II. Anatomy

  1. Bone and Ligament
    1. orthoAnteriorBoneShoulder.jpgAlso available as a Poster size image. See printing instructions and image restrictions.
    2. orthoPosteriorBoneShoulder.jpgAlso available as a Poster size image. See printing instructions and image restrictions.
    3. orthoArmShoulderJointGrayBB326.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    4. orthoArmShoulderJointGrayBB327.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    5. orthoArmShoulderJointGrayBB328.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  2. Muscles
    1. ShoulderAnteriorBiceps.jpg
    2. orthoArmShoulderMusclesLtGrayBB410.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    3. orthoArmShoulderMusclesLtDeepGrayBB411.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    4. orthoArmShoulderMusclesLtPosteriorGrayBB412.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)

III. Anatomy: Bones

  1. Scapula
    1. Scapular spine
      1. Third thoracic Vertebrae
    2. Scapular inferior angle
      1. Eighth thoracic Vertebrae (7th rib)
  2. Clavicle
  3. Humerus

IV. Anatomy: Muscles

  1. Muscles attaching Axial skeleton to Scapula
    1. Trapezius
    2. Levator Scapulae
    3. Rhomboids
    4. Serratus anterior
  2. Muscles attaching Axial skeleton to Humerus
    1. Latissimus dorsi
    2. Pectoralis major

V. Anatomy: Joints and Articulations

  1. Glenohumeral joint (GH Joint)
    1. Glenoid of Scapula meets humeral head
    2. Golf ball on golf tee
      1. Articulation with bone: 30%
      2. Articulation with glenoid labrum: 75%
  2. Posterior Chest Wall (Scapulothoracic articulation)
  3. Acromioclavicular Joint (AC Joint)
    1. Acromion of Scapula meets the clavicle
  4. Sternoclavicular Joint (SC Joint)
    1. Four ligaments (in addition to a saddle-like structure) stabilize the joint
      1. Anterior sternoclavicular ligament
      2. Posterior sternoclavicular ligament
      3. Interclavicular ligament
      4. Costoclavicular ligament

VI. Anatomy: Nerves

  1. Rotator cuff is innervated by Brachial Plexus derived nerves
    1. Suprascapular nerve
      1. Innervates supraspinatus and infraspinatus
    2. Axillary nerve
      1. Wraps around the Humerus surgical neck
      2. Innervates teres minor
      3. Also innervates the deltoid Muscle (not part of the rotator cuff)
    3. Subscapular nerve
      1. Innervates subscapularis

VII. Anatomy: Subacromial Space

  1. Coracoclavicular arch forms the roof of the subacromial space
    1. Coracoid process
    2. Coracoacromial ligament
    3. Acromion process
  2. Rotator cuff composition (mnemonic: SITS Muscles)
    1. Anterior Rotator Cuff
      1. Subscapularis Muscle
    2. Posterior Rotator Cuff
      1. Infraspinatus Muscle
      2. Teres Minor Muscle
    3. Superior Rotator Cuff
      1. Supraspinatus Muscle
  3. Subacromial bursae
    1. Separates cuff from overlying coracoacromial arch
    2. Includes subdeltoid bursa and subcoracoid bursa
  4. Image
    1. ShoulderAnteriorRotatorCuff.jpg
    2. orthoShoulderSuperior.png

VIII. Physiology: Function

  1. Scapula stabilized prior to arm movement
  2. Rotator Cuff (Musculotendinous)
    1. Steadies humeral head in glenoid
    2. Results in humeral head descent
  3. Scapulothoracic Musculature
    1. Results in forward and lateral Scapula movement
    2. Initiates first 60-70 degrees of Shoulder Abduction
  4. Glenohumeral Musculature
    1. Deltoid and supraspinatus Muscles
    2. Accounts for last two thirds of Shoulder Abduction

IX. Physiology: Muscle action at Glenohumeral joint

  1. Shoulder Abduction
    1. Middle deltoid Muscle
    2. Supraspinatus Muscle
  2. Shoulder Adduction
    1. Pectoralis major Muscle
    2. Latissimus dorsi Muscle
  3. Shoulder Flexion
    1. Anterior deltoid Muscle
    2. Coracobrachialis Muscle
  4. Shoulder Extension
    1. Posterior deltoid Muscle
    2. Latissimus dorsi Muscle
    3. Teres major Muscle
  5. Shoulder Internal Rotation
    1. Pectoralis major Muscle
    2. Latissimus dorsi Muscle
    3. Teres major Muscle
    4. Subscapularis Muscle
  6. Shoulder External Rotation
    1. Infraspinatus Muscle
    2. Teres Minor Muscle

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Related Studies

Ontology: Shoulder (C0037004)

Definition (SCTSPA) Región del cuerpo definida por la articulación del hombro y las estructuras circundantes
Definition (SNOMEDCT_US) The body part defined by the shoulder joint and its surrounding structures
Definition (NCI) The region of the body between the neck and the upper arm.
Definition (NCI_CDISC) The region of the body between the neck and the upper arm. (NCI)
Definition (CSP) junction of the arm and trunk; also that part of the trunk which is bounded at the back by the scapula.
Concepts Body Location or Region (T029)
MSH D012782
SnomedCT 16982005
HL7 SHOL, SHOLJ
LNC LP7584-8, MTHU002689, LA4298-1
English Shoulder, Shoulders, Shoulder region, Structure of shoulder region, Structure of shoulder region, unspecified, anatomies shoulder, shoulder anatomy, shouldering, shoulder, anatomy shoulder, shoulders, SHOULDER, Shoulder region structure, Shoulder region structure (body structure), Shoulder, NOS, Shoulder (Anatomy), Sholder Joint
Swedish Skuldra
Spanish estructura de la región de la espalda, estructura de la región del hombro, estructura de la región del hombro (estructura corporal), estructura de región de hombro (estructura corporal), estructura de región de hombro, Hombros, hombro, estructura de la región de la espalda (estructura corporal), Hombro
Czech rameno
Finnish Olkapää
Russian PLECHO, ПЛЕЧО
Croatian RAME
Latvian Plecs
Polish Okolica naramienna, Bark, Obręcz kończyny górnej
Norwegian Skulder
Portuguese Ombros, Ombro
French Épaule
German Schulter
Italian Spalla
Dutch Schouder

Ontology: Shoulder Injuries and Disorders (C1456701)

Definition (MEDLINEPLUS)

Your shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). Your shoulders are the most movable joints in your body. They can also be unstable because the ball of the upper arm is larger than the shoulder socket that holds it. To remain in a stable or normal position, the shoulder must be anchored by muscles, tendons and ligaments. Because the shoulder can be unstable, it is the site of many common problems. They include sprains, strains, dislocations, separations, tendinitis, bursitis, torn rotator cuffs, frozen shoulder, fractures and arthritis.

Usually shoulder problems are treated with RICE. This stands for Rest, Ice, Compression and Elevation. Other treatments include exercise, medicines to reduce pain and swelling, and surgery if other treatments don't work.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Concepts Injury or Poisoning (T037)
English Shoulder Injuries and Disorders