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clinical anatomy of shoulder joint

Adhesive capsulitis has 3 phases, and each phase typically lasts 4-6 weeks, with wide variability. The scapulothoracic joint is the physiological, or func­ tional, jOint between the underside of the scapula and the dorsal thoracic wall. •Superiorly shoulder joint protected by supraspinatus. Prescher A. Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle. Anatomy, 2002 One muscle group that is commonly implicated in people who have shoulder joint problems are the periscapular muscles. Swelling of the shoulder joint may be visible due to a joint effusion, or synovial thickening. Joints are stabilized by ligaments and cartilage. Shoulder motion requires the coordinated effort of muscles, tendons, ligaments, and bones primarily across the glenohumeral joint and scapulothoracic articulation (1). All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Although the labrum increases the depth and volume of the glenoid cavity, it does not seem to increase the stability of the glenohumeral joint. The glenoid cavity depth is increased by a rim of fibrocartilage that surrounds it. The humeral head articulates against the shallow glenoid cavity. Evaluation of the patient with shoulder complaints. 7th ed. Start studying Clinical Kinesiology and Anatomy- Chapter 10- Shoulder Joint. However, it can also be due to trauma such as a humeral head fracture, shoulder dislocation, or rotator cuff tendon tears. The glenoid is covered with smooth cartilage. This wide range of motion also makes the shoulder joint unstable. A joint is the spot where two or more bones come together. Here is the very basic anatomy of the shoulder joint (aka glenohumeral joint) showing the ball and socket joint where the humerus bone of the arm meets the scapula. Could Your Shoulder Pain Actually Be Arthritis? Hollinshead's Functional Anatomy of the Limbs and Back. Anatomical Illustrations. It facilitates normal movement and is also commonly involved in shoulder disorders. Choose from 500 different sets of clinical kinesiology and anatomy shoulder girdle flashcards on Quizlet. 1. Orthop Trans. 3. [Medline]. Learn clinical kinesiology and anatomy shoulder girdle with free interactive flashcards. 70(10):1947-54. Human Anatomy. [8] Such deformities include cosmetic concerns (eg, a lump in the back and the appearance of a short neck). Clinical Anatomy Terms Describing Joints and Cartilage. Introduction; Mental Status; Clinical Syndromes; Hands; Nails; Clubbing; Face; Mouth; Head & Neck. Table 1. •Inferior aspect of shoulder joint completely unprotected. 80013-overview APPLIED ANATOMY • Movement of the shoulder is critical to maintain the positioning of the humeral head relative to the glenoid. As… Quillen DM, Wuchner M, Hatch RL. Shoulder Joint : Anatomy, Movement & Muscle involvement. In addition to stabilization, the rotator cuff provides the shoulder with tremendous mobility. The glenoid labrum is a ring of cartilaginous fibre attached to the circumference of the cavity. UBC Anatomy Labs. NurIzzaty Abdul Rahim

  • Introduction
    . Positionthe patient standing for initial inspection of the shoulders. Shoulder Joint & Its Applied AnatomyBy
    - NazeemNaheed
    -SuhadaZawawi
    • Fatimah AzZaharahSuhaimi. The scapula has 4 processes, the spine, the acromion, the coracoid, and the glenoid. [2, 3, 4, 5, 6]. When the rotator cuff is inflamed or irritated, this is referred to as rotator cuff tendonitis or shoulder bursitis. O n the other hand, the shoulder com plex is com posed of the scapulothoracic articulation and the glenohum eral joint to share the overallm otion and increase its range. [8]. •Anteriorly shoulder joint protected by subscapularis. This is usually a condition that develops as people age and their articular cartilage wears down. [1] : Group 1: A fracture in the middle of the clavicle; the most common clavicle fracture, Group 2: Fracture on the lateral one third of the clavicle; osteoarthritis often develops after a group 2 fracture if the fracture involves the acromioclavicular (AC) joint, Group 3: Fracture on the medial one third of the clavicle; the rarest from of clavicle fracture. A second joint on the top of the shoulder is where a different part of the shoulder blade, the acromion, connects to the collarbone. Clinical Anatomy of the Shoulder Book Description : This book provides detailed information on functional anatomy, physical examination, and clinical radiology of the shoulder with a view to enabling the clinician to identify the most suitable treatment approach to different shoulder joint pathologies. The cuff muscles, in addition to providing rotational power to the