Shoulder girdle | |
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Details | |
Identifiers | |
Latin | cingulum pectorale |
TA98 | A01.1.00.020 |
TA2 | 361 |
FMA | 23217 |
Anatomical terms of bone |
The shoulder girdle or pectoral girdle is the set of bones in the appendicular skeleton which connects to the arm on each side. In humans, it consists of the clavicle and scapula; in those species with three bones in the shoulder, it consists of the clavicle, scapula, and coracoid. Some mammalian species (such as the dog and the horse) have only the scapula.
The pectoral girdles are to the upper limbs as the pelvic girdle is to the lower limbs; the girdles are the part of the appendicular skeleton that anchor the appendages to the axial skeleton.
In humans, the only true anatomical joints between the shoulder girdle and the axial skeleton are the sternoclavicular joints on each side. No anatomical joint exists between each scapula and the rib cage; instead the muscular connection or physiological joint between the two permits great mobility of the shoulder girdle compared to the compact pelvic girdle; because the upper limb is not usually involved in weight bearing, its stability has been sacrificed in exchange for greater mobility. In those species having only the scapula, no joint exists between the forelimb and the thorax, the only attachment being muscular.
The shoulder girdle is the anatomical mechanism that allows for all upper arm and shoulder movement in humans. [1]
The shoulder girdle consists of five muscles that attach to the clavicle and scapula and allow for the motion of the sternoclavicular joint (connection between sternum and clavicle) and acromioclavicular joint (connection between clavicle and scapula). [2] The five muscles that comprise the function of the shoulder girdle are the trapezius muscle (upper, middle, and lower), levator scapulae muscle, rhomboid muscles (major and minor), serratus anterior muscle, and pectoralis minor muscle. [3]
The shoulder girdle is a complex of 5 joints that can be divided into two groups. 3 of these joints are true anatomical joints, while 2 are physiological ("false") joints. [explain 1] Within each group, the joints are mechanically linked so that both groups simultaneously contribute to the different movements of the shoulder to variable degrees. [4] : 20
In the first group, the scapulohumeral or glenohumeral joint is the anatomical joint mechanically linked to the physiological subdeltoid or suprahumeral joint (the "second shoulder joint") so that movements in the suprahumeral joint results in movements in the glenohumeral joint.
In the second group, the scapulocostal or scapulothoracic joint is the important physiological joint that can not function without the two anatomical joints in the group, the acromioclavicular and sternoclavicular joints, i.e. they join both ends of the clavicle. [4] : 20
The glenohumeral joint is the articulation between the head of the humerus and the glenoid cavity of the scapula. It is a ball and socket type of synovial joint with three rotatory and three translatory degrees of freedom. The glenohumeral joint allows for adduction, abduction, medial and lateral rotation, flexion and extension of the arm.
The acromioclavicular joint is the articulation between the acromion process of the scapula and the lateral end of the clavicle. It is a plane type of synovial joint. The acromion of the scapula rotates on the acromial end of the clavicle.
The sternoclavicular joint is the articulation of the manubrium of the sternum and the first costal cartilage with the medial end of the clavicle. It is a saddle type of synovial joint but functions as a plane joint. The sternoclavicular joint accommodates a wide range of scapula movements and can be raised to a 60° angle.
The scapulocostal joint (also known as the scapulothoracic joint) is a physiological joint formed by an articulation of the anterior scapula and the posterior thoracic rib cage. It is musculotendinous in nature and is formed predominantly by the trapezius, rhomboids and serratus anterior muscles. The pectoralis minor also plays a role in its movements. The gliding movements at the scapulocostal joint are elevation, depression, retraction, protraction and superior and inferior rotation of the scapula. Disorders of the scapulocostal joint are not very common and usually restricted to snapping scapula. [5]
The suprahumeral joint (also known as the subacromial joint) is a physiological joint formed by an articulation of the coracoacromial ligament and the head of the humerus. It is formed by the gap between the humerus and the acromion process of the scapula. This space is filled mostly by the subacromial bursa and the tendon of supraspinatus. This joint plays a role during complex movements while the arm is fully flexed at the glenohumeral joint, such as changing a lightbulb, or painting a ceiling.
From its neutral position, the shoulder girdle can be rotated about an imaginary vertical axis at the medial end of the clavicle (the sternoclavicular joint). Throughout this movement the scapula is rotated around the chest wall so that it moves 15 centimetres (5.9 in) laterally and the glenoid cavity is rotated 40–45° in the horizontal plane.
