Sternoclavicular joint

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Sternoclavicular joint
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Sternoclavicular joint. Anterior view.
Pectoral girdles-en.svg
Sternoclavicular joint visible near center but not labeled.
Details
Identifiers
Latin articulatio sternoclavicularis
MeSH D013247
TA98 A03.5.04.001
TA2 1750
FMA 25883
Anatomical terminology

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. [1]

Contents

Structure

The joint is structurally classified as a synovial saddle joint and functionally classed as a diarthrosis and multiaxial joint. It is composed of two portions separated by an articular disc of fibrocartilage. [1]

The joint is formed by the sternal end of the clavicle, the clavicular notch of the sternum, and (the superior surface of) the costal cartilage of the first rib. [1] The articular surface of the clavicle is larger than that of the sternum, and is invested with a layer of cartilage, which is considerably thicker than that of the sternum. [1]

The joint receives arterial supply via branches of the internal thoracic artery and the suprascapular artery. It is innervated via the medial supraclavicular nerve (superficially), and the nerve to subclavius (deeply). [1]

Joint capsule

The joint capsule is thickened anteriorly and posteriorly, but is thinner superiorly and (especially) inferiorly, where it consists mostly of loose areolar connective tissue. [1]

Articular disc

The joint features a fibrocartilaginous articular disc which completely divides the joint to form two articular compartments. [1] the disc acts to increase the range of movement of the joint. [2]

Ligaments

The joint is reinforced by two intrinsic and two extrinsic ligaments. [1] The costoclavicular ligament is the main limitation to movement, and therefore the main stabilizer of the joint.[ citation needed ]

Function

The sternoclavicular joint allows movement of the clavicle in three planes, predominantly in the anteroposterior and vertical planes, although some rotation also occurs. A description of movement would be elevation and depression. Muscles do not directly act on this joint, although almost all actions of the shoulder girdle or the scapula will cause some motion at this articulation.[ citation needed ]

The unique double-hinged articular disk found at the junction of the clavicular head and manubrium allows for movement between the clavicle and the disk during elevation and depression of the scapula. This disk also allows motion between the sternum (manubrium) and itself during protraction and retraction of the scapula. [3]

Clinical significance

Dislocation

Sternoclavicular dislocation is rare, [2] but may result from direct trauma to the clavicle or indirect forces applied to the shoulder. [4] Posterior dislocations deserve special attention, as they have the potential to be life-threatening because of the risk of damage to vital structures in the mediastinum; [5] surgery can be used to fix such dislocations, as they are unlikely to heal by themselves. [6] A spontaneous partial dislocation may also sometimes occur.[ citation needed ]

Other

In SAPHO syndrome there may be arthropathy of the sternoclavicular joint.[ citation needed ]

Septic arthritis may rarely affect the sternoclavicular joint.[ citation needed ]

See also

Related Research Articles

<span class="mw-page-title-main">Rib cage</span> Bone structure that protects the vital organs and major blood vessels

The rib cage is an endoskeletal enclosure in the thorax of most vertebrate animals that comprises the ribs, vertebral column and sternum, which protects vital organs such as the heart, lungs and great vessels. The circumferential enclosure formed by left and right rib cages, together known as the thoracic cage, is a semi-rigid bony and cartilaginous structure which surrounds the thoracic cavity and supports the shoulder girdles to form the core part of the axial skeleton.

<span class="mw-page-title-main">Clavicle</span> Long bone that serves as a strut between the scapula and the sternum

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.

<span class="mw-page-title-main">Temporomandibular joint</span> Joints connecting the jawbone to the skull

In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the mandible below; it is from these bones that its name is derived. This joint is unique in that it is a bilateral joint that functions as one unit. Since the TMJ is connected to the mandible, the right and left joints must function together and therefore are not independent of each other.

<span class="mw-page-title-main">Joint</span> Location at which two or more bones make contact

A joint or articulation is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole. They are constructed to allow for different degrees and types of movement. Some joints, such as the knee, elbow, and shoulder, are self-lubricating, almost frictionless, and are able to withstand compression and maintain heavy loads while still executing smooth and precise movements. Other joints such as sutures between the bones of the skull permit very little movement in order to protect the brain and the sense organs. The connection between a tooth and the jawbone is also called a joint, and is described as a fibrous joint known as a gomphosis. Joints are classified both structurally and functionally.

<span class="mw-page-title-main">Shoulder problem</span> Medical condition

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.

<span class="mw-page-title-main">Shoulder</span> Part of the body

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.

<span class="mw-page-title-main">Upper limb</span> Consists of the arm, forearm, and hand

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 arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.

<span class="mw-page-title-main">Acromioclavicular joint</span> Shoulder junction between the scapula and the clavicle

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.

