Download - Pectoral Girdle and Shoulder
COLLEGE OF ALLIED COLLEGE OF ALLIED HEALTH AND SCIENCEHEALTH AND SCIENCE
HERMIZAN HALIHANAFIAHHERMIZAN HALIHANAFIAHBsc Biomedicine (Hons) UKMBsc Biomedicine (Hons) UKM
Pectoral/shoulder Girdle
Upper LimbPelvic Girdle
Lower LImb
Pectoral GirdlesPectoral Girdles Attach the bones of upper limb to the axial Attach the bones of upper limb to the axial
skeleton.skeleton.
Consist Consist clavicleclavicle and and scapulascapula bones. bones.
The pectoral girdles does not articulate The pectoral girdles does not articulate with the vertebral column. Held in position with the vertebral column. Held in position by complex of muscle attachment.by complex of muscle attachment.
Pectoral GirdlesPectoral Girdles
S shapeS shape
Also known as a collarboneAlso known as a collarbone
Classified as a long bone.Classified as a long bone.
Medial 2/3 convex anteriorly and lateral 1/3 Medial 2/3 convex anteriorly and lateral 1/3
concave anteriorly.concave anteriorly.
Situated lies horizontally in the superior and Situated lies horizontally in the superior and
anterior part of the thorax, superior to the 1anterior part of the thorax, superior to the 1stst rib. rib.
CLAVICLE
It acts as a strut to keep the scapula in position so the It acts as a strut to keep the scapula in position so the
arm can hang freely.arm can hang freely.
Palpable region because most of the region cover by Palpable region because most of the region cover by
skin (subcutaneous).skin (subcutaneous).
Have several function:Have several function:
- rigid support for the scapula and upper limb - rigid support for the scapula and upper limb
suspended. This arrangement keep upper limb (arm) suspended. This arrangement keep upper limb (arm)
away from thorax – maximum ROMaway from thorax – maximum ROM
CLAVICLECLAVICLE
Covers the cervicoaxillary canal (passageway between Covers the cervicoaxillary canal (passageway between
the neck and arm), through which several important the neck and arm), through which several important
structures pass (brachial plexus, artery etc)structures pass (brachial plexus, artery etc)
Transmits physical impacts from the upper limb to the Transmits physical impacts from the upper limb to the
axial skeleton. axial skeleton.
Provide some muscles attachment. (Deltoid, subclavius, Provide some muscles attachment. (Deltoid, subclavius,
trapezius, pec major etc)trapezius, pec major etc)
CLAVICLECLAVICLE
ClavicleClavicle
CLAVICLECLAVICLE
CLAVICLECLAVICLE
The medial end of the clavicle called sternal end is The medial end of the clavicle called sternal end is
rounded shape articulate with clavicular notch of rounded shape articulate with clavicular notch of
manubrium of sternum to form sternoclavicular manubrium of sternum to form sternoclavicular
joints.joints.
The lateral end of the clavicle called acromial The lateral end of the clavicle called acromial
extremity is broad and flat and articulate with extremity is broad and flat and articulate with
acromion process of scapula to form acromion process of scapula to form
acromioclavicular joint.acromioclavicular joint.
CLAVICLECLAVICLE
Sternoclavicular JointSternoclavicular Joint
Acromioclavicular Joint
The conoid tubercle on the inferior surface of the The conoid tubercle on the inferior surface of the
lateral end of the clavicle is a point attachment for lateral end of the clavicle is a point attachment for
the conoid ligament (coracoclavicular lig)the conoid ligament (coracoclavicular lig)..
The costal tuberosity on the inferior surface of the The costal tuberosity on the inferior surface of the
medial end is point attachment for the medial end is point attachment for the
costoclavicular ligament.costoclavicular ligament.
CLAVICLECLAVICLE
SCAPULASCAPULA Shoulder bladeShoulder blade
Large boneLarge bone
TriangularTriangular
Flat Flat
IrregularIrregular
SCAPULASCAPULA
Situated in the superior part of the Situated in the superior part of the
posterolateral aspect of the thorax posterolateral aspect of the thorax
between the levels of the 2between the levels of the 2ndnd and 7 and 7thth ribs. ribs.
