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Shoulder Anatomy

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Shoulder Arthroplasty

Abstract

The shoulder is a complex structure which is comprised of various bones, joints, muscles, nerves, and vessels. It has the importance of being the only true connection between the axial skeleton and the upper extremity, and it plays the key role for upper extremity movements. In order to make the positioning of the upper extremity properly, all structures forming the shoulder must be intact and interoperate. Knowing the anatomy of the shoulder is essential for surgeons who want to evaluate the pathologies correctly and avoid the possible complications while performing surgical procedures. In this chapter, we will review the basic anatomy of the shoulder.

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References

  1. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 76–8. ISBN: 978-1-4511-1945-9.

    Google Scholar 

  2. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 144–5. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  3. Horch RE, Willy C, Kutschka I. Deep sternal wound infections. Berlin: Springer International Publishing AG; 2016. p. 7–12. ISBN: 978-3-662-49764-7.

    Google Scholar 

  4. Berdajs D, Zünd G, Turina MI, Genoni M. Blood supply of the sternum and its importance in internal thoracic artery harvesting. Ann Thorac Surg. 2006;81(6):2155–9. https://doi.org/10.1016/j.athoracsur.2006.01.020.

    Article  PubMed  Google Scholar 

  5. Scheuer L, Black S. Developmental Juvenile osteology. Amsterdam: Elsevier Academic Press; 2010. p. 223–9. ISBN: 0-12-624000-0.

    Google Scholar 

  6. Schoenwolf GC, Bleyl SB, Brauer PR, Francis-West PH. Larsen’s human embryology. 4th ed. Philadelphia, PA: Churchill Livingstone; 2009. ISBN: 978-0443-06811-9

    Google Scholar 

  7. Gray H, Lewis WH. Anatomy of the human body. 20th ed. Philadelphia, PA: Lea & Febiger; 1918. p. 119–23. ISBN: 1-58734-102-6.

    Google Scholar 

  8. Duraikannu C, Noronha OV, Sundarrajan P. MDCT evaluation of sternal variations: pictorial essay. Indian J Radiol Imag. 2016;26(2):185–94. https://doi.org/10.4103/0971-3026.184407.

    Article  Google Scholar 

  9. Muscolino JE. Kinesiology: the skeletal system and muscle function. St. Louis, MO: Mosby, Inc.; 2006. p. 374–6. ISBN: 0-323-02524-2

    Google Scholar 

  10. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 673–5. ISBN: 978-1-4511-1945-9

    Google Scholar 

  11. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 665. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  12. Scheuer L, Black S. Developmental Juvenile osteology. Amsterdam: Elsevier Academic Press; 2010. p. 244–52. ISBN: 0-12-624000-0.

    Google Scholar 

  13. Miller MD, Hart JA. Review of orthopaedics. 5th ed. Philadelphia, PA: Saunders; 2008. p. 279–80. ISBN: 978-1-4160-4093-4

    Google Scholar 

  14. Netter FH. Atlas of human anatomy. 6th ed. Philadelphia, PA: Saunders; 2014. p. 404–6. ISBN: 978-0-8089-2451-7.

    Google Scholar 

  15. Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries. Am Fam Physician. 2004;70(10):1947–54.

    PubMed  Google Scholar 

  16. Miller MD, Hart JA. Review of orthopaedics. 5th ed. Philadelphia, PA: Saunders; 2008. p. 575. ISBN: 978-1-4160-4093-4.

    Google Scholar 

  17. Knudsen FW, Andersen M, Krag C. The arterial supply of the clavicle. Surg Radiol Anat. 1989;11(3):211–4.

    CAS  PubMed  Google Scholar 

  18. Huri G, Paschos NK. The shoulder. Cham: Springer International Publishing AG; 2017. p. 3–5. ISSN: 2520-1115.

    Google Scholar 

  19. Miller MD, Hart JA. Review of orthopaedics. 5th ed. Philadelphia, PA: Saunders; 2008. p. 135–40. ISBN: 978-1-4160-4093-4

    Google Scholar 

  20. Brunnstrom S. Brunnstrom’s clinical kinesiology. 2nd ed. Philadelphia, PA: F.A. Davis Company; 1966. p. 123–8. ISBN: 0-8036-1320-2.

