1. Examination Of Shoulder Joint (Range Of Movements)

2. There are three types of joints in the shoulder complex.
Sterno clavicular articulation
Acromioclavicular Articulation
Humeral Articulation

3. Sterno-clavicular articulation
Articulatio Sternoclavicularis

4. Double arthrodial joint
The parts entering into its formation are
sternal end of clavicle
upper and lateral part of the manubrium sterni
cartilage of first rib

5. Ligaments The Interclavicular The Anterior Sternoclavicular
The Articular Capsule
The Costoclavicular
The Posterior Sternoclavicular
The Articular Disk

6. Articular Capsule (capsula articularis)
Surrounds the
Thick in front and behind
Forms the anterior and posterior sternoclavicular ligaments
Thin above and below, (more of the character of areolar than of true fibrous tissue)

7. Anterior Sternoclavicular Ligament (ligamentum sternoclaviculare anterior)
Attached to
antero-superior part of the sternal end of clavicle
antero-superior part of manubrium sterni

8. Posterior Sternoclavicular Ligament (ligamentum sternoclaviculare posterius)
Attached to
postero-superior part of the sternal end of clavicle
postero-superior part of the manubrium sterni

9. The Interclavicular Ligament (ligamentum interclaviculare)
Passes in a curved direction from the superior part of the sternal end of one clavicle to that of the other
Also attached to the upper margin of the sternum

10. Costoclavicular Ligament (ligamentum costoclaviculare)
Rhomboid in form
Attached to
superio-medial part of cartilage of first rib
costal tuberosity on under surface of the clavicle

11. Articular Disk (discus articularis)
Flat and nearly circular
Attached to
postero-superior border of articular surface of clavicle
cartilage of the first rib, near junction with the sternum
interclavicular and anterior & posterior sternoclavicular ligaments
It divides the joint into two cavities, each of which is furnished with a synovial membrane

12. Synovial Membranes
Lateral is reflected from the sternal end of the clavicle, over the adjacent surface of the articular disk, and around the margin of the facet on the cartilage of the first rib
Medial is attached to the margin of the articular surface of the sternum and clothes the adjacent surface of the articular disk

13. Movements
Limited amount of motion in nearly every direction—upward, downward, backward, forward, as well as circumduction
When these movements take place in the joint, the clavicle in its motion carries the scapula with it, this bone gliding on the outer surface of the chest
Forms the center from which all movements of the supporting arch of the shoulder originate
Only point of articulation of the shoulder girdle with the trunk

14. Acromioclavicular Articulation
(Articulatio Acromioclavicularis)

15. Arthrodial joint
Between the acromial end of the clavicle and the medial margin of the acromion of the scapula.

16. Ligaments The Articular Capsule The Articular Disk
The Superior Acromioclavicular
The Coracoclavicular {Trapezoid and Conoid)
The Inferior Acromioclavicular  

17. Articular Capsule (capsula articularis)
Completely surrounds the articular margins
Strengthened above and below by the superior and inferior acromioclavicular ligaments

18. Superior Acromioclavicular Ligament (ligamentum acromioclaviculare)
Extending between the upper part of the acromial end of the clavicle and the adjoining part of the upper surface of the acromion

19. Inferior Acromioclavicular Ligament
Attached to the adjoining surfaces of the two bones

20. Articular Disk (discus articularis)
Frequently absent in this articulation
When present, it generally only partially separates the articular surfaces
Occupies the upper part of the articulation

21. The Synovial Membrane
Usually only one synovial membrane in this articulation, but when a complete articular disk is present, there are two

22. Coracoclavicular Ligament (ligamentum coracoclaviculare)
Connects the clavicle with the coracoid process of the scapula

23. Trapezoid Ligament (ligamentum trapezoideum)
The anterior and lateral fasciculus
Between upper surface of coracoid process and oblique ridge on the under surface of clavicle
Anterior border is free
Posterior border is joined with the conoid ligament