The medial border of scapula lie about The medial border of scapula lie about
5cm from the vertebral column.5cm from the vertebral column.
Anterior View Posterior View
Consist 3 border; superior, lateral (axillary) and Consist 3 border; superior, lateral (axillary) and
medial (vertebra) border.medial (vertebra) border.
Consist 3 angle; superior angle, inferior angle Consist 3 angle; superior angle, inferior angle
and lateral angle.and lateral angle.
Consist 3 fossa; supraspinous and infraspinous Consist 3 fossa; supraspinous and infraspinous
fossa (posterior) and subscapular fossa fossa (posterior) and subscapular fossa
(anterior).(anterior).
ScapulaScapula
SpineSpine, runs diagonally across the posterior of , runs diagonally across the posterior of
the scapula separate supraspinous and the scapula separate supraspinous and
infraspinous fossa.infraspinous fossa.
The lateral end of spine projects as a flattened, The lateral end of spine projects as a flattened,
expanded process called the expanded process called the acromion acromion
processprocess..
ScapulaScapula
Acromion process articulate with the acromial Acromion process articulate with the acromial
extremity of clavicle to form extremity of clavicle to form acromioclavicular acromioclavicular
jointjoint..
Inferior to the acromion process is a shallow Inferior to the acromion process is a shallow
depression called depression called glenoid cavityglenoid cavity..
This cavity accepts the head of humerus to form This cavity accepts the head of humerus to form
glenohumeral jointglenohumeral joint..
ScapulaScapula
Medial (vertebral) border – the Medial (vertebral) border – the thin edgethin edge of the of the
bone near to the vertebral column.bone near to the vertebral column.
Lateral (axillary border) – the Lateral (axillary border) – the thick edgethick edge closer closer
to the arm.to the arm.
Medial border join the lateral border at the Medial border join the lateral border at the
inferior angleinferior angle..
ScapulaScapula
The superior edge of scapula , called superior The superior edge of scapula , called superior
border joins the vertebral border at the superior border joins the vertebral border at the superior
angle.angle.
The scapular notch is a prominent indentation The scapular notch is a prominent indentation
along the superior border through which the along the superior border through which the
subscapular nerve passes.subscapular nerve passes.
ScapulaScapula
At the lateral end of the superior border is At the lateral end of the superior border is
projection of the anterior surface called projection of the anterior surface called coracoid coracoid
processprocess, which the tendons and muscle attach., which the tendons and muscle attach.
Superior and inferior to the spine are two fossae; Superior and inferior to the spine are two fossae;
supraspinoussupraspinous and i and infraspinousnfraspinous fossafossa, surfaces , surfaces
of attachment of muscles and tendons.of attachment of muscles and tendons.
On the anterior surface is a slightly hollowed out On the anterior surface is a slightly hollowed out
area called area called subscapular subscapular fossafossa..
ScapulaScapula
Movements of the Movements of the ScapulaScapula
Movements of the ScapulaMovements of the Scapula
Elevation of ScapulaElevation of Scapula
Superior movement
of the shoulder
girdle; moving the
scapula up.
Depression of ScapulaDepression of Scapula
Inferior movement of
the shoulder girdle;
moving the scapula
down.
Movements of the ScapulaMovements of the Scapula
Upward Rotation of ScapulaUpward Rotation of Scapula
Rotary movement of
the scapula; moving
inferior angle of scapula
laterally and upward
Downward Rotation of Downward Rotation of ScapulaScapula
Rotary movement of
the scapula; moving
inferior angle of
scapula medially and
downward.
Movements of the ScapulaMovements of the Scapula
Abduction/Protraction of Abduction/Protraction of ScapulaScapula
Forward movement
away the midline of
the body; moving the
scapula away from
the spine during
protraction of the
shoulder girdle.
Adduction/Retraction of Adduction/Retraction of ScapulaScapula
Backward movement
toward the midline of the
body; moving the
scapula back toward the
spine during retraction
of the shoulder girdle.