    Google Scholar 

  21. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 675–6. ISBN: 978-1-4511-1945-9

    Google Scholar 

  22. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 665–7. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  23. Rockwood CA, Matsen FA, Wirth MA, Lippitt SB. The shoulder. 4th ed. Philadelphia, PA: Saunders; 2009. p. 5–8. ISBN: 978-1-4160-3427-8.

    Google Scholar 

  24. Rania EM, Dina MA. Assessment of acromial morphology in association with rotator cuff tear using magnetic resonance imaging. Egypt J Radiol Nucl Med. 2014;45(1):169–80. https://doi.org/10.1016/j.ejrnm.2013.11.013.

    Article  Google Scholar 

  25. Gray H, Lewis WH. Anatomy of the human body. 20th ed. Philadelphia, PA: Lea & Febiger; 1918. p. 125–7. ISBN: 1-58734-102-6.

    Google Scholar 

  26. Oatis CA. Kinesiology: the mechanics and pathomechanics of human movement. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004. p. 113–6. ISBN: 0781719828.

    Google Scholar 

  27. Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:228.

    Google Scholar 

  28. Gagey N, Ravaud E, Lassau JP. Anatomy of the acromial arch: correlation of anatomy and magnetic resonance imaging. Surg Radiol Anat. 1993;15(1):63–70.

    CAS  PubMed  Google Scholar 

  29. Yadav SK, Zhu WH. A systematic review: Of acromion types and its effect on degenerative rotator cuff tear. Int J Orthop Sci. 2017;3(1):453–8. https://doi.org/10.22271/ortho.2017.v3.ilf.67.

    Article  Google Scholar 

  30. Epstein RE, Schweitzer ME, Frieman BG, Fenlin JM Jr, Mitchell DG. Hooked acromion: prevalence on MR images of painful shoulders. Radiology. 1993;187(2):479–81. https://doi.org/10.1148/radiology.187.2.8475294.

    Article  CAS  PubMed  Google Scholar 

  31. Worland RL, Lee D, Orozco CG, SozaRex F, Keenan J. Correlation of age, acromial morphology, and rotator cuff tear pathology diagnosed by ultrasound in asymptomatic patients. J South Orthop Assoc. 2003;12(1):23–6.

    CAS  PubMed  Google Scholar 

  32. Akhtar MJ, Kumar B, Fatima N, Kumar V. Morphometric analysis of glenoid cavity of dry scapulae and its role in shoulder prosthesis. Int J Res Med Sci. 2016;4(7):2770–6. https://doi.org/10.18203/2320-6012.irjms20161948.

    Article  Google Scholar 

  33. Rajput HB, Vyas KK, Shroff BD. A study of morphological patterns of glenoid cavity of scapula. Natl J Med Res. 2012;2(4):504–7.

    Google Scholar 

  34. Churchill RS, Brems JJ, Kotschi H. Glenoid size, inclination, and version: an anatomic study. J Shoulder Elbow Surg. 2001;10(4):327–32.

    CAS  PubMed  Google Scholar 

  35. Bayramoğlu A, Demiryürek D, Tüccar E, Erbil M, Aldur MM, Tetik O, Doral MN. Variations in anatomy at the suprascapular notch possibly causing suprascapular nerve entrapment: an anatomical study. Knee Surg Sports Traumatol Arthrosc. 2003;11(6):393–8. https://doi.org/10.1007/s00167-003-0378-3.

