anatomy of the shoulderrlhots.com/.../2015/09/anatomy-of-the-shoulder-edit.pdfintroduction -...
TRANSCRIPT
![Page 1: Anatomy of the Shoulderrlhots.com/.../2015/09/Anatomy-of-the-shoulder-edit.pdfIntroduction - Glenohumeral joint is a synovial ball and socket joint - Ball is mean 43mm in diameter](https://reader036.vdocuments.us/reader036/viewer/2022070906/5f7aa8b65919af2eea1187b4/html5/thumbnails/1.jpg)
Anatomy of the Shoulder
- Mustafa Rashid
- ST3 Trauma & Orthopaedics
- Percivall Pott Rotation
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Me and a Cowboy…
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Aims
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
- Brief introduction
- Bony anatomy
- Static stabilisers of the GH joint
- Dynamic stabilisers of the GH joint
- Arthroscopic anatomy of the GH joint
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Introduction
- Glenohumeral joint is a synovial ball and socket joint
- Ball is mean 43mm in diameter and the glenoid is 1/3 the size
of humeral head
- Glenoid is highly congruent (1% deviation) to the humeral
head
- Commonest joint to experience instability
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Bony Anatomy
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Bony Anatomy
Glenoid fossa:
- 9mm in sup-inf plane
- 2.5mm in AP plane (5mm with labrum)
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Neurovascular Structures
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
- Axillary nerve - Musculocutaneous nerve
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Neurovascular Structures
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
- Brachial Plexus
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Neurovascular Structures
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Muscles (I)
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Muscles (II)
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Cuff Tendon
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Cuff Tendon
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Static Stabilisers- Articular version
- Labrum
- Articular conformity
- Negative intra-articular pressure
- Capsule ligaments
- Rotator cuff
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Static Stabilisers
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Static Stabilisers
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
![Page 17: Anatomy of the Shoulderrlhots.com/.../2015/09/Anatomy-of-the-shoulder-edit.pdfIntroduction - Glenohumeral joint is a synovial ball and socket joint - Ball is mean 43mm in diameter](https://reader036.vdocuments.us/reader036/viewer/2022070906/5f7aa8b65919af2eea1187b4/html5/thumbnails/17.jpg)
Static Stabilisers
- Coracohumeral ligament
- From coracoid to both tuberosities
- Most consistently present condensation
- SGHL
- Present in 90%; substantial in 50%
- Just anterior to LHB proximal lesser tuberosity
- Important inferior stabiliser (most in ER)
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Static Stabilisers
- MGHL
- Absent in 30%
- Inferior to SGHL
- Blends with SSc 2cm medial to insertion to LT
- Max tension in ER and lower angles of abduction (anterior stabiliser)
- Secondary restraint to inferior translation
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Static Stabilisers
- IGHL
- “Hammock”
- Critical role in inferior and anterior stability
- Anterior labrum (anterior to posterior) to articular margin of humeral head
- Anterior band tight in abduction and external rotation
- Posterior band tight in flexion and internal rotation
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
![Page 20: Anatomy of the Shoulderrlhots.com/.../2015/09/Anatomy-of-the-shoulder-edit.pdfIntroduction - Glenohumeral joint is a synovial ball and socket joint - Ball is mean 43mm in diameter](https://reader036.vdocuments.us/reader036/viewer/2022070906/5f7aa8b65919af2eea1187b4/html5/thumbnails/20.jpg)
Dynamic Stabilisers
- Concavity compression
- Direct capsular tension
- Proprioception
- Scapular stabilisers
- Dynamic muscle action
- Biceps*
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Arthroscopic Anatomy
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Arthroscopic Anatomy
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
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Arthroscopic Anatomy
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
- Viewing from posterior portal…
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Arthroscopic Anatomy
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
- Viewing from anterior portal…
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Aims
Aims Introduction Bony Anatomy Static Stabilisers Dynamic Stabilisers Arthroscopic Anatomy
- Brief introduction
- Bony anatomy
- Static stabilisers of the GH joint
- Dynamic stabilisers of the GH joint
- Arthroscopic anatomy of the GH joint
![Page 26: Anatomy of the Shoulderrlhots.com/.../2015/09/Anatomy-of-the-shoulder-edit.pdfIntroduction - Glenohumeral joint is a synovial ball and socket joint - Ball is mean 43mm in diameter](https://reader036.vdocuments.us/reader036/viewer/2022070906/5f7aa8b65919af2eea1187b4/html5/thumbnails/26.jpg)
Thank you.