SPR L2 Glenohumoral Joint and Movement

Question 1

Learning Outcomes

Answer 1

Describe the anatomy of the glenohumeral joint

Describe and demonstrate the movements of the upper limb at the glenohumeral joint and give an account of the movements produced by the rotator cuff group of muscles

Question 2

Glenohumoral Joint - what this lecture covers

Answer 2

• —Classification of the joint i.e. type of joint
• —Articular surfaces
• —Joint stability
• —Arterial supply
• —Nerve supply
• —Range of movement

Question 3

Glenohumoral Joint

What are the articular surfaces of the glenohumeral joint covered with?

Answer 3

hyaline cartilage.

Question 4

Gleno-humoral Joint X-Ray

Question 5

Glenohumoral Joint

1. What are the tendons of the rotator cuff?

Answer 5

1. Supraspinous, Subscapularis, Infraspinatus, Teres Minor

Question 6

Joint Capsule

Where is the capsule of the glenohumoral joint attached to?

Answer 6

the margin of the glenoid cavity and to the anatomical neck of the humerus

Question 7

Glenohumoral Joint - Joint Stability

Which ligaments help to provide support to the glenohumeral joint?

Which overlies the long head of the biceps brachii tendon?

Answer 7

Glenohumeral ligaments

Coracohumeral ligament

Transverse humeral ligament

Transverse Humeral Ligament

Question 8

What provides an elements of stability to the glenohumeral joint?

Answer 8

The rotator cuff group of muscles, they surround the joint (shown in the picture)

Question 9

Label the muscles in the picture

Answer 9

Supraspinatus m

Infraspinatus m.

Teres m.

Question 10

Rotator Cuff group of Muscles

Name the muscle shown in the picture

Answer 10

Subscapularis M.

Question 11

What is the arterial supply of the glenohumoral joint?

Answer 11

Suprascapular Artery

and

Anterior and Posterior Circumflex Humoral Arteries

Question 12

Glenohumoral Joint - Innervation

1. Where does the glenohumoral joint recieve articular branches from?

Answer 12

1. the axillary nerve. (arrow in picture)

Note how closely related this nerve is to the surgical neck of the humerus. Fracture(s) to the surgical neck of the humerus will place the axillary nerve at risk of damage. Such damage can result in significant motor and/or sensory deficits for the patient.

Question 13

Glenohumoral Joint - Innervation

1. Which nerve is closely related to the surgical neck of the humerus, and can be affected by it’s damage?
   
   1. What can the damage cause?

Answer 13

1. Axillary Nerve
   
   1. the damage can result in significant motor and/or sensory deficits for the patient.

Question 14

Dislocation of the Glenohumeral Joint

Describe the dislocation shown in the image

What needs to be given consideration?

Answer 14

the head of the humerus has been displaced from the glenoid cavity, infero-anteriorly.

Important to note the close proximity of the posterior cord of the brachial plexus, the axillary nerve and the radial nerve.

Question 15

Glenohumoral Joint - Range of Movements

What are the ranges of movements that take place at the glenohumoral joint?

Answer 15

• Flexion and extension
• Abduction and Adduction
• Medial Rotation and Lateral Rotation
• Circumduction

Question 16

What are the key concepts to consider when thinking about movement produced by any muscle?

Answer 16

Question 17

Rotator Cuff Muscles - Movement

1. Which is the only rotator cuff muscle that isn’t a rotator muscle of the humerus?
   
   1. What do the following rotator cuff muscles do?
      
      1. Infraspinatous
      2. Teres Minor
      3. Subscapularis

Answer 17

1. Supraspinatus
   
   1. Initiates and assists the deltoid in the first 15 degrees of abduction of the arm
2. Rotator Cuff Muscle Actions
   
   1. Laterally Rotates the Shoulder
   2. Laterally Rotates the Shoulder
   3. Rotates humerus medially, stabilises the shoulder