<span class="mw-page-title-main">Shoulder joint</span> Synovial ball and socket joint in the shoulder

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.

<span class="mw-page-title-main">Sternohyoid muscle</span>

The sternohyoid muscle is a bilaterally paired, long, thin, narrow strap muscle of the anterior neck. It is one of the infrahyoid muscles. It is innervated by the ansa cervicalis. It acts to depress the hyoid bone.

<span class="mw-page-title-main">Subclavius muscle</span> Muscle between the clavicle and first rib

The subclavius is a small triangular muscle, placed between the clavicle and the first rib. Along with the pectoralis major and pectoralis minor muscles, the subclavius muscle makes up the anterior axioappendicular muscles, also known as anterior wall of the axilla.

<span class="mw-page-title-main">Shoulder girdle</span> Set of bones which connects the arm to the axial skeleton on each side

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 have only the scapula.

<span class="mw-page-title-main">Posterior sternoclavicular ligament</span> Ligament connecting the breastbone and the collarbone

The posterior sternoclavicular ligament is a band of fibers, covering the posterior surface of the sternoclavicular joint. It is attached above to the upper and back part of the sternal end of the clavicle, and, passing obliquely downward and medialward, is fixed below to the back of the upper part of the manubrium sterni.

<span class="mw-page-title-main">Articular disc</span> Anatomical feature in joint cavities

The articular disc is a thin, oval plate of fibrocartilage present in several joints which separates synovial cavities. This separation of the cavity space allows for separate movements to occur in each space.

<span class="mw-page-title-main">Anterior sternoclavicular ligament</span> Ligament between the sternum and clavicle

The anterior sternoclavicular ligament is a broad band of fibers attached to the clavicle above, and to the manubrium below. The ligament overlies the anterior (front) surface of sternoclavicular joint.

<span class="mw-page-title-main">Costoclavicular ligament</span> Ligament of the shoulder girdle

The costoclavicular ligament, also known as the rhomboid ligament or Halsted's ligament, is a ligament of the shoulder girdle. It is short, flat, and rhomboid in form. It is the major stabilizing factor of the sternoclavicular joint and is the axis of movement of the joint, especially during elevation of the clavicle.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Articular disc of sternoclavicular joint</span>

The articular disc of the sternoclavicular joint is flat and nearly circular, interposed between the articulating surfaces of the sternum and clavicle.

<span class="mw-page-title-main">Sternum</span> Flat bone in the middle front part of the rib cage

The sternum or breastbone is a long flat bone located in the central part of the chest. It connects to the ribs via cartilage and forms the front of the rib cage, thus helping to protect the heart, lungs, and major blood vessels from injury. Shaped roughly like a necktie, it is one of the largest and longest flat bones of the body. Its three regions are the manubrium, the body, and the xiphoid process. The word sternum originates from Ancient Greek στέρνον (stérnon) 'chest'.

<span class="mw-page-title-main">Clavicular facet of scapula</span>

Clavicular facet of scapula is small oval facet on the medial border of the acromion for articulation with the acromial facet on the lateral end of the clavicle. Also called Clavicular articular facet of acromion.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 Gray's anatomy : the anatomical basis of clinical practice. Susan Standring (Forty-second ed.). [New York]. 2021. ISBN   978-0-7020-7707-4. OCLC   1201341621.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: others (link)
  2. 1 2 Cadogan, Mike (February 2010). "Sternoclavicular Joint Dislocations". Life in the Fast Lane. Retrieved June 5, 2011.
  3. Lippert, Lynn. Clinical Kinesiology and Anatomy, 4th edition; pg.95-96.
  4. Arend CF. Ultrasound of the Shoulder. Master Medical Books, 2013. Free section on sternoclavicular joint dislocation available at ShoulderUS.com
  5. Jougon, Jacques B.; Lepront, Denis J.; Dromer, Claire E.H. (1996). "Posterior dislocation of the sternoclavicular joint leading to mediastinal compression". The Annals of Thoracic Surgery. 61 (2): 711–3. doi:10.1016/0003-4975(95)00745-8. PMID   8572795.
  6. Terra, Bernardo Barcellos; Rodrigues, Leandro Marano; Pádua, David Victoria Hoffmann; Martins, Marcelo Giovanini; Teixeira, João Carlos de Medeiros; De Nadai, Anderson (2015-07-01). "Sternoclavicular dislocation: case report and surgical technique". Revista Brasileira de Ortopedia (English Edition). 50 (4): 472–477. doi:10.1016/j.rboe.2015.06.019. ISSN   2255-4971. PMC   4563050 . PMID   26401506.

PD-icon.svgThis article incorporates text in the public domain from page 313 of the 20th edition of Gray's Anatomy (1918)