    Article  PubMed  Google Scholar 

  36. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 676–7. ISBN: 978-1-4511-1945-9

    Google Scholar 

  37. Pencle FJ, Gossman WG. Fracture, humerus, proximal. Treasure Island, FL: StatPearls Publishing; 2019. PMID: 29262220.

    Google Scholar 

  38. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 667–8. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  39. Huri G, Paschos NK. The shoulder. Cham: Springer International Publishing AG; 2017. p. 5. ISSN: 2520-1115.

    Google Scholar 

  40. Scheuer L, Black S. Developmental Juvenile osteology. Amsterdam: Elsevier Academic Press; 2010. p. 274–85. ISBN: 0-12-624000-0.

    Google Scholar 

  41. Boileau P, Walch G. The three-dimensional geometry of the proximal humerus. Implications for surgical technique and prosthetic design. J Bone Joint Surg Br. 1997;79(5):857–65.

    CAS  PubMed  Google Scholar 

  42. Meyer AW. Spontaneous dislocation and destruction of tendon of long head of biceps brachii, 59 instances. Arch Surg. 1928;17(3):493–506. https://doi.org/10.1001/archsurg.1928.01140090140010.

    Article  Google Scholar 

  43. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691–7. https://doi.org/10.1016/j.injury.2006.04.130.

    Article  PubMed  Google Scholar 

  44. Burkhart KJ, Dietz SO, Bastian L, Thelen U, Hoffmann R, Müller LP. The treatment of proximal humeral fracture in adults. Dtsch Arztebl Int. 2013;110(35–36):591–7. https://doi.org/10.3238/arztebl.2013.0591.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Neer CS. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am. 1970;52(6):1077–89.

    PubMed  Google Scholar 

  46. Hertel R, Hempfing A, Stiehler M, Leunig M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg. 2004;13(4):427–33. https://doi.org/10.1016/S1058274604000795.

    Article  CAS  PubMed  Google Scholar 

  47. Laing PG. The arterial supply of the adult humerus. J Bone Joint Surg Am. 1956;38-A(5):1105–16.

    CAS  PubMed  Google Scholar 

  48. Gerber C, Schneeberger AG, Vinh TS. The arterial vascularization of the humeral head. An anatomical study. J Bone Joint Surg Am. 1990;72(10):1486–94.

    CAS  PubMed  Google Scholar 

  49. Hettrich CM, Boraiah S, Dyke JP, Neviaser A, Helfet DL, Lorich DG. Quantitative assessment of the vascularity of the proximal part of the humerus. J Bone Joint Surg Am. 2010;92(4):943–8. https://doi.org/10.2106/JBJS.H.01144.

    Article  PubMed  Google Scholar 

  50. Duparc F, Muller JM, Fréger P. Arterial blood supply of the proximal humeral epiphysis. Surg Radiol Anat. 2001;23(3):185–90.

    CAS  PubMed  Google Scholar 

  51. Meyer C, Alt V, Kraus R, Giebel G, Koebke J, Schnettler R. The arteries of the humerus and their relevance in fracture treatment. Zentralbl Chir. 2005;130(6):562–7. https://doi.org/10.1055/s-2005-918157.

    Article  CAS  PubMed  Google Scholar 

  52. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 712–3. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  53. Veeramuthu M, Elangovan M, Manoranjitham. Nutrient foramina: a study in the long bones of human upper extremities. Int J Anat Res. 2017;5(3.3):4394–9. https://doi.org/10.16965/ijar.2017.348.

    Article  Google Scholar 

  54. Yaseen S, Nitya W, Ravinder M. Morphological and topographical study of nutrient foramina in adult Humerii. Int J Innov Res Develop. 2014;3(4):7–10.

    Google Scholar 

  55. Kizilkanat E, Boyan N, Ozsahin ET, Soames R, Oguz O. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat. 2007;189(1):87–95. https://doi.org/10.1016/j.aanat.2006.07.004.