Movement of the Scapula Movement of the Scapula as a Wholeas a Whole
Movement of the pec girdle serve to Movement of the pec girdle serve to increase the range of movement increase the range of movement (ROM) of the shoulder jt.(ROM) of the shoulder jt.
Remember!!! – movements of the Remember!!! – movements of the pectoral girdle accompany virtually pectoral girdle accompany virtually to all movements of the shoulder to all movements of the shoulder joint.joint.
Pairing of Pec Girdle and Pairing of Pec Girdle and Shoulder Jt MovementsShoulder Jt Movements
Shoulder Jt Shoulder Girdle
Abduction Upward rotation
Adduction Downward rotation
Flexion Elevation / upward rotation
Extension Depression / downward rotation
Internal rotation Internal rotation Abduction (protraction)Abduction (protraction)
External rotationExternal rotation Adduction (retraction)Adduction (retraction)
Horizontal abductionHorizontal abduction Adduction (retraction)Adduction (retraction)
Horizontal adductionHorizontal adduction Abduction (protraction)Abduction (protraction)
Orientation Muscles of the Orientation Muscles of the Pectoral GirdlePectoral Girdle
Muscles of the thorax that move the pectoral Muscles of the thorax that move the pectoral
girdlegirdle
Anterior thoracic musclesAnterior thoracic muscles
Posterior thoracic musclesPosterior thoracic muscles
Muscles of the thorax that move the humerus.Muscles of the thorax that move the humerus.
Axial muscles that move the humerusAxial muscles that move the humerus
Scapular muscles that move the humerus.Scapular muscles that move the humerus.
Muscles of the Thorax Move the Muscles of the Thorax Move the Pectoral GirdlePectoral Girdle
Anterior thoracic Anterior thoracic
musclesmuscles
SubclaviusSubclavius
Pectoralis minorPectoralis minor
Serratus anteriorSerratus anterior
Posterior thoracic Posterior thoracic
musclesmuscles
Fiber of trapeziusFiber of trapezius
Levator scapulaeLevator scapulae
Rhomboid minorRhomboid minor
Rhomboid majorRhomboid major
Muscles of the Thorax that Move Muscles of the Thorax that Move the Humerusthe Humerus
Axial musclesAxial muscles
Pectoralis majorPectoralis major
Latissumus dorsiLatissumus dorsi
Scapular musclesScapular muscles
Fiber of deltoidFiber of deltoid
Rotator cuffRotator cuff
Teres majorTeres major
CoracobrachalisCoracobrachalis
Long & short head of Long & short head of
bicepsbiceps
Long head of tricepsLong head of triceps
ORIGIN, INSERTION, ACTIONS ORIGIN, INSERTION, ACTIONS AND NERVE SUPPLYAND NERVE SUPPLY
Subclavius MuscleSubclavius Muscle Origin – 1Origin – 1stst rib rib
Insertion – lower surface of clavicleInsertion – lower surface of clavicle
Action Action
Depression and move clavicle Depression and move clavicle
anteriorly anteriorly
Helps stabilize pectoral girdleHelps stabilize pectoral girdle
Nerve supplyNerve supply
Subclavian nerveSubclavian nerve
Subclavius
Pectoralis MinorPectoralis Minor Origin Origin
22nd nd - 5- 5thth ribs, 3 ribs, 3rdrd – 5 – 5thth ribs or 2 ribs or 2ndnd – 4 – 4thth ribs. ribs.
InsertionInsertion Coracoid process of scapulaCoracoid process of scapula
ActionAction Abduction scapula and rotates it downwardAbduction scapula and rotates it downward Elevate the ribs during forced inhalation.Elevate the ribs during forced inhalation.
Nerve supplyNerve supply Medial pectoral nerveMedial pectoral nerve
Pectoralis MinorPectoralis Minor
Serratus AnteriorSerratus Anterior Origin – Superior 8 or 9 ribsOrigin – Superior 8 or 9 ribs Insertion – vertebral border and Insertion – vertebral border and
inferior angle of scapulainferior angle of scapula Action Action
Abduction and rotates the Abduction and rotates the scapula upwardscapula upward
Elevate ribs when scapula Elevate ribs when scapula stabilized.stabilized.