When the scapula is moved medially it lies in a frontal plane with the glenoid cavity facing directly laterally. At this position, the lateral end of the clavicle is rotated posteriorly so that the angle at the acromioclavicular joint opens up slightly. When the scapula is moved laterally it lies in a sagittal plane with the glenoid cavity facing anteriorly. At this position, the lateral end of the clavicle is rotated anteriorly so that the clavicle lies in a frontal plane. While this slightly closes the angle between the clavicle and the scapula, it also widens the shoulder. [4] : 40
The scapula can be elevated and depressed from the neutral position to a total range of 10 to 12 centimetres (3.9 to 4.7 in); at its most elevated position the scapula is always tilted so that the glenoid cavity is facing superiorly. During this tilting, the scapula rotates to a maximum angle of 60° about an axis passing perpendicularly through the bone slightly below the spine; this causes the inferior angle to move 10 to 12 centimetres (3.9 to 4.7 in) and the lateral angle 5 to 6 centimetres (2.0 to 2.4 in). [4] : 40
Shoulders are a common place for tissue injuries, especially if the person plays overhead sports such as tennis, volleyball, baseball, swimming, etc. According to Bahr's major injury related statistics, shoulder dislocations or subluxations account for 4% of injuries in adults ages 20–30 and 20% of shoulder injuries are fractures. [6] Damage to the shoulder and adjacent features can fluctuate in severity depending on the person's age, sport, position, recurring shoulder dysfunction, and many other factors. Some other common shoulder injuries are fractures to any shoulder girdle bones i.e. clavicle, ligamentous sprains such as AC joint or GH ligaments, rotator cuff injuries, different labral tears, and other acute or chronic conditions related to shoulder anatomy.
Shoulder girdle pain can be acute or chronic and be due to a number of causes. Inflammation or injury of associated tendons, bone, muscles, nerves, ligaments, and cartilage can all cause pain. Also, past injury compensation, and stress can result in complicated shoulder pain. [7]
In humans, winged scapula is a condition in which the shoulder blade protrudes from a person's back in an abnormal position.
The pectoral girdle demonstrates an enormous variation in amniotes (vertebrates adapted to a full terrestrial life), both among extant species and along evolutionary lines, and determining homologies for individual pectoral elements is difficult. Except for the sternum, these elements (along with the pelvic girdle) were, however, present in early bony fishes before there were even limbs, arising from their ancestral external armor plates. In digitless choanates, the cleithrum, clavicle, and interclavicle are dermal and linked to the caudal part of the head while the humerus articulates with a small scapulocoracoid bone. As the first digits appeared, the pectoral structure lost its direct connection to the head skeleton while the scapulocoracoid grew more prominent and started to face laterally. In true tetrapods, the dermal part of the girdle was gradually reduced and the scapulocoracoid split into a dorsal scapula and a ventral coracoid. [8] As for the sternum, it also came from the fusion of the inner ends of the pectoral girdles in tetrapods, subsequently growing between the ribs.
In dinosaurs, the main bones of the pectoral girdle were the scapula (shoulder blade) and the coracoid, both of which directly articulated with the clavicle. The clavicle was present in saurischian dinosaurs but largely absent in ornithischian dinosaurs. The place on the scapula where it articulated with the humerus (upper bone of the forelimb) is the called the glenoid. The scapula served as the attachment site for a dinosaur's back and forelimb muscles.
Chimpanzees are far better at brachiation than humans. Their clavicles possess a cranially oriented twist on the acromial end, conducive to better force transfer through it - a very important function in arboreal locomotion. Chimpanzee scapulas also possess a considerably larger supraspinous fossa, allowing for a larger supraspinatus muscle. Through the process of evolution, humans have lost the atlantoclavicularis muscle, originating on the atlas of the vertebral column, and inserting onto the acromial clavicle. This muscle acts to elevate the clavicle. [9]
A specimen of the placoderm Kolymaspis demonstrates that the shoulder girdle evolved from gill arches present in ancient vertebrates. [10]
The clavicle, collarbone, or keybone is a slender, S-shaped long bone approximately 6 inches (15 cm) long that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on the left and one on the right. The clavicle is the only long bone in the body that lies horizontally. Together with the shoulder blade, it makes up the shoulder girdle. It is a palpable bone and, in people who have less fat in this region, the location of the bone is clearly visible. It receives its name from Latin clavicula 'little key' because the bone rotates along its axis like a key when the shoulder is abducted. The clavicle is the most commonly fractured bone. It can easily be fractured by impacts to the shoulder from the force of falling on outstretched arms or by a direct hit.
