1. Dr. Sama ul Haque Dr. Sama ul Haque Dr. Rania Jabr Dr. Rania Jabr

2. Objectives  Understand the formation of the shoulder joint and its type.  Explain the structures related to the shoulder joint.  Name the movements taking place on shoulder joint.  Define shoulder joint dislocation and subluxation.

3. Shoulder joint Articulation : head of the humerus glenoid cavity of the scapula. Type: Type: Synovial ball and socket

4. Capsule and ligaments of the Shoulder Joint Ligaments 1.Glenohumeral Ligament 2.Transverse humeral Ligament 3.Coracohumeral Ligament 4.Coracoacromial Ligament

8. Capsule Surrounds joint and attached -Medially to the scapula beyond the supraglenoid tubercle and the margins of the labrum. -Laterally to the anatomical neck of humerus. Thin and lax, allow wide range of movement. Strengthened by slips of tendons of subscapularis m., supraspinatus m., infraspinatus m. & teres minor (rotator cuff muscles).

9. Subdeltoid / Subacromial bursa. Bursa : a closed sac or envelope, lined with synovium and containing fluid, usually in areas subject to friction.

10. BURSAE IN RELATION TO SHOULDER JOINT reduce friction  They reduce friction between tendons, joint capsule & bone. inflammed  They are liable to be inflammed following injury of rotator cuff muscles. 1.Subscapularis bursa: 1.Subscapularis bursa: between subscapularis tendon & capsule. 2.Infraspinatus bursa: 2.Infraspinatus bursa: between infraspinatus tendon & capsule. 3.Subacromial bursa: 3.Subacromial bursa: between deltoid, supraspinatus and capsule. 3 1 2

11. Capsule and ligaments of the Shoulder Joint

12. NOT STABLE DUE TO: 1.Head of humerus is 3 times larger than glenoid cavity 2.Capsule is redundant. 3.Little ligamentous support. 4.Wide range of movement (it is the most mobile joint of the human body) 5.Main support: muscles around the joint (ROTATOR CUFF) Stability

13. Movement of the Shoulder Joint

14.  Dislocation: 1.commonly dislocated due to it’s freedom of movement and instability. 2.Most common site of dislocation is inferior. 3.Cause: fall on shoulder-excessive extension and lateral rotation of shoulder.  Subluxation: A lesser degree of displacement.  Fracture: Fracture is a break in the structural continuity of bone. Clinical anatomy of the Shoulder Joint

15. A.Subluxation B.Partial dislocation C.Complete dislocation Subluxation (A) Partial dislocation (B) Complete dislocation ©

16. Dislocation of shoulder joint