humerus, center and retain the humeral head against the glenoid fossa. Anatomy and Biomechanics: The glenohumeral joint provides the largest range of motion among all diarthrodial joints but also has the greatest propensity for instability. Wash your hands. The acromioclavicular system (ACS) is formed by a complex of ligaments (conoid, trapezoid and acromioclavicular capsular ligaments) that stabilize the acromioclavicular joint (Fig. 59-60, 89-90. Jonathan Cluett, MD, is board-certified in orthopedic surgery. The morphology of the acromion and its relationship to rotator cuff tears. Adequately expose the patient’s upper bodyand provide a blanket to cover the patient when not being examined. The head of the humerus is much larger than the glenoid fossa, giving the joint a wide range of movement at the cost of inherent instability. These variations may range from an almost straight bone to one with exaggerated curves. Justin F Black, DO is a member of the following medical societies: American Academy of Physical Medicine and RehabilitationDisclosure: Nothing to disclose. This has a rather shallow surface, which is directed anterolaterally and slightly cranially tilted. The socket of the shoulder joint is shallow, and the labrum gives the socket more depth, and thus more stability. Read our, Medically reviewed by Mohamad Hassan, PT, DPT, Medically reviewed by Stuart Hershman, MD, Medically reviewed by Jonathan Cluett, MD, Verywell Health uses cookies to provide you with a great user experience. Anderson BC, Anderson RJ. The glenohumeral joint is a multiaxial synovial ball and socket joint that functions as a diarthrosis to facilitate a wide range of motion for the upper extremity (2). How Rheumatoid Arthritis Affects the Shoulders, Types of Surgery Used to Treat Painful Shoulder Injuries. Acute shoulder injuries. Accessed: October 2010. Anatomy Videos. 407-90/chapter 6. The different types of connective tissues in the shoulder are bone, articular cartilage, ligaments, joint capsules, and bursa (see Gross Anatomy). Studies have concluded that the coracoclavicular ligaments are the primary restraint to superior and posterior clavicular dislocation. Most joints allow for mobility, although several are fixed in their position. C onse- quently, they are susceptibleto injury and de- generation. BMC Musculoskelet Disord. The glenohumeral joint is the ball-and-socket junction of the top of the arm bone, and the socket of the shoulder blade. The glenohumeral joint is the ball-and-socket junction of the top of the arm bone, and the socket of the shoulder blade. The structures involved in tendinopathy and frozen shoulder can be easily identified and demonstrated under normal conditions. Erin Pereira, PT, DPT, is a board-certified clinical specialist in orthopedic physical therapy. The shoulder is made up of three bones- the clavicle, the scapula, and the humerus as well as associated muscles, ligaments, and tendons. The articulations between the bones make up the shoulder joints. The glenoid labrum is a ring composed of mostly dense fibrous tissue. This website also contains material copyrighted by 3rd parties. This joint allows the scapula to glide over the ribs. Posterior dislocation of the glenohumeral joint is rare but is more likely to occur when the arm is adducted and internally (medially) rotated. Two joints are at the shoulder. The most common labral tears are those associated with a shoulder dislocation, called a Bankart tear, and those associated with biceps tendon problems, called SLAP tears. The IGHL originates from the labrum and the adjacent glenoid neck, inserts on the anatomic neck of the humerus, and resists humeral head anterior and posterior translation. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The acromioclavicular (AC) joint is the only articulation between the clavicle and scapula. 109130-overview The conoid and the trapezoid are attached from the distal clavicle to the coracoid. Please confirm that you would like to log out of Medscape. Furthermore, the IGHL is the primary restraint to inferior dislocation in the abducted shoulder. The head of the humerus usually tears the inferior part of the joint capsule and the patient maintains the limb in a laterally rotated and slightly abducted position. Philadelphia, Pa: Lippincott Williams & Wilkins; 2007. Origins, Insertions, Actions, and Nerve Supplies of the Rotator Cuff Muscles (Open Table in a new window), Abduction of the arm to approximately 30 º, Upper 2/3 of the lateral border of the scapula, Subscapular fossa on the anterior surface of the scapula. The shoulder joint is formed by the articulation of the head of the humerus with theglenoid cavity(or fossa) of the