Shoulder joint

Shoulder - spherical joint is formed by the head of the humerus and the articular cavity blade (Fig. 1). Articular surface of the head shoulder spherical shape, covered with hyaline cartilage.

shoulder joint Fig. 1. Shoulder joint (structure):
1 and 7 joint capsule;
2 - shoulder bone of the shoulder blades;
3 - and 5 - tendon long head of the biceps shoulder;
4 - ogbogoro synovial vagina;
6 - humerus;
8 - articular lip;
9 - blade.

Shoulder joint is surrounded by dense joint bag (capsule), coming in from the edges joint socket blades outside and to anatomical cervical front and inside and back - up surgical neck shoulder. Joint bag strengthened by ligaments, and muscles that surround the shoulder joint and attached to different points of the shoulder bone near the joint. Muscles and ligaments firmly fixed head shoulder into the joint socket. The front-bottom surface of P.F. deprived of muscles. In this area are more likely to have breaks joint capsule I. dislocated joint.
Around the shoulder joint, there is a number of mucous bags, communicating with the cavity of the joint. The greatest practical importance Chuck and podelitsia handbags, where septic processes can descend ulcers and spread further in axillary hole and under the deltoid muscle.
The blood supply of the shoulder joint is through the front and rear envelopes humerus artery. Innervation is axillary nerve and long branches chest, radial and subscapularis nerves.
Shoulder joint has a great mobility, it is possible, lead, flexion, extension, rotate, circular motion.
The damage. There are closed and open damage P... It closed injuries include: bruises with bleeding in the soft tissues surrounding the joint (subcutaneous, megascale, acrocephalidae bruises, and sprains. Bruises and sprains are accompanied by pain on movement, a time limit of function of joints, swelling.
It closed injuries include sprains (see). There are several types dislocated shoulder. More common front dislocations, when the head of the shoulder is shifted toward the front from the glenoid. While the shoulder area flattened, active movement impossible. Offset cylinder shoulder can compress vessels or nerves.
First aid for the dislocation of the shoulder joint - chambers, transport immobilization. The victim should be immediately transported to the surgeon for reposition dislocation; with bruises and sprains calm, with 4-5-day heat, paraffin, and in the subsequent remedial gymnastics, massage.
Less frequent are the rupture of tendons or muscles in the shoulder joint degrees dysfunction. Treatment - online - stitching tendons and muscles.
Damage to the articular capsule, cartilage, bags and synovial membrane shoulder joint is accompanied by severe pain with active and passive movements, the emergence of effusion in the joint, a forced position of the limb. Treatment: peace, fixing limbs onto the bus, later, physiotherapy, physiotherapy.
Open injuries of the shoulder joint (injured) in time of peace, stab, in the military - fire. Wounds can be penetrating and not penetrating into the joint. When penetrating injuries observed the expiration of synovial fluid, hemarthrosis (see), sharp restriction of the function and pain in the joint, aggravated by movement. In all cases, at the open and closed damage area P.F. shown checking the integrity of blood vessels (the study of the pulse) and major nerve trunks (conservation of sensitivity and movements of the hand and fingers shows the history of nerves).


Fig. 2. Treatment of a gunshot wound of the shoulder joint outlet plaster cast.

First aid for injuries of the shoulder joint aseptic bandage, mandatory introduction of anti-tetanus serum on Besedke (3000 AE), the imposition of transport bus with fixation of the limbs from the blades to the toes, shipping in the surgical hospital. Treatment: a thorough surgical treatment of wounds with the introduction of antibiotics, the imposition of discharge bus or plaster bandages (Fig. 2), further - the use of physical therapy and physiotherapy.
Inflammation of the shoulder joint (metric) can be serous, sero-purulent or purulent. Purulent ometric most often occurs as a complication in open injuries of the shoulder joint, or as a result of the transition to the joint tissues suppurative process in osteomielite the head of the humerus or joint socket blades and from purulent foci in mucous handbags (bursitis)surrounding the joint. Treatment and surgery.

Shoulder joint (subtalar humeri) - spherical joint is formed by the head of the humerus and the articular cavity blades.
Anatomy. Articular surface blades increases fibrous cartilage ring - joint lip (labrum glenoidale),which is attached to the edge of the glenoid. Articular surface of the head and shoulder joint depression blades covered with hyaline cartilage. The head of the shoulder has a spherical shape; some of it is covered with cartilage, represents hemisphere. Head center shoulder lies in the plane of anatomical cervix. Around this point are made of motion of the shoulder. Articular surface of the head arm about three times more joint socket blades; this, as well as a large amount of its joint capsule is explained by the high mobility of P.F. (Fig. 1 and 2).

Fig. 1. Shoulder joint front: 1 - m. subscapular and her bag; 2 - lig. coracohumerale; 3 - processus coracoideus; 4 - lig. transversum scapulae sup.; 5 - scapula; 6 - capsula articularis; 7 - humerus; 8 - m. biceps brachii (caput longum).
Fig. 2. Shoulder back: 1 - acromion; 2 - processus coracoideus; 3 - lig. coracohumerale; 4 - word " Collum " anatomicum humeri; 5 - humerus; in - capsula articularis; 7 - lig. transversum scapulae inf.; 8 - scapula; 9 - spina scapulae.

