Shoulder joint- Types, ligament & movement

Shoulder joint
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Shoulder joint

Type: The shoulder joint is a synovial joint of ball and socket variety. The articular surface ligament and bursae related to this important joint are explained below.

Articular surface: The joint is formed by articular of the glenoid cavity of scapula and the head of the humerus. So, it is known as glenohumeral articulation. Structurally, it is a weak joint because glenoid cavity is too small and shallow to hold head of the humerus. It give more a great mobility.
 
Stability of joint is maintained by
  • The coracoacromial arch for the head of the humerus.
  • The musculotendinous cuff of the shoulder
  • Glenoid labrum helps in depending the glenoid fossa.
  • Stability is also provided by the muscle attaching the humerus to the pectoral girdle, long head of the biceps brachii and the long head of the triceps brachii.
Ligament: 
  1. The capsular ligament
  2. The coracohumeral ligament
  3. Transverse humeral ligament
  4. The glenoid labrum
The capsular ligament: It is very loose and give free movement.  It is less supported inferiorly where dislocation are common. Such dislocation damage closely related to axillary nerve.
  • Medially – Capsule is attached to the scapula beyond the supraglenoid tubercle and the margins of the labrum.
  • Laterally – Capsular ligament attached to the anatomical neck of the humerus,
  • Inferiorly- The attachments extends down to the surgical neck
  • Superiorly – Attached to the tendon of the long head of the biceps brachii.
  • Anteriorly- The capsule is reinforced by sapplemental bands called the superior, middle , and inferior glenohumeral ligament.

The coracohumeral ligament –  Extends from  root of the coracoid process to  neck of the humerus opposite the greater tubercle.

 
Transverse humeral ligament – It pass the upper part of the bicipital groove of the humerus. Long head of the biceps brachii  tendon passes deep to the liagment.
The glenoid labrum: It is a fibro cartilagenous rim which covers the margins of the glenoid cavity and increase the depth of cavity. 
Bursa related to the joint:
  • The subacromial bursa
  • The Subscapularis bursa, commonicate withe the joint cavity.
  •  Infraspinatus bursa, may communicate with the joint cavity.
Relations: 
  • Superiorly: Coracoacromial arch, subacromial bursa, supraspinatus and deltoid.
  • Inferiorly – Long head of the triceps brachii, Posterior  circumflex humeral artery and axiallary nerve.
  • Anteriorly – Subscapularis, coracobrachialis, short head of the biceps,  brachii  and deltoid.
  • Posterior – Infraspinatus, teres minor, and deltoid.
With in the joint : Tendon of the long head of the biceps brachii.
 
Blood supply: 
  • Anterior circumflex humeral vessel
  • Posterior circumflex humeral vessel
  • Suprascapular vessels
  • Subscapular vessels
Nerve supply:
  • Axillary nerve
  • Musculocutaneous nerve
  • Suprascapular nerve
Movement of shoulder joint: 
Shoulder joint give great freedom of mobility and the stability. There is no other joint in the body  which is mobile more than shoulder joint.
  • Flexion and extensions: During flexion arm move forward  medially. During extension arm move backwards and laterally.  Flexion and extenson take place in sagittal plane from axis. E.g clavicular head and pectoralis major, extension, deltoid, coracobrachialis, and lattismus dorsi.
  • Abduction/adduction: In abduction  – Arm move anterolaterally away from the trunk.  Frontal olane and sagitaal axis. E.g Adduction – Pectoralis major, lattismus dorsi, biceps brachii. Abduction : Supraspinoatius, deltoid.
  • Medial and lateral rotations: In this position the hand is move medially across the chest in medial rotation and laterally in lateral rotation of the shoulder joint.  E.g medial rotation- pectoralis major, lattismus dorsi. Lateral rotation – deltoid, teres major, infra spinatus and teres minor.
  • Circumduction: It is a combination of different movement as a result which hand move along the circle.
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