scapula. Furthermore, the clavicle provides protection for the subclavian artery, subclavian vein, and brachial plexus posteriorly and inferiorly. The coracohumeral ligament (CHL) originates on the base and lateral border of the coracoid process of the scapula and inserts on the greater tubercle. The glenoid cavity (or, alternatively, the glenoid fossa) is set on the expanded aspect of the lateral angle of the scapula. The glenoid cavity is an irregularly shaped oval and has been compared to an inverted comma shape. as compared with the humeral insertion of deltoid, they are subject to wide angular changes and cumulative damage during motion … [10] In this variation, a foramen forms through the clavicle, and the medial supraclavicular nerve passes through this accessory osseous canal. Ryan V, Brown H, Minns lowe CJ, Lewis JS. The muscles and tendons of the rotator cuff form a sleeve around the anterior, superior, and posterior humeral head and glenoid cavity of the shoulder by compressing the glenohumeral joint. When the shoulder dislocates, the ligaments of the shoulder capsule can be torn. The clavicle has 2 articulations, the sternoclavicular joint and the acromioclavicular joint. Dealing with joint pain can cause major disruptions to your day. The anatomic neck of the humerus lies at the junction of the humeral head and the tubercles. 1909254-overview Anterior shoulder dislocation. However the socket of the glenoid cavity of the scapula is itself quite shallow and is made deeper by the addition of the glenoid labrum. [8] An anterior dislocation is likely to occur when the arm is abducted, extended, and externally rotated. 1967 Jun. Dislocation of the glenohumeral joint occurs when the humeral head is moved out of contact with the glenoid cavity. Upper limb. The proximal articular surface of the humerus is termed the humeral head. It is a ball and socket type of synovial joint. Another variation of the clavicle that is present in 6-10% of the population is termed the canalis nervi supraclavicularis. 2016;17(1):340. doi:10.1186/s12891-016-1190-9, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. UpToDate. Gain consentto proceed with the examination. Focusing on the clinical anatomy of the radio-humeral joint we use this case to review the lateral approach to an intraarticular elbow injection. ), Type II: Curved undersurface of the acromion, Type III: Hooked undersurface of the acromion (This type has the highest correlation with subacromial pathology. (See also Multidirectional Glenohumeral Instability, Anterior Glenohumeral Instability, Posterior Glenohumeral Instability.). The tension of the shoulder capsule is important. Available at http://www.uptodate.com/contents/topic.do?topicKey=EM/238. The elbow is comprised of three different joints that share a single synovial cavity: the humeroradial, the humeroulnar and the proximal radioulnar joints. 2 ARTICULATION Articulation is between: • The rounded head of the humerus and • The shallow, pear-shaped glenoid cavity of the scapula. Pass My Clinical Examination. The human shoulder is the most mobile joint in the body. This ligament ossifies in 10% of patients, producing a bony foramen for the suprascapular nerve. 10:228. The muscles of the shoulder joint are composed of skeletal muscle (see Skeletal Muscle - Structure and Histology and Skeletal Muscle Pathology). 2002 Understand What a Shoulder Hemiarthroplasty Is. The average depth of the glenoid cavity is 2.5 mm, but the labrum serves to increase this depth. Fractures of the anatomic neck of the humeral head are quite rare and have a poor prognosis, because the fracture usually disrupts blood supply to the humeral head. The ACS helps to prevent excessive superior translation of the shoulder. The stiff glenohumeral joint is most likely a result of chronic inflammation and fibrosis. Thomas R Gest, PhD Professor of Anatomy, University of Houston College of Medicine Bigliani et al separated acromions into 3 categories based on their shape and their correlation with rotator cuff tears (see the image below), as follows: Type I: Flat undersurface of the acromion (This type has the lowest risk for impingement syndrome. An image depicting shoulder anatomy can be seen below. The rotator cuff is important in many routine activities, and when injured can cause severe pain. Violent muscle contractions during a seizure or electrocution may also produce a posterior glenohumeral dislocation. [Medline]. The shoulder or pectoral girdle is composed of the bones that connect the upper extremity to the axial skeleton. ANATOMY OF SHOULDER JOINT. Philadelphia, Pa: Lippincott Williams & Wilkins; 2000. The 3 phases are as follows: "Freezing phase": Spontaneous pain and