Shoulder Girdle Anatomy PDF

Anatomy of Upper Limb Shoulder Girdle By Anatomy Department  Objectives: by the end of this lecture the student must understand the following knowledge: UPPER LIMB ▪ Identify and demonstrate the Shoulder Girdle regarding:...

Anatomy of Upper Limb Shoulder Girdle By Anatomy Department  Objectives: by the end of this lecture the student must understand the following knowledge: UPPER LIMB ▪ Identify and demonstrate the Shoulder Girdle regarding: 1) Articular surfaces. 2) Type. 3) Ligaments. 4) Special characters. 5) Movements. 6) Stability. August 24, 2024 2  Case Study UPPER LIMB August 24, 2024 3 UPPER LIMB Joints of Upper Limb August 24, 2024 4  Introduction UPPER LIMB August 24, 2024 5 UPPER LIMB August 24, 2024 6 UPPER LIMB August 24, 2024 7 UPPER LIMB August 24, 2024 8 UPPER LIMB August 24, 2024 9 UPPER LIMB August 24, 2024 10 UPPER LIMB August 24, 2024 11  Introduction Shoulder Complex UPPER LIMB ▪ The three joints in the shoulder complex are: 1. Sternoclavicular joint. Shoulder Girdle 2. Acromioclavicular joint. 3. Shoulder (Glenohumeral) joint. ▪ The sternoclavicular joint and the acromioclavicular joint link the two bones of the pectoral girdle (clavicle & scapula) to each other and to the trunk (SEE LATER) ▪ The combined movements at these two joints enable the scapula to be positioned over a wide range on the thoracic wall. ▪ In cleidocranial dysplasia: The clavicle are either poorly developed or absent, which allows the shoulders to be brought close together. August 24, 2024 12 UPPER LIMB August 24, 2024 13  Objective # ( 1 ) Shoulder Girdle A. Sternoclavicular Joint Type synovial - Saddle joint UPPER LIMB 1-Medially: Articular the clavicular notch of the manubrium sternii. Surfaces 1st costal cartilage 2-Laterally: medial (sternal) end of the clavicle. Special The articular cavity is completely separated into two compartments (medial & lateral) by an articular disc. characters Four ligaments: (1) & (2) Anterior and Posterior sterno-clavicular ligaments: are anterior and posterior, respectively, to the joint. Supporting (3) Inter-clavicular ligament: links the ends of the two clavicles to each other and to the superior surface of Ligaments the manubrium of the sternum. (4) Costo-clavicular ligament: links the proximal end of the clavicle to the first rib and related costal cartilage. 1- Retraction & Protraction. Movements 2- Elevation & Depression. August 24, 2024 14 UPPER LIMB August 24, 2024 15 UPPER LIMB August 24, 2024 16  Objective 1: (1) Shoulder (Pectoral) Girdle B. Acromioclavicular Joint UPPER LIMB Type synovial - Plane joint Articular 1-Medially: acromial end of the clavicle Surfaces 2-Laterally: medial surface of the acromion Two ligaments: Supporting (1) Acromio-clavicular ligament superior to the joint and passing between adjacent regions of the clavicle and Ligaments acromion. (2) Coraco-clavicular ligament: SEE LATER 1- Retraction & Protraction. Movements 2- Elevation & Depression. August 24, 2024 17 UPPER LIMB August 24, 2024 18  Coracoclavicular ligament It is an important strong accessory ligament: UPPER LIMB a) Providing weight-bearing support for the upper limb on the clavicle as in lifting a heavy weight b) Maintaining the position of the clavicle on the acromion (it spans the distance between the coracoid process of the scapula and the inferior surface of the acromial end of the clavicle). Attachments: Inferiorly: is attached to the coracoid process of the scapula. Superiorly: It is splitted in to two parts: 1) Trapezoid ligament: attaches to the trapezoid line on the clavicle. 2) Conoid ligament attaches to the conoid tubercle on the clavicle. August 24, 2024 19 UPPER LIMB August 24, 2024 20  Movements of Shoulder Girdle Movements Muscles 1. Upper fibers of Trapezius 1 Elevation of the scapula (Elevation of Shoulder) 2. Levator scapulae UPPER LIMB 2 Depression of the scapula (Depression of Shoulder) Pectoralis minor 1. Upper fibers of Trapezius Upward rotation of the scapula (Abduction) 3 2. Lower fibers of Trapezius (Raising the arm above the head) 3. Lower digitations of serratus anterior 1. Levator scapulae 4 Downward rotation of the scapula 2. Rhomboideus major and minor 3. Pectoralis minor 1. Serratus anterior 5 Protraction (Movement the shoulder forward) 2. Pectoralis minor 1. Middle fibers of trapezius 6 Retraction (Movement of the shoulder backward) 2. Rhomboideus major and minor August 24, 2024 21  Clinical Correlation Fractures of the clavicle UPPER LIMB The clavicle provides the only bony connection between the upper limb and trunk. It transmits the forces from the upper limb to the trunk. The typical site of fracture is the medial 2/3 and lateral 1/3. The acromial end of the clavicle tends to dislocate downwards. August 24, 2024 22 UPPER LIMB August 24, 2024 23  × UPPER LIMB August 24, 2024 24  Clinical Correlation Dislocations of the UPPER LIMB acromioclavicular joint Severe trauma will disrupt (tear) of the coracoclavicular ligament, which results in elevation and upward dislocation of the clavicle. August 24, 2024 25  Clinical Correlation Dislocations of the UPPER LIMB sternoclavicular joint The injury at the medial end of the clavicle is an anterior or posterior dislocation of the sternoclavicular joint. A posterior dislocation of the clavicle may compress on the great vessels in the root of the neck. August 24, 2024 26  Case Scenario A 21-year-old male presents to the emergency department after a fall on his right shoulder while playing soccer. He reports pain over the top of his shoulder. On physical examination, UPPER LIMB there is tenderness over the acromioclavicular joint, and a mild prominence of the distal clavicle is noted. The patient exhibits pain with shoulder abduction. X-ray imaging of the shoulder shows no fracture but a slight widening of the acromioclavicular joint space. Which of the following is the most appropriate initial management for this patient's condition? A. An immediate surgical repair B. Immobilization with a sling and referral to physical therapy C. Administration of corticosteroid injection into the AC joint D. Application of a figure-of-eight bandage August 24, 2024 27  Reference UPPER LIMB Gray's anatomy for students, 4th edition. ISBN: 978-0-7020-5131-9 Copyright© 2019 by Churchill Livingstone, an imprint of Elsevier Inc. Chapter 7 – Upper Limb August 24, 2024 28 UPPER LIMB August 24, 2024 29