In human anatomy, the acromion is a bony process on the scapula. Together with the coracoid process, it extends laterally over the shoulder joint. The acromion is a continuation of the scapular spine, and hooks over anteriorly. It articulates with the clavicle to form the acromioclavicular joint.
The scapula, also known as the shoulder blade, is the bone that connects the humerus with the clavicle. Like their connected bones, the scapulae are paired, with each scapula on either side of the body being roughly a mirror image of the other. The name derives from the Classical Latin word for trowel or small shovel, which it was thought to resemble.
The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.
Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.
The human shoulder is made up of three bones: the clavicle (collarbone), the scapula, and the humerus as well as associated muscles, ligaments and tendons.
The deltoid muscle is the muscle forming the rounded contour of the human shoulder. It is also known as the 'common shoulder muscle', particularly in other animals such as the domestic cat. Anatomically, the deltoid muscle is made up of three distinct sets of muscle fibers, namely the
The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the shoulder, arm, elbow, forearm, wrist and hand, and is primarily used for climbing, lifting and manipulating objects. In anatomy, just as arm refers to the upper arm, leg refers to the lower leg.
The acromioclavicular joint, or AC joint, is a joint at the top of the shoulder. It is the junction between the acromion and the clavicle. It is a plane synovial joint.
In human anatomy, the infraspinatus muscle is a thick triangular muscle, which occupies the chief part of the infraspinatous fossa. As one of the four muscles of the rotator cuff, the main function of the infraspinatus is to externally rotate the humerus and stabilize the shoulder joint.
The shoulder joint is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial joint. It involves an articulation between the glenoid fossa of the scapula and the head of the humerus. Due to the very loose joint capsule ,that gives a limited interface of the humerus and scapula, it is the most mobile joint of the human body.
The sternoclavicular joint or sternoclavicular articulation is a synovial saddle joint between the manubrium of the sternum, and the clavicle, and the first costal cartilage. The joint possesses a joint capsule, and an articular disc, and is reinforced by multiple ligaments.
The glenoid fossa of the scapula or the glenoid cavity is a bone part of the shoulder. The word glenoid is pronounced or and is from Greek: gléne, "socket", reflecting the shoulder joint's ball-and-socket form. It is a shallow, pyriform articular surface, which is located on the lateral angle of the scapula. It is directed laterally and forward and articulates with the head of the humerus; it is broader below than above and its vertical diameter is the longest.
The coracoacromial ligament is a strong triangular ligament between the coracoid process and the acromion. It protects the head of the humerus. Its acromial attachment may be repositioned to the clavicle during reconstructive surgery of the acromioclavicular joint.
In human anatomy, the glenohumeral ligaments (GHL) are three ligaments on the anterior side of the glenohumeral joint. Reinforcing the anterior glenohumeral joint capsule, the superior, middle, and inferior glenohumeral ligaments play different roles in the stability of the head of the humerus depending on arm position and degree of rotation.
A separated shoulder, also known as acromioclavicular joint injury, is a common injury to the acromioclavicular joint. The AC joint is located at the outer end of the clavicle where it attaches to the acromion of the scapula. Symptoms include non-radiating pain which may make it difficult to move the shoulder. The presence of swelling or bruising and a deformity in the shoulder is also common depending on how severe the dislocation is.
Shoulder surgery is a means of treating injured shoulders. Many surgeries have been developed to repair the muscles, connective tissue, or damaged joints that can arise from traumatic or overuse injuries to the shoulder.
The axillary joints are two joints in the axillary region of the body, and include the shoulder joint and the acromioclavicular joint.
The scapulocoracoid is the unit of the pectoral girdle that contains the coracoid and scapula. The coracoid itself is a beak-shaped bone that is commonly found in most vertebrates with a few exceptions. The scapula is commonly known as the shoulder blade. The humerus is linked to the body via the scapula, and the clavicle is connected to the sternum via the scapula as well.
Shoulder impingement syndrome is a syndrome involving tendonitis of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion. It is particularly associated with tendonitis of the supraspinatus muscle. This can result in pain, weakness, and loss of movement at the shoulder.