Pectoral girdle from anatomy to orthopedics

Pectoral Girdle: �from anatomy to orthopedics
�(for the 2nd year students)

1. PECTORAL GIRDLE:
FROM ANATOMY TO ORTHOPEDICS
(for the 2
nd
year students)
Presented by
Dr. Maryna Kornieieva
Asst. of Anatomy Department
•Osteology
•Anatomy of Joints
•Radiologic Anatomy
•Clinical Considerations

2. Pectoral Girdle

3. Clavicle
Scapula

4. Scapula: clinical notes
The suprascapular notch is bridged by its ligament
called sometimes “superior scapular ligament”(3).
The
suprascapular vessels and nerve (4-
5)
moves from the supraspinous fossa(6) to
the infraspinous fossa via the spinoglenoid
notch(8) and held in place by a fibrous
band, sometimes called by clinicians
“inferior scapular ligament”(9).
The coraco-acromial arch
consists of the acromion, coraco-
acromial ligament and the coracoid
process.

5. Joints of pectoral girdle
Sternoclavicular
Acromioclavicular
O
Glenohumera
l (Shoulder)

6. S
ternoclavicular joint
Clavicle
Sternum
Synovial double-plane joint
Articular disc
4
-Sternoclavicular lig.; 5 -Interclavicular lig.; 2 -Costoclavicular
lig..
Rib

7. Sternoclavicular joint: movements

8. Sternoclavicular Joint Injuries
Anterior dislocation
Posterior dislocation
Enhanced CT scan
Plain film tomography

10. Fractures of the Clavicle
Nondisplaced clavicle fractureDisplaced clavicle fracture

11. Case Report
•
A 30 year old man presented to ED with bilateral “shoulder pain” after a quad bike
accident. The patient took a corner at high- speed landing heavily on his right shoulder and
crushed by the bike landing on his left shoulder.
•
On examination – both right and left s houlders were dislocated anteriorly.
•
On arrival into the department and XR was performed and both shoulders.
•
Subsequent examination revealed swelling and te nderness over both sternoclavicular joints
and the patient was unable to abduct either shoulder actively. Passive movement of the
shoulders was limited by pain “over the collarbo ne”, although the clavicles themselves were
only tender near their junction with the sternum. Specifically, the AC joints and humerus
were non-tender and arm neurovascular status was normal.

12. Case Report
The Chest XR was
reported as ‘normal’…
However, CT scan confirmed
superior dislocation of
bilateral sternoclavicular joints

13. Acromioclavicularjoint
Synovial plane joint.
Ligaments: 1. Superior and Inferior
acromioclavicular;
2. Coracoclavicular ligament.
Movements:
gliding
movements when the
scapula rotates, elevates or
depresses.

14. AcromioclavicularDislocation

15. Shoulder joint
Synovial ball-and-socket joint.

16. Shoulder joint
Gleno-humeral
ligaments
Coracoacromial lig.
Coracohumeral lig.
Transverse humeral lig.

17. Shoulder MRI
Coronal plane
Sagittal plane

18. Shoulder joint and biceps

19. Shoulder joint: bursae

21. Shoulder joint: movements

22. The scapular-humeral mechanism
The scapula and humerus move in 1:2 ratio. When the arm is
abducted 180 degrees, 60 degrees occurs by rotation of the
scapula, and 120 degrees by rotation of the humerus at the
shoulder joint.

23. Shoulder joint: dislocation

24. Shoulder joint: dislocation
Anterior dislocation
Posterior dislocation