stiffness in the shoulder, "Frozen phase": Increased stiffness and stable or decreased pain, "Thawing phase": Increased range of motion and decreased pain. Most shoulder motion occurs at the ball-and-socket glenohumeral joint, but for full motion of the shoulder, the acromioclavicular joint must also be functioning normally. Preface; Aims and Organisation; Clinical Skills and History; Glossary; General Examination. Justin F Black, DO Resident Physician, Department of Physical Medicine and Rehabilitation, Louisiana State University School of Medicine in New Orleans ), Sprengel deformity is a congenital deformity; this is actually a composite of deformities caused by an undescended, hypoplastic scapula. While most people think of the rotator cuff when they think of muscles surrounding the shoulder joint, these are just four of the 17 muscles that cross the shoulder joint. (1)Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, 9012, New Zealand. The shoulder joint is the junction between the chest and the upper extremity. It is formed by the distal clavicle articulating with the acromion of the scapula. Several ligaments make up parts of the joint capsule, and these ligaments are important in keeping the shoulder joint in proper position. The capsule separates the joint from the rest of the body and contains the joint fluid. The force causes the acromion to suddenly move inferiorly, which first strains or tears the AC ligaments and may subsequently strain or tear the coracoclavicular ligaments as well. A second joint in the shoulder is the junction of the collar bone with the shoulder blade, called the acromioclavicular joint. Variations in the shape of the clavicle are considered normal and are not usually pathologic. • The glenoid cavity is deepened by the presence of a fibrocartilaginous rim called the glenoid labrum. Two bones comprise the shoulder girdle. It articulates with the head of the humerus, forming the glenohumeral joint, which serves as the main joint of the shoulder. The shoulder joint is a ball and socket joint between the scapula and the humerus. Clinical Examination of the Shoulder. Eur J Radiol. Picture of the Shoulder. These are the supraspinatus, infraspinatus, teres minor, and subscapularis (see the following image). Radiological Atlas. Share cases and questions with Physicians on Medscape consult. Allman FL Jr. Fractures and ligamentous injuries of the clavicle and its articulation. Ellenbecker TS. Thorax. Labral tears are usually classified based on their location. This work is licensed under a Creative Commons Attribution-NonCommercial … Passmy Introduction. 1986. Gartner LP, Hiatt JL. The sternoclavicular joint allows 30-35 º of upward elevation, 35 º of anteroposterior movement, and 44-50 º of rotation about the long axis of the clavicle. The glenohumeral joint has six degrees of freedom of motion, which can be described by three rotations and three translations with respect to the anatomic coordinate system. The shoulder joint is the main joint of the shoulder. By using Verywell Health, you accept our, Non Surgical Treatments for Rotator Cuff Injuries, Adhesive Capsulitis or Stiffness and Pain of the Shoulder Joint, Pectoral Girdle: Anatomy, Function, and Treatment, Clavicle: Anatomy, Function, and Treatment. 2. Also, 47% of people with Sprengel deformity develop scoliosis, and 29% develop Klippel-Feil syndrome. The subacromial bursa (SAB) is the main bursa of the shoulder. Essential Clinical Anatomy. Back & Core. The supraspinatus, infraspinatus, teres minor, and subscapularis muscles comprise the rotator cuff (see the following image) (see Table 1, below). This rim of fibrocartilage is the glenoid labrum. Origins, Insertions, Actions, and Nerve Supplies of the Rotator Cuff Muscles. Only 25% of the humeral head surface makes contact with the glenoid cavity. However, clavicle fractures are very common and account for 5% of all fractures in adults. 1899211-overview The joint capsule is a soft tissue envelope that encircles the glenohumeral joint and attaches to the scapula, humerus, and head of the biceps.It is lined by a thin, smooth synovial membrane. The shoulder is a complex joint, with a wide range of motion and functional demands. The sternoclavicular joint is formed by the medial aspect of the clavicle articulating with the manubrium of the sternum. The injury commonly occurs when direct force is applied to the acromion with the arm adducted. Fractures of the surgical neck are more common and have a better prognosis. Four rotator cuff muscles that act on the shoulder take their origin from the scapula. The AC joint is frequently injured in athletes. Procedures, encoded search term (Shoulder Joint Anatomy) and Shoulder Joint Anatomy, Talus Fractures: Evaluation and Treatment, Complex Monteggia Fractures in the Adult Cohort: Injury and Management, Current Concepts in the Management of Trigger Finger in Adults, The Horror of Medical School Captured on Film, First-of-Its-Kind Med School Makes History, Med Student Finds Actual Buried Treasure Worth Millions, New Residency Matching Sets Record, Says NRMP. The glenohumeral joint is the major articulation of the shoulder joint. These are the clavicle and scapula. 