Also known as “boxer’s Also known as “boxer’s muscles”muscles”
Nerve supplyNerve supply Long thoracic nerveLong thoracic nerve
Fiber of TrapeziusFiber of Trapezius Consists 3 fibersConsists 3 fibers
Superior or upper fiber, Superior or upper fiber,
middle fiber and inferior or middle fiber and inferior or
lower fiber.lower fiber.
Important for move the Important for move the
scapula.scapula.
Nerve supply - accessory Nerve supply - accessory
nerve and cervical spinal nerve and cervical spinal
nervenerve..
Upper / Superior Upper / Superior Fiber of TrapeziusFiber of Trapezius
Origin – medial one third of Origin – medial one third of
the superior nuchal line, the superior nuchal line,
external occipital protuberance external occipital protuberance
and ligamentum nuchae.and ligamentum nuchae.
Insertion – posterior border of Insertion – posterior border of
the lateral one third of the the lateral one third of the
clavicle.clavicle.
Action – scapular elevationAction – scapular elevation
Middle Fiber of TrapeziusMiddle Fiber of Trapezius
Origin – spinous process Origin – spinous process
of T1 – T5of T1 – T5
Insertion – medial border Insertion – medial border
of the acromion process of the acromion process
of scapula, and superior of scapula, and superior
border of the spine of the border of the spine of the
scapula.scapula.
Action – scapular Action – scapular
adductionadduction..
Lower / Inferior Fiber of Lower / Inferior Fiber of TrapeziusTrapezius
Origin – spinous Origin – spinous
process of T6-T12process of T6-T12
Insertion – spine of the Insertion – spine of the
scapulascapula
Action scapular Action scapular
depression and depression and
adductionadduction
Levator ScapulaeLevator Scapulae Origin – transverse process of Origin – transverse process of
Superior four or five cervical Superior four or five cervical
vertebrae.vertebrae.
Insertion – superior vertebral Insertion – superior vertebral
border of scapulaborder of scapula
Action – Elevates scapula and Action – Elevates scapula and
rotates it downward.rotates it downward.
Nerve supply – dorsal scapular Nerve supply – dorsal scapular
nerve and cervical spinal nervenerve and cervical spinal nerve
Rhomboid MajorRhomboid Major
Origin – Spine of 2Origin – Spine of 2ndnd to 5 to 5thth thoracic vertebraethoracic vertebrae
Insertion – vertebral border of Insertion – vertebral border of scapula inferior to spine of scapula inferior to spine of scapulascapula
Action – elevates and adducts Action – elevates and adducts scapula and rotate it scapula and rotate it downward; stabilize scapuladownward; stabilize scapula
Nerve – dorsal scapular nerveNerve – dorsal scapular nerve
Rhomboid MinorRhomboid Minor Origin – Spine of 7Origin – Spine of 7thth cervical cervical
and 1and 1stst thoracic vertebrae. thoracic vertebrae. Insertion – Vertebrae border Insertion – Vertebrae border
of scapula superior to spineof scapula superior to spine Action – elevates and Action – elevates and
adducts scapula and rotate it adducts scapula and rotate it downward; stabilize scapuladownward; stabilize scapula
Nerve – dorsal scapular Nerve – dorsal scapular nervenerve
Clavicle origin of Clavicle origin of Pectoralis MajorPectoralis Major
Origin – medial half of anterior Origin – medial half of anterior clavicleclavicle
Insertion – greater tubercle and Insertion – greater tubercle and intertubercular sulcus of humerusintertubercular sulcus of humerus
Action – Flexion, adduction and Action – Flexion, adduction and medial rotation arm at shoulder medial rotation arm at shoulder joint.joint.
Nerve supplyNerve supply Medial and lateral pectoral Medial and lateral pectoral
nervenerve
Sternal origin of Pectoralis Sternal origin of Pectoralis MajorMajor
Origin – anterior surface of Origin – anterior surface of sternum, costal cartilage of 2sternum, costal cartilage of 2ndnd - -66thth ribs. ribs.
Insertion – greater tubercle and Insertion – greater tubercle and intertubercular sulcus of humerusintertubercular sulcus of humerus
Action – extend arm at shoulder Action – extend arm at shoulder joint.joint.