24. Conoid Ligament (ligamentum conoideum)
Posterior and medial fasciculus
Attached by its apex to the base of the coracoid process, medial to the trapezoid ligament and by its expanded base, to the coracoid tuberosity on the under surface of the clavicle

25. Movements
(1) a gliding motion of the articular end of the clavicle on the acromion
(2) rotation of the scapula forward and backward upon the clavicle

26. Ligaments of the Scapula
Coracoacromial
Superior and Inferior Transverse

27. Coracoacromial Ligament (ligamentum coracoaromiale)
Attached, by its apex, to the summit of the acromion just in front of the articular surface for the clavicle and by its broad base to the whole length of the lateral border of the coracoid process
forms a vault for the protection of the head of the humerus.

28. Superior Transverse Ligament (ligamentum transversum scapulæ superius)
Converts the scapular notch into a foramen
Attached by one end to the base of the coracoid process, and by the other to the medial end of the scapular notch
Suprascapular nerve runs through the foramen; the transverse scapular vessels cross over the ligament

29. Inferior Transverse Ligament (ligamentum transversum scapulæ inferius)
Stretching from the lateral border of the spine to the margin of the glenoid cavity
Forms an arch under which the transverse scapular vessels and suprascapular nerve enter the infraspinatous fossa

30. GLENOHumeral Articulation
(Articulatio Humeri)

31. Enarthrodial or ball-and-socket joint
The joint is protected above by an arch, formed by the coracoid process, the acromion, and the coracoacromial ligament

33. Ligaments The Articular Capsule The Glenohumeral The Coracohumeral
The Transverse Humeral
The Glenoidal Labrum

34. Articular Capsule (capsula articularis)
Completely encircles the joint
Attached to the circumference of the glenoid cavity beyond the glenoidal labrum & to the anatomical neck of the humerus
Strengthened
above, by the Supraspinatus
below, by the long head of the Triceps brachii
behind, by the tendons of the Infraspinatus and Teres minor
In front, by the tendon of the Subscapularis.
Three openings in the capsule
Anteriorly, below the coracoid process
Posteriorly, between the joint and bursal sac
Between the tubercles of the humerus

36. Coracohumeral Ligament (ligamentum coracohumerale)
Arises from the lateral border of the coracoid process, and passes to the front of the greater tubercle of the humerus, blending with the tendon of the Supraspinatus
Intimately united to the capsule by its posterior and lower border
Anterior and upper border presents a free edge, which overlaps the capsule

37. Glenohumeral Ligaments
From medial edge of the glenoid cavity to the lower part of the lesser tubercle
From under edge of the glenoid cavity to the under part of the anatomical neck
From apex of the glenoid cavity to just above the lesser tubercle of the humerus

39. Transverse Humeral Ligament
From the lesser to the greater tubercle of the humerus
Converts the intertubercular groove into a canal

40. Glenoidal Labrum (labrium glenoidale)
Fibrocartilaginous rim attached around the margin of the glenoid cavity
Triangular on section
Base fixed to the circumference of the cavity
Free edge is thin and sharp
Continuous above with the tendon of the long head of the Biceps brachii

41. Synovial Membrane
Reflected from the margin of the glenoid cavity over the labrum
Reflected over the inner surface of the capsule, and covers the lower part and sides of the anatomical neck of the humerus as far as the articular cartilage on the head of the bone

42. Bursæ Between the tendon of the Subscapularis muscle and the capsule
Between the tendon of the Infraspinatus and the capsule
Between the under surface of the Deltoideus and the capsule
On the summit of the acromion
Between the coracoid process and the capsule
Beneath the Coracobrachialis
Between the Teres major and the long head of the Triceps brachii
In front of, and another behind, the tendon of the Latissimus dorsi

43. Arterial supply Nerve supply
Articular branches of the anterior and posterior humeral circumflex
Transverse scapular
Derived from the axillary and suprascapular

44. Movements
The shoulder-joint is capable of every variety of movement, flexion, extension, abduction, adduction, circumduction, and rotation

45. THANK YOU  THAKSITHAN . S of VL