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Anatomy Of The Shoulder

The shoulder girdle is a sophisticated mechanism that acts as the fulcrum for the upper limb, and its smooth function, strength and stability are vital in order to reliably place the hand in space to undertake everyday tasks.

It is composed of 3 bones:

  • Scapula (shoulder blade)
  • Clavicle (collarbone)
  • Humerus (arm bone)

Shoulder Anatomy

The shoulder girdle is a sophisticated mechanism that acts as the fulcrum for the upper limb, and its smooth function, strength and stability are vital in order to reliably place the hand in space to undertake everyday tasks.

It is composed of 3 bones:

  • Scapula (shoulder blade)
  • Clavicle (collarbone)
  • Humerus (arm bone)

The scapula is a large flat bone which has a body (the flat part), a spine (the ridge at the back of the shoulder), an acromion (tip of the shoulder blade) and a coracoid process (a projection from the front of the blade that serves as an attachment point for muscles and ligaments)

These bones are linked by ligaments to form joints, upon which framework the tendons and muscles facilitate movement.

The joints are:

  • Sternoclavicular (between the breastbone and the collarbone)
  • Acromioclavicular (between the collarbone and the shoulderblade)
  • Glenohumeral (the main ball and socket joint)
  • Scapulothoracic (not a joint in the usual sense, but a plane of motion between the shoulder blade and chest wall)

These bones and joints depend on linkages provided by ligaments which are tough fibrous flexible bands. Some of the important ligaments are:

  • Coraco-clavicular (suspending the scapula from the collarbone)
  • Acromio-clavicular (connecting the collarbone to the tip of the shoulder blade)
  • Coraco-acromial (forms an arch over the ball of the humerus)
  • Glenohumeral (three in number – superior, middle and inferior- connecting the ball and socket )
  • Joint capsule (a sheet of ligament tissue wrapping around the ball, and thickened in parts to form the glenohumeral ligaments)

The shoulder blade serves as the origin of several important muscles that attach to the humerus. Tendons are the short bands or cords of tough connective tissue that connect muscles to bones. The tendons from the muscles arising from the scapula converge on the ball, together forming the ‘rotator cuff’.

The main functional components of the rotator cuff are:

  • Subscapularis (at the front, rotates the ball inwards)
  • Supraspinatus (at the top, elevates the arm)
  • Infraspinatus (at the back, rotates the ball outwards)
  • Teres minor (rotates the ball outwards when the arm is elevated)

In addition, the biceps muscle has two attachments from the scapula. One (the “short head’) arises from the coracoid process outside the joint, while the other (the “long head’) arises from the top of the socket and travels across the ball, through a groove and into the arm to join together to the main biceps muscle.

Where the tendons pass over or under bony prominences a special membranous sac called a bursa exists to lubricate the motion. Numerous bursae have been identified around the shoulder, of which the subacromial (or subdeltoid) bursa is the largest and the most often implicated in shoulder problems. When irritated or injured, the bursa may produce fluid and the walls of the sac may thicken and contribute to impingement.

The shoulder is also richly supplied with nerves and blood vessels. Nerves carry sensory signals from the joint tissues to the brain and also convey motor signals from the brain via the spinal cord to the muscles. The most important nerves are:

  • Axillary (supplying the deltoid muscle)
  • Suprascapular (supplying the supraspinatus and infraspinatus)
  • Musculocutaneous (supplying the biceps and brachialis muscles)
  • Accessory (supplying the trapezius muscle)

Private Orthopaedic Clinic

The Orthopaedic Unit at St John & St Elizabeth Hospital is one of the country’s leading private orthopaedic centres. We provide a complete service for the assessment, treatment and management of orthopaedic and musculoskeletal problems.

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Patient information

Our Hospital is renowned for providing exemplary levels of care across more than 90 services. From orthopaedics, to urology, our private GP practice and Urgent Care Clinic, our services are led by some of London’s leading Consultants. For more information, and to find a service suitable for your care, find out more about the services that we offer.

Make an enquiry

If you have any questions relating to treatment options or pricing information, get in touch with us by filling out one of our contact boxes or giving us a call on 0207 078 3891.

Our Appointments Team have a dedicated and caring approach to finding you the earliest appointment possible with the best specialist.

If you are self-paying you don’t need a referral from your GP for a consultation. You can simply refer yourself* and book an appointment.

If you have health insurance (e.g. Bupa, Axa Health, Aviva), you will need to contact your insurer to get authorisation before any treatment, and in most cases you will also require a referral letter from your GP.

If you are not registered with a GP, we have an in-house private GP practice you can use. Alternatively, we can suggest the most appropriate course of action for you to take, given your location and individual circumstances.

*Please note – for investigations such as X-rays and MRIs, a referral will be required. However, we may be able to arrange this for you through our on-site private GP.

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