Nerve supplyNerve supply Medial and lateral pectoral Medial and lateral pectoral
nervenerve
Latissimus DorsiLatissimus Dorsi Origin – Spines of inferior 6 thoracic vertebrae Origin – Spines of inferior 6 thoracic vertebrae
(T6-T12), lumbar vertebrae (L1-L5), crest of (T6-T12), lumbar vertebrae (L1-L5), crest of
sacrum and illiac crest of hip bone and inferior sacrum and illiac crest of hip bone and inferior
four ribs.four ribs.
Insertion – Intertubecular sulcus of humerusInsertion – Intertubecular sulcus of humerus
ActionAction
Extends, adduction and medial rotation arm at Extends, adduction and medial rotation arm at
shoulder joint.shoulder joint.
Nerve supply - Thoracodorsal nerveNerve supply - Thoracodorsal nerve
Latissimus Dorsi
Fiber of DeltoidFiber of Deltoid
Consists 3 fibersConsists 3 fibers
Anterior, middle and Anterior, middle and
posterior fibers.posterior fibers.
Responsible for Responsible for
movements of the humerus movements of the humerus
at GH jointat GH joint
Nerve supply – axillary Nerve supply – axillary
nerve.nerve.
Anterior Fiber of DeltoidAnterior Fiber of Deltoid
Origin – anterior border of Origin – anterior border of
the lateral one third of the the lateral one third of the
clavicleclavicle
Insertion – deltoid Insertion – deltoid
tuberosity tuberosity
Action – flexion and Action – flexion and
middle rotation arm at GH middle rotation arm at GH
joint.joint.
Middle fiber of DeltoidMiddle fiber of Deltoid
Origin – lateral border and Origin – lateral border and
superior surface of the superior surface of the
acromion process of the acromion process of the
scapulascapula
Insertion – deltoid Insertion – deltoid
tuberositytuberosity
Action – abduction arm at Action – abduction arm at
GH jointGH joint
Posterior Fiber of DeltoidPosterior Fiber of Deltoid
Origin – inferior lip of the Origin – inferior lip of the
crest of the spine of the crest of the spine of the
scapulascapula
Insertion – deltoid Insertion – deltoid
tuberositytuberosity
Action – extension and Action – extension and
lateral rotation arm at GH lateral rotation arm at GH
joint.joint.
Rotator Cuff MusclesRotator Cuff Muscles
Consists 4 musclesConsists 4 muscles
S – SupraspinatusS – Supraspinatus
I – InfraspinatusI – Infraspinatus
T – teres minorT – teres minor
S – SubscapularisS – Subscapularis
Group of muscles that stabilize GH jointGroup of muscles that stabilize GH joint..
Supraspinatus MuscleSupraspinatus Muscle Origin – supraspinous fossa Origin – supraspinous fossa
of scapulaof scapula Insertion – Greater tubercle Insertion – Greater tubercle
of humerus (anterior aspect)of humerus (anterior aspect) Action – initially abduction Action – initially abduction
(15 degrees) at shoulder (15 degrees) at shoulder joint, stabilizing shoulder jointjoint, stabilizing shoulder joint
Nerve supply - Nerve supply - Suprascapular nerveSuprascapular nerve
Infraspinatus MuscleInfraspinatus Muscle
Origin – Infraspinous fossa Origin – Infraspinous fossa of scapulaof scapula
Insertion – Greater tubercle Insertion – Greater tubercle of humerus (posterior of humerus (posterior aspect)aspect)
Action – Laterally rotation Action – Laterally rotation and adduction arm at and adduction arm at shoulder jointshoulder joint
Nerve supply - Nerve supply - Suprascapular nerveSuprascapular nerve
Teres MinorTeres Minor Origin – Inferior lateral Origin – Inferior lateral
border of scapulaborder of scapula
Insertion – Greater tubercle Insertion – Greater tubercle
of humerus (inferior aspect)of humerus (inferior aspect)
Action – Laterally rotation, Action – Laterally rotation,
extends and adduction arm extends and adduction arm
at shoulder jointat shoulder joint
Nerve supply – axillary Nerve supply – axillary
nervenerve
Subscapularis MuscleSubscapularis Muscle
Origin – subscapular Origin – subscapular
fossa of scapulafossa of scapula
Insertion – lesser tubercle Insertion – lesser tubercle
of humerusof humerus
Action – Medial rotation Action – Medial rotation
arm at shoulder jointarm at shoulder joint
Nerve supply – upper and Nerve supply – upper and
lower subscapular nervelower subscapular nerve
Teres MajorTeres Major Origin – Inferior angle of Origin – Inferior angle of
scapulascapula Insertion – Intertubecular Insertion – Intertubecular
sulcus of humerussulcus of humerus ActionAction
Extends arm at shoulder Extends arm at shoulder jointjoint
Assist in adduction and Assist in adduction and medial rotation of arm medial rotation of arm at shoulder joint.at shoulder joint.