Joint capsule begins from the edge labrum glenoidale and partly from the bone and is attached to the shoulder bones anatomical cervix (the word " Collum " anatom icum). Inside and behind capsule comes to surgical cervix, that is below the epiphyseal line; over libparanoia furrow (sulcus intertubercularis) she shifted in the form of a bridge (Fig. 3). Outside and in front of the capsule are tight and closely merge with it near the places of their attachments for upper arm muscles: if (m. subscapulars), supraspinatus (m. supraspinatus), infraspinatus (m. infraspinatus) and small round (m. teres minor). In strengthening P.F. are also important large muscles: deltoid (m. deltoideus), biceps and triceps (m. biceps brachii et m. triceps brachii)and kljuvovidno-shoulder (m. coracobrachialis), large round (m. teres major), latissimus dorsi muscles (m. latissimus dorsi) and large pectoral muscle (m. pectoralis major) (Fig. 4 and 5; printing. Fig. 2 and 3).



Fig. 3. Shoulder joint in the front section: 1 - lig. transversum scapulae sup.; 2 - capsula articularis; 3 - facies articularis acrom.; 4 - acromion; 5 - m. biceps brachii (caput longum); in - vagina mucosa intertubercularis; 7 - m. biceps brachii (caput longum); 8 - humerus; 9 - capsula articularis; 10 - labrum glenoidale; 11 - scapula.
Fig. 4. The muscles of the anterior surface of the shoulder and chest, deep layer: 1 - m. sternocleidomastoideus; 2 - bone; 3 - m. omohyoideus; 4 - m. trapezius; 5 - fascia clavipeetoralis (partially removed); 6 - processus coracoideus; 7 - m. deltoideus (start); 8 - lig. coracoacromialis; 9 - fascia clavipectoralis; 10 - capsula articularis; 11 - m. coracobrachialis; 12 - m. pectoralis major (attachment); 13 - caput longum m. bicipitis brachii; 14 - m. biceps brachii (caput breve); 15 - m. triceps brachii; 16 - m. biceps brachii.
Fig. 5. The muscles of the shoulder joint rear: 1 - Ty m. trapezii; 2 - m. infraspinatus; 3 - in. deltoideus (cut and turned upwards); 4 - bursa subdeltoidea; 5 - m. teres min.; in - m. biceps brachii; 7 - humerus; 8 - m. deltoideus (attachment); 9 I 10 - m. triceps brachii (9 - caput laterale; 10 - caput longum); 11 - m. latissimus dorsi; 12 - m. teres major.
shoulder joint
Fig. 2. Frontal cut through the shoulder area.
Fig. 3. Shoulder joint (opened) with the places of attachment of muscles in the area of upper section of the humerus, 1 - v. cephallca; 2-m. pectoralis major; 3 - caput longum m. biclpitis brachii; 4 - caput breve m. blclpltls brachii; 5 n. musculocutaneus; 6 - n. medianus; 7 - n. cutaneus antebrachli medialis; 8 and 8'- v. basilica; 9 - n. ulnaris; 10 - caput longum ra. trlcipitis brachii; 11 - caput lat. m. triclpltis brachii; 12 - caput med. m. trlcipitis brachii; 13 - humerus; 14-n. radlalis; 15 - a. et v. brachiales; 16 - m. brachioradialls; 17 - m. brachialis; 18 - septum intermusculars med.; 19 - septum Intermusculars lat.; 20 - fascia brachii; 21 - m. deltoideus; 22 - m. coracobrachialis; 23 - plexus brachialis; 24-L. subclavia; 25-v. subclavia; 26 - m. subscapulars; 27-m. serratus ant.; 28 - a branch. circumflexae humeri post.; 29 - articular gap; 30 - acromion; 31 - m. supraspinatus; 32 - processus coracoideus; 33 - bone; 34-L. et w. suprascapular; 35 - cavitas glenoldalis; 36 - scapula; 37 - labrum glenoidale; 38 - capsula articularis; 39 - caput humeri; 40 - vagina synovialls intertubercularis; 41 - lig. coracoacromlale; 42 - tendo m. latlssirai dorsi; 43 - tendo m. teretls majorls.

Joint capsule shoulder joint is strengthened by ligaments. One of the features of P.F. is that through its cavity is sinew of the long head of the biceps. The root of the coracoid process is located bag subscapularis muscle (bursa m. subscapularis subtendinea). In addition, under the deltoid muscle are two more mucous bags: podelitsia (bursa subdeltoidea), occurring on a large mound of the humerus, and the second (bursa subacromialis)located under acromial process on the tendon m. supraspinatus. P.F. a blood supply mainly from the front and back along the humerus arteries (aa. circumflexa humeri anterior et posterior); nerves depart from nadopasana and axillary (nn. suprascapularis and axillaris).
In P.F. possible large volume of movements, there are perpendicular to the axis of rotation (Fig. 6). In P.F. possible bend (forward motion), extension (reverse), abduction and coercion. Possible rotation of the shoulder rotation (outside and inside) and a General circular motion (circumductio).

Fig. 6. Diagram of the axis of rotation of the shoulder joint.