Anatomy- The SHOULDER GIRDLE

Dr. Abiog

HUMERUS

1. Proximal
Head Covered with cartilage , directed
medially, upward and a little backward
- Anatomical neck- attachment of the
articular capsule of the glenohumeral joint
- Surgical neck - frequent site of fracture
- Greater tubercle/tuberosity - attachment
of S, I, T muscles
- Lesser tubercle attachment of the
Supscapularis
- Intertubercular Groove (Bicipital Groove)
where tendon of biceps long head is found
- Crests of the tubercles (lips of the groove)
Lateral lip (crest of greater tubercle)
insertion of Clavicular part of Pectoralis
major
Medial lip (crest of lesser tubercle)
insertion of Teres major and Latissimus
Dorsi

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
- Stability is sacrificed for mobility of the
joint (movement along sagittal +
movement along transverse axis= rotation
+ lateral bending)
- Head- angular value of 153
- Glenoid fossa- 75(shallower, larger
radius)
- Stability of GH
Negative atm pressure
Upward direction of glenoid
Static stabilizers:
Presence of glenoid labrum-
makes fossa deeper
Ligaments and capsules
Dynamic Stabilizers:
Musculotendinous cuff
muscles (SITS)

Shaft
- Borders
Lateral
Medial
- Surfaces
Anterolateral
Anteromedial
posterior
- Radial sulcus (radial groove)radial
nerve
3 Structures located:
- Radial nerve
- Deep brachial artery
- ? sorry guys we cant find it.


Humeromuscular tunnel:
- Formed by 3 heads of triceps brachii and
radial sulcus of the humerus for the radial
nerve
- Extends downwards from the medial to the
lateral side of the back of middle part of
humerus
- Transmits the radial nerve and the deep
brachial vessels (profunda brachii artery)
Deltoid tuberosity insertion of the deltoid
muscle

2. Distal
- Lateral and medial supracondylar ridge
- Lateral and medial epicondyle
- Radial fossa - anterior
- Capitulum (capitellum)
- Ulnar sulcus (groove) - posterior aspect
of the medial epicondyle of the humerus
Cubital tunnel-formed by tendinous
arch
- Trochlea - forms the cubital angle,
normally 5-19
- Coronoid fossa - anterior
- Olecranon fossa - posterior

Brachial Region
1. Anterior Compartment
Coracobrachialis
Biceps brachii
Brachialis
2. Posterior compartment
Triceps brachii
+ anconeus (not anatomically included)

Peculiarities
1. Biceps is in a position to act on 3 joints i.e.
glenohumeral, humeroulnar and proximal
radioulnar joints
In the shoulder it can flex, or abduct; at
the humeroulnar it can flex the elbow
At the prox. Radioulnar, it can supinate
Polyrticular, multijointed

2. Brachialis known as flexor par excellence or
the workhorse among the elbow flexors as it is
uninfluenced by the position of the forearm in its
strength of elbow flexion
Studies by Basmajian showed that
brachialis is always active as an elbow
flexor with or without a load and whether
the motion is rapid or slow

-Harnessing the 2 joint mechanism can enhance
action of triceps or biceps long head tendon
portion. The head tendon of triceps is elongated
when the shoulder is flexed. So elbow extension
combined with shoulder flexion enhances the
strength capability of triceps and is used to
advantage in pushing activity
-Combination: sanding, polishing, pulling the
beater of a loom
-Biceps and triceps acting simultaneously as
synergists, though they are antagonistic with
each other. This can be verified and felt when
screwing with screwdriver
*Strongest head of triceps Medial, closest to the
elbow joint.

Joints and Ligaments
*shoulder girdle
True:
a. Glenohumeral
Types
Triaxial
Coracohumeral
glenohumeral (with superior and
middle, inferior)
*bet. superior and middle glenohumeral
ligament is a recess called foramen of
Weitbrecht
*bet. middle and inferior, foramen of
Rouvier
Weakest lower portion
Stability:
Static: glenoid labrum, ligament,
capsule
Dynamic: muscles
(musculotendinous cap muscle)

b. Sternoclavicular
Type: sellar/saddle
Triaxial
Only joint of attachment of upper
extremity to the trunk
Ligaments:
Anterior- prevents upward and lateral
displacement
Posterior- same as anterior
Costoclavicular- same as anterior, fulcrum
Interclavicular prevents lateral
displacement
c. Acromioclavicular
arthrodial
nonaxial
ligaments
o Superior
o Inferior
o Coracoclavicular:
Conoid Medial Posterior, prevents
medial displacement
Trapezoid Lateral Anterior, prevents
ventral rotation.
d. costovertebral
e. costosternal























Anterior Compartment
Name Origin Insertion Action Nerve supply
Coracobrachialis Coracoid
process
Middle
shaft of
humerus
Flexes arm
horizontally;
adduct
humerus
Musculocutaneous

(C5, 6,7)
Biceps Brachi
Long head

Supraglenoid
tuberosity

Radial
tuberosity,
Bicipital
aponeurosis

Flexes elbow,
Supinates arm
(Long head can
abduct arm
when in
external
rotation
position)




Musculocutaenous
(C5, C6)
Short head Coracoid
process
The lateral part of the brachialis often receives a branch from the radial nerve, although the
functional significance of this is not clear
This branch does help supply the elbow joint but there is disagreement

Posterior Compartment:
Name Origin Insertion Action Nerve supply
Triceps
brachii
Long head


Infraglenoid
tuberosity


Post and
upper
olecranon,
Fascia of
the forearm


Extends
forearm (elbow
extension) +
**Extends and
adduct arm (for
the long head
only),


Radial (C6, 7, 8)
Lateral Head Post humerus,
above radial
groove

Post humerus,
below radial
groove



Medial Head
+ Anconeus
(only a part of it
is located)
Posterior aspect
of lateral
epicondyle
Olecranon,
upper post
ulna
Extends
forearm,
stabilizes joint,
cocontractor of
triceps
Radial (C7, 8, T1)