Nerve supplyNerve supply Lower subscapular Lower subscapular
nervenerve
CoracobrachialisCoracobrachialis
Origin - Coracoid process of Origin - Coracoid process of
scapulascapula
Insertion - Middle of medial Insertion - Middle of medial
surface of shaft of humerus.surface of shaft of humerus.
Action - Flexion and adduction Action - Flexion and adduction
arm at shoulder joint.arm at shoulder joint.
Nerve supply - Nerve supply -
Musculocutaneous nerveMusculocutaneous nerve
Biceps BrachiiBiceps Brachii
Consists 2 headConsists 2 head Long head and Long head and
short head of short head of
bicepsbiceps
Short head of BicepsShort head of Biceps Origin – Coracoid process of Origin – Coracoid process of
scapulascapula Insertion – radial tuberosity of Insertion – radial tuberosity of
radius radius Action – Flexion forearm at Action – Flexion forearm at
elbow joint, flexion arm at GH elbow joint, flexion arm at GH joint and supination at joint and supination at radioulnar joint.radioulnar joint.
Nerve supply - Nerve supply - Musculocutaneous nerveMusculocutaneous nerve
Long head of BicepsLong head of Biceps
Origin – Tubercle above the Origin – Tubercle above the glenoid cavity of scapula glenoid cavity of scapula (supraglenoid tubercle)(supraglenoid tubercle)
Insertion – Radial tuberosity Insertion – Radial tuberosity of radiusof radius
Action – flexion forearm at Action – flexion forearm at elbow joint, flexion arm at elbow joint, flexion arm at GH joint and supination GH joint and supination forearm at radioulnar joint.forearm at radioulnar joint.
Nerve supply - Nerve supply - Musculocutaneous nerveMusculocutaneous nerve
Long head of TricepsLong head of Triceps
Origin – tubercle below to Origin – tubercle below to
glenoid cavity of scapula glenoid cavity of scapula
(infraglenoid tubercle)(infraglenoid tubercle)
Insertion – Olecranon of ulnaInsertion – Olecranon of ulna
Action - Extends forearm at Action - Extends forearm at
elbow joint , Extends arm at elbow joint , Extends arm at
shoulder jointshoulder joint
Nerve supply - Radial nerveNerve supply - Radial nervePosterior View
Sternomastoid / Sternomastoid / CleidomastoidCleidomastoid
Join together to form sternocleidomastoid Join together to form sternocleidomastoid
musclemuscle
Origin Origin
(i) Sternomastoid - upper part of the anterior (i) Sternomastoid - upper part of the anterior
surface of the manubrium of sternum.surface of the manubrium of sternum.
(ii) Cleidomastoid - superior border and anterior (ii) Cleidomastoid - superior border and anterior
surface of the medial third of the clavicle.surface of the medial third of the clavicle.
Insertion – Mastoid process of Insertion – Mastoid process of
the mastoid portion of temporal the mastoid portion of temporal
bone.bone.
Action - Acting together, flexes Action - Acting together, flexes
the neck, raises the sternum and the neck, raises the sternum and
assists in forced inspiration.assists in forced inspiration.
