Вы находитесь на странице: 1из 29

THE SHOULDER GIRDLE

Danielle G. Devilleres, PTRP

Major components
Bony segments
Clavicle
Scapula
Humerus

The articular segments of the


shoulder complex are designed
primarily for mobility
Stability is provided by the muscles
and therefore called, dynamic
stability

THE JOINTS
Sternoclavicular joint
Only structural attachment of the
shoulder complex and upper
extremity to the axial skeleton
Plane synovial joint
Synovial joint capsule
Presence of a joint disc
3 rotatory and translatory degrees of
freedom
3 major ligaments

THE JOINTS
Sternoclavicular joint
ARTICULAR SURFACES
Consist of 2 shallow saddle-shaped
surfaces
(1) medial end of the clavicle
(2) notch formed by the manubrium of
sternum and 1st costal cartilage

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-2A

THE JOINTS
Sternoclavicular joint
ARTICULAR SURFACES
Both surfaces are incongruent
Superior portion of medial clavicle does not
contact the manubrium at all but serves as
attachement for sternoclavicular disc and
interclavicular ligament

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-2A

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR DISC
Fibrocartilage disc or meniscus
Increases the congruency between the
articulating surfaces
Upper portion is attached to
posterosuperior clavicle
Lower portion is attached to manubrium
and 1st costal cartilage as well as to the
anterior and posterior aspect of fibrous
SC capsule

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-3

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR DISC
Transects the SC joint space diagonally
dividing the joint into 2 separate cavities
Acts like a hinge of pivot joint for the
medial end of clavicle during shoulder
motion
Provides stability = increasing jt.
Congruence and by absorbing forces
transmitted along the clavicle

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-3

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR DISC
During elevation and depression of
clavicle
Medial end of clavicle rolls and glides on the
SC disc
Upper attachment of disc serves as the pivot
point

During protraction and retraction of


clavicle
SC disc and medial end of clavicle roll and
slide together on the manubrial facet

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR DISC
Therefore, the SC disc is considered part
of the manubrium during elevation and
depression
SC disc is considered part of the clavicle
during protraction and retraction

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR JOINT CAPSULE
AND LIGAMENTS
Fairly strong fibrous capsule
Posterior capsule provides the primary
restraint to both anterior and posterior
translations of the medial clavicle on the
sternum

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR JOINT CAPSULE
AND LIGAMENTS
But majorly depends on 3 ligament
complexes for support
Anterior and posterior SC ligaments
Reinforce the capsule
Check anterior and posterior translatory
movement of the medial end of clavicle

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-4

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR JOINT CAPSULE
AND LIGAMENTS
But majorly depends on 3 ligament
complexes for support
Costoclavicular ligament
Very strong ligament between clavicle and the
first rib
Has 2 segments or laminae
Anterior lamina fibers directed laterally from
the 1st rib to the clavicle
Posterior lamina fibers directed medially
from the 1st rib to the clavicle

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-4

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR JOINT CAPSULE
AND LIGAMENTS
But majorly depends on 3 ligament
complexes for support
Costoclavicular ligament
Both laminae limit elevation of the lateral end of
the clavicle and, when taut, may contribute to the
inferior gliding of the medial clavicle during
elevation
Also limits the superiorly directed forces applied
to the clavicle by the SCM and sternohyoid
muscles

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR JOINT CAPSULE
AND LIGAMENTS
But majorly depends on 3 ligament
complexes for support
Costoclavicular ligament
Posterior lamina resist medial movement of the
clavicle, absorbing some of the force that would
be imposed on the SC disc

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-4

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-5

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR JOINT CAPSULE
AND LIGAMENTS
But majorly depends on 3 ligament
complexes for support
Interclavicular ligament
Limits excessive depression of the distal clavicle
and superior gliding of medial clavicle on the
manubrium
Limitation of clavicular depression is critical to
protect the brachial plexus and subclavian artery,
which pass under the clavicle and over the 1st rib

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-4

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-2A

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR MOTIONS
3 rotatory degrees of freedom
Elevation/depression
Protraction/retraction
Anterior/posterior rotation

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR MOTIONS
Elevation/depression
AP axis
Elevation = lateral end of clavicle rotates
upward
Depression = lateral end of clavicle rotates
downward
Convex surface of clavicle must slide
inferiorly on the concave manubrium and 1st
costal cartilage during elevation
Available range of SC elevation = 48
degrees

THE JOINTS
Sternoclavicular joint
* insert picture here
Fig 7-5

THE JOINTS
Sternoclavicular joint
STERNOCLAVICULAR MOTIONS
Protraction/retraction
Vertical axis
Protraction = lateral clavicle moves
anteriorly
Retraction = lateral clavicle moves
posteriorly
Concave surface of clavicle

Вам также может понравиться