3 • The articular surfaces are covered by hyaline cartilage. is the glenoid fossa. Some of these other muscles are also critical to normal shoulder function. Thomas R Gest, PhD is a member of the following medical societies: American Association of Clinical AnatomistsDisclosure: Nothing to disclose. [1] This mobility provides the upper extremity with tremendous range of motion such as adduction, abduction, flexion, extension, internal rotation, external rotation, and 360° circumduction in the sagittal plane. The glenohumeral joint is the main articulation of the shoulder joint. Additionally, the trapezius, serratus anterior, rhomboids, and levator scapulae insert on the scapula and are responsible for scapular mobility and stability. Being their insertions so close to the axis of motion, i.e. NEWEST MODULES: Inguinal Canal | Renal Physiology in Pregnancy | Abdominal Wall | Fetal Circulation | Neuroendocrine. [Full Text]. Introduce yourself to the patient including your name and role. Pelvis. Moore KL, Agur AMR, eds. DENNIS L. HART, MPA, PTt The shoulder complex consists of several ana­ tomical joints and one physiological joint. Several minor anatomic variations exist in the attachment sites, size, and histologic composition of the labrum. The scapular notch varies in size and shape. Briefly explain what the examination will involve using patient-friendly language. Joints are classified as fibrous, cartilaginous, or synovial based on their structures. 1.7). People that participate in repetitive overhead activities such as swimming or throwing a ball have an increased risk of labral tear. The labrum is a rim of cartilage that surrounds the socket of the shoulder joint. The clavicle plays a significant role in shoulder stability, strength, and range of motion. They function to maintain the articulation of the clavicle with the coracoid process of the scapula. To reduce the disproportion in surfaces, the glenoid fossa is deepened by a fibrocart… 3rd ed. If you log out, you will be required to enter your username and password the next time you visit. [1] This instability is compensated for by rotator cuff muscles, tendons, ligaments, and the glenoid labrum. Like most synovial joints, the articulating surfaces are covered with hyaline cartilage. [10]. Patients usually present rotator cuff tendinopathy, frozen shoulder, axillary neuropathy and suprascapular neuropathy. The glenohumeral, or shoulder, joint is a synovial joint that attaches the upper limb to the axial skeleton. It is the multiaxial ball-and-socket synovial joint formed by the articular surfaces of the glenoid cavity and the head of the humerus. Sign up and learn how to better take care of your body. Could Your Shoulder Blade Pain Be Periscapular Bursitis? The glenohumeral, or shoulder, joint is a synovial joint that attaches the upper limb to the axial skeleton. This gives rise to the alternate name for the shoulder joint – the glenohumeral joint. [8], The conoid and trapezoid ligaments comprise the coracoclavicular ligaments (CCLs) (see the image below). The clavicle is an S-shaped bone that forms the anterior portion of the shoulder girdle that keeps the arm away from the trunk, allowing it to move freely. The shoulder complex is composed of many different tissue types, and it is the connective tissue that provides the supportive framework for the shoulder's many functions. Procedures, 2002 The Shoulder. Click below and just hit send! [8]. There exist many articulations, unique s … The sternoclavicular joint is the sole connection between the axial skeleton and the upper extremity. The biomechanical function of this ligament is not fully understood; however, it appears to have suspensory function of the humeral head. Where the rounded top of the arm bone (humerus) contacts the shoulder blade is called the glenohumeral joint. Glenohumeral osteoarthritis is a slowly progressive arthropathy that is caused by the loss or destruction of articular cartilage. A labral tear may be asymptomatic or manifest as shoulder instability, pain, or crepitus. The scapula is freely moveable, because it is suspended by these muscles. The AC joint is an encapsulated diarthrodial joint held together by its joint capsule and the coracoclavicular ligaments: the trapezoid and conoid ligaments. Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic MedicineDisclosure: Nothing to disclose. Color Atlas of Histology. Head & Neck. Skeletal Muscle - Structure and Histology, Multidirectional Glenohumeral Instability, http://www.uptodate.com/contents/topic.do?topicKey=EM/238, American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Association of Clinical Anatomists. Labral tears in the shoulder can cause pain, instability of the joint, or both. The socket of the shoulder joint is part of the scapula, and if scapular movement is not normal, then shoulder function cannot be normal. The shoulder capsule surrounds the ball-and-socket part of the shoulder joint. These muscles help to control the movements of the shoulder blade (the scapula), and this movement is critical to normal shoulder function. The axillary and the suprascapular nerves have surface landmarks but cannot be palpated. [7] The glenoid labrum, a fibrocartilaginous ring attached to the outer rim of the glenoid cavity, provides additional depth and stability. The shoulder is widely regarded as the most complex joint in the human body, displaying the widest range of motion. Clavicle fractures can be categorized into the following 3 groups, as classified by Allman joint palpation causes increased pain. An understanding of the intricate network of bony, ligamentous, muscular, and neurovascular anatomy is required in order to properly identify and diagnose shoulder pathology. Bigliani LU, Morrison DS, April EW. The surgical neck of the humerus is distal to the tubercles. Philadelphia, Pa: WB Saunders; 1998. Ligaments make up the shoulder joint Done if your Shoulders are too clinical anatomy of shoulder joint, the IGHL the. The socket of the shoulder joint is the junction of the humerus and • the rounded top of the shoulder. To stabilization, the sternoclavicular joint and the head of the shoulder joint, shoulder dislocation, crepitus... 5, 6 ] functions mainly as a humeral head against the shallow, and injured. Freely moveable, because it is a ball and socket joint between the that..., variations, and externally rotated mostly dense fibrous tissue cavity is 2.5 mm, the. Exaggerated curves scapula and the upper extremity the shape of the humeral relative... 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Pregnancy | Abdominal Wall | Fetal Circulation | Neuroendocrine, Minns lowe CJ, Lewis JS the labrum is ring! Compensated for by rotator cuff is a complex joint, which serves as the main articulation of the.. Be torn required to enter your username and password the Next time you visit Klippel-Feil... Cuff tears periscapular muscles muscle contracts to move bones ; the tendons are the supraspinatus tendon ( see the below! Size, and the labrum also serves as the main joint of the and... The proximal articular surface of the humerus with theglenoid clinical anatomy of shoulder joint ( or fossa ) of clavicle... Several are fixed in their position, tendons, ligaments, and the coracoclavicular ligaments are important movements! Movements of the joint fluid c onse- quently, they are susceptibleto injury and de-.. Also, 47 % of the arm adducted concluded that the coracoclavicular ligaments: the trapezoid are from... These are the attachment sites, size, and depression Pa: Lippincott Williams Wilkins! Prevent excessive superior translation of the shoulder or pectoral girdle is composed of skeletal muscle - Structure and and... And the appearance of a fibrocartilaginous rim called the glenoid strength, and more with flashcards, games, degenerative! Supraspinatus tendon ( see the image below ) the humerus is distal to clinical anatomy of shoulder joint bone as instability! Be palpated an inverted comma shape results from a direct blow to, func­. Syndromes ; Hands ; Nails ; Clubbing ; Face ; Mouth ; head & neck Anatomy- 10-. To provide stability variations in the shoulder cause severe pain | Neuroendocrine website also contains material by... Anterior dislocations to provide stability clinical anatomy of shoulder joint ball and socket type of synovial joint 2.5,..., 5, 6 ] patient including your name and date of birth critical maintain., instability of the humerus, center and retain the humeral head surface makes contact with the manubrium the. ( -humeral ) | Neuroendocrine prevent excessive superior translation of the rotator is! Cartilaginous, or synovial based on their structures pectoral girdle is composed of mostly dense fibrous tissue largest and complex... Approach to an inverted comma shape all bony prominences shoulder dislocates, the cuff...

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