Nerve supply – accessory nerve Nerve supply – accessory nerve
(cranial nerve XI)(cranial nerve XI)
Sternomastoid / CleidomastoidSternomastoid / Cleidomastoid
Joints on Pectoral GirdleJoints on Pectoral Girdle
There is two type of joint:There is two type of joint:
1.1. Sternoclavicular jointSternoclavicular joint
2.2. Acromioclavicular jointAcromioclavicular joint
Sternoclavicular JointSternoclavicular Joint
1.1. Articular componentsArticular components
• Between sternal end of clavicle and clavicular Between sternal end of clavicle and clavicular
notch of manubrium of sternum.notch of manubrium of sternum.
2.2. ClassificationClassification
• Synovial joint (planar)Synovial joint (planar)
3.3. MovementsMovements
• Gliding, with limited movements in nearly every Gliding, with limited movements in nearly every
direction.(backward, upward, forward, direction.(backward, upward, forward,
downward, circumduction)downward, circumduction)
Cont…Cont…
Sternoclavicular joint strengthen by series of Sternoclavicular joint strengthen by series of
ligaments:ligaments:
The Articular Capsule The Articular Capsule
The Anterior Sternoclavicular The Anterior Sternoclavicular
The Posterior Sternoclavicular The Posterior Sternoclavicular
The Interclavicular The Interclavicular
The Costoclavicular The Costoclavicular
Sternoclavicular Ligaments
Articular CapsuleArticular Capsule
The articular capsule surrounds the articulation and The articular capsule surrounds the articulation and
varies in thickness and strength. varies in thickness and strength.
In front and behind it is of considerable thickness, In front and behind it is of considerable thickness,
and forms the anterior and posterior and forms the anterior and posterior
sternoclavicular ligaments; but above, and sternoclavicular ligaments; but above, and
especially below, it is thin and partakes more of the especially below, it is thin and partakes more of the
character of areolar than of true fibrous tissue.character of areolar than of true fibrous tissue.
Anterior Sternoclavicular Anterior Sternoclavicular LigamentLigament
The anterior sternoclavicular ligament is a broad The anterior sternoclavicular ligament is a broad
band of fibersband of fibers
Covering the anterior surface of the articulation Covering the anterior surface of the articulation
attached attached aboveabove to the upper and front part of the to the upper and front part of the
sternal end of the clavicle, and, passing obliquely sternal end of the clavicle, and, passing obliquely
downward and medialward, is attached below to downward and medialward, is attached below to
the front of the upper part of the manubrium the front of the upper part of the manubrium
sternum.sternum.
Posterior Sternoclavicular Posterior Sternoclavicular LigamentLigament
The posterior sternoclavicular ligament is a similar The posterior sternoclavicular ligament is a similar
band of fibers, covering the posterior surface of the band of fibers, covering the posterior surface of the
articulationarticulation
attached above to the upper and back part of the attached above to the upper and back part of the
sternal end of the clavicle, and, passing obliquely sternal end of the clavicle, and, passing obliquely
downward and medialward, is fixed below to the back downward and medialward, is fixed below to the back
of the upper part of the manubrium of sternum.of the upper part of the manubrium of sternum.
Interclavicular LigamentInterclavicular Ligament
This ligament is a flattened band, which varies This ligament is a flattened band, which varies
considerably in form and size in different individuals, considerably in form and size in different individuals,
it passes in a curved direction from the upper part of it passes in a curved direction from the upper part of
the sternal end of one clavicle to that of the other, and the sternal end of one clavicle to that of the other, and
is also attached to the upper margin of the sternum. is also attached to the upper margin of the sternum.
Costoclavicular LigamentsCostoclavicular Ligaments
This ligament is short, flat, strong, and rhomboid in This ligament is short, flat, strong, and rhomboid in
form. form.
Attached below to the upper and medial part of the Attached below to the upper and medial part of the
cartilage of the first rib, it ascends obliquely cartilage of the first rib, it ascends obliquely
backward and lateralward, and is fixed above to the backward and lateralward, and is fixed above to the
costal tuberosity on the under surface of the clavicle. costal tuberosity on the under surface of the clavicle.
