RCSI Scapular Region and Shoulder Joint Lecture Notes 2024 PDF

SCAPULAR REGION and SHOULDER JOINT Class Year 1 Course Medicine – BMF Module Title Scapular Region and Shoulder Joint Lecturer Prof. Oran D. Kennedy (Dr Claire Conway) Date 29/11/2024 Housekeeping/Admin Anatomy Room reminders: Return instruments after session Close whi...

SCAPULAR REGION and SHOULDER JOINT Class Year 1 Course Medicine – BMF Module Title Scapular Region and Shoulder Joint Lecturer Prof. Oran D. Kennedy (Dr Claire Conway) Date 29/11/2024 Housekeeping/Admin Anatomy Room reminders: Return instruments after session Close white-bags and cover cadaver after each session Bring your gloves Notice – Barker Prize Competition Barker Prize is an annual award for a ‘dissection of surgical importance’ Dates for competition and details for applications will be announced in Jan/Feb Typically takes place the week or two after summer exams Prof Fabio Quondamatteo will be organising  REVISION Gateway: - Boundaries - Contents  LEARNING OUTCOMES 1. Describe the osteology, joints and muscles of the pectoral girdle 2. Summarise scapular movements and the muscles responsible 3. Describe the structure and function of the scapulo-humeral muscles 4. Describe the course and function of neurovascular structures in the scapular region 5. Describe the structure and function of the shoulder joint 6. Recognise common injuries in the shoulder area and discuss their causes and complications  TERMINOLOGY Pectoral Girdle = Clavicle & Scapula OSTEOLOGY OF SCAPULA  OSTEOLOGY OF SCAPULA Inferior angle Vertebral levels….. CLAVICLE Smooth on top Rough underneath CLAVICLE - INJURY CLAVICLE - INJURY  JOINTS OF THE PECTORAL GIRDLE Sternoclavicular joint – Atypical synovial Fibrocartilage & disc What the 2 ofthe joints girdle pectoral are joint sternoclavicular Costoclavicularl igament Costoclavicular ligament  HUMERUS - ARM Greater tuberosity Anatomical neck Lesser tuberosity Intertubercular Groove Surgical neck SHOULDER JOINT Tissue type Synovial Mobility Very mobile Structure Ball and socket STABILITY - MOBILITY Glenoid fossa Head of the humerus acetabular fossa Head of the Femur  GLENOID LABRUM Fibrocartilaginous ring around the glenoid fossa Glenoid labrum Glenoid fossa GLENOID LABRUM - INJURY  ROTATOR CUFF MUSCLES *Most important factor in stabilizing the shoulder *  Allow the humerus to ‘S.S.I.T.’ against the glenoid cavity – Subscapularis – Supraspinatus Supraspinatus – Infraspinatus Infraspinatus Teres minor – Teres minor Subscapularis Nerve supply: Supraspinatus: suprascapular nerve Infraspinatus: suprascapular nerve Teres minor: axillary nerve Subscapularis: subscapular (upper & lower) nerves ROTATOR CUFF INJURY  ROTATOR CUFF INJURY: MRI Coronal Transverse SHOULDER- INJURY Anterior -inferior dislocation of the shoulder joint most common What nerve can be damaged ? Axillary nerve BURSA(E) Fluid filled pouch They reduce friction between bone and soft tissue. They occur between bone and tendons /muscle or bone and the skin  SUPERFICIAL MUSCLES Trapezius Deltoid  MOVEMENTS - SCAPULA Elevation Depression  MOVEMENTS - SCAPULA Protraction Retraction ROTATIONS - SHOULDER Chief medial rotator – subscapularis – teres major – also pec. major Chief lateral rotator – infraspinatus – teres minor – (posterior. deltoid) FLEXION OF SHOULDER – Pectoralis major (clavicular part) – Deltoid (anterior part) – Some coracobrachialis & biceps EXTENSION OF SHOULDER – Latissimus dorsi – Deltoid (posterior fibres) – Some Teres major, Triceps ADDUCTION OF SHOULDER – Pectoralis major (sternal part) – Latissimus dorsi – Also teres major ABDUCTION OF THE SHOULDER Supraspinatus (0-15°) Deltoid (15-90°) Abduction >90° - *(Trapezius & serratus anterior) - Infraspinatus - Teres minor - Lower deltoid fibres  SHOULDER – BLOOD SUPPLY Subclavian artery ends lateral to 1 rib st Axillary artery ends at teres major (Lower boarder) Branches 1st part: 1 branch superior thoracic 2nd part 2 branches Lateral thoracic & thoracoacromial 3rd part 3 branches anterior circumflex humeral artery posterior circumflex humeral artery Subscapular artery circumflex – blood supply to the shoulder joint  Important Clinical/Anatomical Regions Quadrangular Space Triangular Interval Triangular Space SHOULDER – VASCULAR  LEARNING OUTCOMES 1.Describe the osteology, joints and muscles of the pectoral girdle 2.Summarize scapular movements and the muscles responsible 3.Describe the structure and function of the scapulo-humeral muscles 4.Describe the course and function of neurovascular structures in the scapular region 5.Describe the structure and function of the shoulder joint 6.Recognize common injuries in the shoulder area and discuss their causes and complication