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Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The synovial joints of the shoulder complex are the glenohumeral and acromioclavicular joints. The scapulothoracic articulation is not a traditional joint and does not have ligaments associated with it. The glenohumeral joint is the primary joint of the shoulder, between the trunk and upper extremity. This joint is a shallow ball and socket joint which relies on its soft tissue structures for stability and support (Figure 20). The ligaments of the glenohumeral joint are thickenings of the joint capsule. They are the glenohumeral ligament and the coracohumeral ligament. The glenohumeral ligament is an anterior thickening of the joint capsule. It consists of superior, middle and inferior parts. It is not particularly strong and is vulnerable to damage during traumatic injuries, such as glenohumeral joint dislocation (see shoulder complex – joints). The coracohumeral ligament runs from the coracoid process of the scapula to the greater and lesser tubercles of the humerus. It is a superior thickening of the joint capsule. This strong ligament helps to support the weight of the upper limb which hangs from the glenoid fossa. Due to its lack of bony support and limited contribution from the glenohumeral ligament, the glenohumeral joint relies heavily on the muscles of the shoulder joint for support.
Upper Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The proximal portion of the humerus includes several gross features: head of the humerus, anatomical neck of the humerus, surgical neck of the humerus; processes for muscle attachment such as the greater tubercle of the humerus, lesser tubercle of the humerus, and deltoid tuberosity; and grooves for passage of tendons and vessels such as the humeral intertubercular sulcus (bicipital groove), and radial groove (Plate 4.7). As their names indicate, the anatomical neck is the one that can be more easily seen in gross observation of dry bones, surrounding the articular surface, while the surgical neck is the one most at risk of fracture. The articulation between the head of the humerus and the glenoid cavity of the scapula is called the glenohumeral joint or shoulder joint. The glenohumeral ligaments connecting the humerus and scapula strengthen the anterior wall of the capsule of the shoulder joint. The shoulder joint allows the humerus to be highly mobile: It can be flexed, extended, adducted, abducted, medially (internally) rotated, and externally (laterally) rotated (see Box 4.3).
Arthroscopic HAGL and RHAGL repair
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Stephen Thon, Felix H. Savoie, Michael J. O'Brien
The glenohumeral ligaments provide the attachment of the glenoid to the humerus via the glenoid labrum. The combination of the labrum and capsular ligaments acts to deepen the socket of the glenoid cavity and provide increased stability to the shoulder girdle. The IGHL complex is made of three discrete sections: the anterior band, the posterior band, and the axillary pouch.14–16 It acts as the primary restraint to anterior, posterior, and inferior glenohumeral translation when the shoulder is in 45°–90° of abduction.14,15 The combination of the three creates a suspensory complex to the inferior portion of the glenohumeral joint, providing increased shoulder stability to anterior and inferior translation. The primary action of the IGHL varies with arm position. In 90° of abduction and external rotation, the anterior band provides the primary restraint to shoulder subluxation, whereas the posterior band provides primary restraint with the arm positioned in flexion and internal rotation.11,15
Influence of glenohumeral joint muscle insertion on moment arms using a finite element model
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
M. Hoffmann, M. Begon, Y. Lafon, S. Duprey
Deformable volume models such as 3D finite element models seem to be a promising method to accurately represent muscle geometry. It allows the representation of structure interactions and complex representation of fibre trajectories (Blemker and Delp 2005). Webb et al. (2014) developed a finite element model limited to the rotator cuff muscles and deltoid which was only evaluated for simple motions, like axial rotation. Moreover, it requires a high computational time. The recent model of Zheng et al. (2019) includes the major structure of the shoulder complex: bones (clavicle, humerus and scapula); humeral and glenoid cartilage; rotator cuff muscles; ligaments (coracohumeral ligament, superior glenohumeral ligament, middle glenohumeral ligament and inferior glenohumeral ligament) but the authors did not a complete validation. In most cases, the model evaluation is performed by comparing moment arms to literature data. Some efforts must be done to have rigorous in vivo experimental data for evaluation of the finite element results as underlined by Zheng et al. (2017).
Comprehensive review of the physical exam for glenohumeral instability
Published in The Physician and Sportsmedicine, 2020
Brandon T. Goldenberg, Lucca Lacheta, Samuel I. Rosenberg, W. Jeffrey Grantham, Mitchell I. Kennedy, Peter J. Millett
Stabilization of the shoulder joint occurs by means of both static and dynamic stabilizers. The bony concavity of the glenoid balances the humeral head. The labrum, a dense, fibrous structure surrounding the glenoid rim increases the depth of the glenoid and acts as an anti-shear bumper [1–3]. The capsuloligamentous complex, consisting of the coracohumeral ligament, the middle glenohumeral ligament, the superior glenohumeral ligament, and the inferior glenohumeral ligament, is variably taught throughout shoulder motion and helps to prevent abnormal humeral head translation and optimize articular cartilage contact mechanics [4]. Additional static constraints include the negative intraarticular pressure created by less than 1 mL of joint fluid sealed in the capsule [5], and the coracoacromial arch, which is thought to prevent anterosuperior translation of the humeral head [4].
A comparison of glenohumeral joint translation between young and older asymptomatic adults using ultrasonography: a secondary analysis
Published in Physiotherapy Theory and Practice, 2020
Sangeeta Rathi, Nicholas F. Taylor, Rodney A. Green
The lack of significant findings when an anteriorly directed translation force was applied in the abducted position was similar in both groups and consistent with previous findings (Rathi, Taylor, and Green, 2017). The inability of rotator cuff contraction to affect glenohumeral joint translation when an anteriorly directed translation force was applied in the abducted position may be an indication that passive restraints, such as glenohumeral ligaments, are the primary structures opposing an anteriorly directed glenohumeral joint translation in this position (Rathi, Taylor, and Green, 2016; Wilk, Arrigo, and Andrews, 1997). It can be postulated that the rotator cuff muscles may not contribute as much to the anterior stability as the glenohumeral ligaments, irrespective of age.