Acromioclavicular JointAcromioclavicular Joint1.1. Articular componentsArticular components
• Between acromion process of scapula and acromial Between acromion process of scapula and acromial
end of clavicle.end of clavicle.
2.2. ClassificationClassification
• Synovial joint (planar)Synovial joint (planar)
3.3. MovementsMovements
• Gliding and rotation of scapula on clavicle.Gliding and rotation of scapula on clavicle.
• Rotation of scapula forward and backward upon Rotation of scapula forward and backward upon
clavicle.clavicle.
Acromioclavicular joint strengthened by series of Acromioclavicular joint strengthened by series of
ligaments:ligaments:
Acromioclavicular ligamentsAcromioclavicular ligaments
Coracoclavicular ligamentsCoracoclavicular ligaments
Coracoacromial ligaments.Coracoacromial ligaments.
Acromioclavicular JointAcromioclavicular Joint
Acromioclavicular JointAcromioclavicular Joint Coracoaromial ligamentCoracoaromial ligament
Controls anterior and posterior translation of the Controls anterior and posterior translation of the lateral claviclelateral clavicle
Coracoclavicular ligamentCoracoclavicular ligament Control vertical stability; restrains superior and Control vertical stability; restrains superior and
anterior displacements.anterior displacements.
Acromioclavicular ligamentAcromioclavicular ligament Provides stability across the joint; restrains posterior Provides stability across the joint; restrains posterior
translation and displacement of the clavicletranslation and displacement of the clavicle..
Acromioclavicular LigamentsAcromioclavicular Ligaments
The AC ligaments surround and support The AC ligaments surround and support
the AC joint. the AC joint.
Together, they form the joint capsule. Together, they form the joint capsule.
The joint capsule is a watertight sac that The joint capsule is a watertight sac that
encloses the joint and the fluids that bathe encloses the joint and the fluids that bathe
the joint.the joint.
Coracoclavicular LigamentsCoracoclavicular Ligaments
The coracoclavicular ligaments, hold the The coracoclavicular ligaments, hold the
clavicle down by attaching it to a bony clavicle down by attaching it to a bony
knob on the scapula called the coracoid knob on the scapula called the coracoid
process.process.
Clinical ConditionClinical Condition
Clavicle fractureClavicle fracture
Frozen shoulderFrozen shoulder
AC joint injuryAC joint injury
Shoulder dislocationShoulder dislocation
Clavicle FractureClavicle Fracture This bone is usually fracture as This bone is usually fracture as
a result of falling badly onto an a result of falling badly onto an
outstretched arm or onto the outstretched arm or onto the
shoulder.shoulder.
The bone usually fractures in The bone usually fractures in
it's middle third and is very it's middle third and is very
painful.painful.
Athletes (physical impact), Athletes (physical impact),
newborn, babynewborn, baby
Frozen Shoulder Frozen Shoulder (Adhesive Capsulitis)(Adhesive Capsulitis)
This is a condition which This is a condition which affects the ability to move the affects the ability to move the shoulder, and usually only shoulder, and usually only occurs on one side. occurs on one side.
Sticky and inflammation of the Sticky and inflammation of the shoulder joint.shoulder joint.
Inflammation of the joint Inflammation of the joint capsule – restricting capsule – restricting movement of the head of movement of the head of
humerushumerus..
AC Joint InjuryAC Joint Injury Separation of the two Separation of the two
bones forming this joint bones forming this joint
is caused by damage to is caused by damage to
the ligaments the ligaments
connecting them. connecting them. The most common way The most common way
of injuring the AC joint of injuring the AC joint
is by landing on the is by landing on the
shoulder, elbow, or onto shoulder, elbow, or onto
an outstretched hand. an outstretched hand.
Shoulder DislocationShoulder Dislocation In most cases, the head of the In most cases, the head of the
humerus is forced forwards humerus is forced forwards
when the arm is turned when the arm is turned
outwards (externally rotated) outwards (externally rotated)
and held out to the side and held out to the side
(abducted).(abducted).
This causes an anterior This causes an anterior
dislocation, which make up dislocation, which make up
approximately 95% of all approximately 95% of all
shoulder dislocations. shoulder dislocations.
Shoulder DislocationShoulder Dislocation