

Ribs 1-8 anterolateral thoracic wall

Inferior angle,
medial border
scapula

Protracts scapula; rotates
scapula upward

LEVATOR
SCAPULA

Posterior tubercles,
transverse process
C1-C4

Upper medial
Elevates and
border, superior rotates scapula
angle scapula
downward;
scapula fixed,
extends and
laterally bends
neck

Dorsal scapular, C3, C4, C5

RHOMBOID
MAJOR

Spinous process,
T2-T5, supraspinous ligament

Medial border,
below spine of
scapula

Retracts (adducts) scapula,
holds scapula
to chest

Dorsal scapular, C5

RHOMBOID
MINOR

Ligamentumnuchae, Medial border,
spinousprocesses
scapula at root
C7-T1
of spine

Retracts (adducts), scapula,
holds scapula
to chest

Dorsal scapular, C5

PECTORALIS
MINOR

Upper outer surface, ribs 3-5

Coracoid process

Medial pectoral
(C6-C8)

SUBCLAVIUS

Rib 1

Undersurface
of scapula

Protracts scapula; depresses
shoulder; aids
in downward
rotation of
scapula
Depresses
scapula, maintains sternoclavicular joint

ANATOMY

NAME
TRAPEZIUS
Upper Fibers

DR
...
John Lorenz Beleno

NAME
DELTOID
Anterior fibers

10
Jlb_MD

THE SHOULDER GIRDLE

Same

LATISSIMUS DORSI

Lumbar aponeurosis to
spines T6-T12, spines
lumbar and sacral vertebra and supraspinous ligaments, iliac
crest, lower 4 ribs

Medial lip (crest of
lesser tubercle) and
floor of intertubercular groove

PECTORALIS MAJOR
(CLAVICULAR)

Medial 2/3 clavicle

PECTORALIS MAJOR
(STERNOCOSTAL)

Lateral sternum to 7th
costal cartilage, costal
cartilages 2-6, aponeurosis of external abdominal oblique

Crest of greater tubercle (lateral lip of
intertubercular
groove)
Same

Extends forearm (elbow
extension)
Extends, hyperextends,
adducts and
rotates arm
medially
Draws shoulder downward
and backward
Helps in
climbing
Flexes, adducts, and
rotates arm
medially
Extends, adducts and rotates arm
medially
...
John Lorenz Beleno

Posterior humerus, below radial groove

ANATOMY

TRICEPS BRACHII
(MEDIAL HEAD)

11
Jlb_MD

THE SHOULDER GIRDLE

DR

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