    Article  PubMed  Google Scholar 

  56. Wegmann K, Burkhart KJ, Koslowsky TC, Koebke J, Neiss WF, Müller LP. Arterial supply of the distal humerus. Surg Radiol Anat. 2014;36:705–11. https://doi.org/10.1007/s00276-013-1240-z.

    Article  PubMed  Google Scholar 

  57. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 794–6. ISBN: 978-1-4511-1945-9

    Google Scholar 

  58. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 668–9. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  59. Muscolino JE. Kinesiology: the skeletal system and muscle function. St. Louis, MO: Mosby, Inc; 2006. p. 377–9. ISBN: 0-323-02524-2

    Google Scholar 

  60. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 796–800. ISBN: 978-1-4511-1945-9

    Google Scholar 

  61. Jerosch J, Steinbeck J, Clahsen H, Schmitz-Nahrath M, Grosse-Hackmann A. Function of the glenohumeral ligaments in active stabilisation of the shoulder joint. Knee Surg Sports Traumatol Arthrosc. 1993;1(3-4):152–8.

    CAS  PubMed  Google Scholar 

  62. Abboud JA, Soslowsky LJ. Interplay of the static and dynamic restraints in glenohumeral instability. Clin Orthop Relat Res. 2002;400:48–57.

    Google Scholar 

  63. Curl LA, Warren RF. Glenohumeral joint stability. Selective cutting studies on the static capsular restraints. Clin Orthop Relat Res. 1996;(330):54–65.

    Google Scholar 

  64. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 670–5. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  65. O’Brien SJ, Neves MC, Arnoczky SP, Rozbruck SR, Dicarlo EF, Warren RF, Schwartz R, Wickiewicz TL. The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med. 1990;18(5):449–56. https://doi.org/10.1177/036354659001800501.

    Article  PubMed  Google Scholar 

  66. Huri G, Paschos NK. The shoulder. Cham: Springer International Publishing AG; 2017. p. 6–8. ISSN: 2520-1115.

    Google Scholar 

  67. Oatis CA. Kinesiology: the mechanics and pathomechanics of human movement. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004. p. 125–6. ISBN: 0781719828

    Google Scholar 

  68. Huri G, Paschos NK. The shoulder. Cham: Springer International Publishing AG; 2017. p. 8. ISSN: 2520-1115.

    Google Scholar 

  69. Standring S. GRAY’S anatomy: the anatomical basis of clinical practice. 41st ed. Philadelphia, PA: Elsevier; 2016. ISBN: 978-0-7020-5230-9

    Google Scholar 

  70. Umer M, Qadir I, Azam M. Subacromial impingement syndrome. Orthop Rev (Pavia). 2012;4(2):e18. https://doi.org/10.4081/or.2012.e18.

    Article  Google Scholar 

  71. McCressh KM, Crotty JM, Lewis JS. Acromiohumeral distance measurement in rotator cuff tendinopathy: is there a reliable, clinically applicable method? A systematic review. Br J Sports Med. 2015;49(5):298–305. https://doi.org/10.1136/bjsports-2012-092063.

    Article  Google Scholar 

  72. Gumina S. Rotator cuff tear. Cham: Springer International Publishing AG; 2017. p. 25–44. ISBN: 978-3-319-33355-7.

    Google Scholar 

  73. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 697–707. ISBN: 978-1-4511-1945-9

    Google Scholar 

  74. Huri G, Paschos NK. The shoulder. Cham: Springer International Publishing AG; 2017. p. 10. ISSN: 2520-1115.

    Google Scholar 

  75. Netter FH. Atlas of human anatomy. 4th ed. Philadelphia, PA: Saunders; 2006. p. 430. ISBN: 978-0-8089-2379-4.

    Google Scholar 

  76. Javed O, Ashmyan R. Anatomy, upper limb, muscles. Treasure Island, FL: StatPearls Publishing; 2018.

    Google Scholar 

  77. Bechtol CO. Biomechanics of the shoulder. Clin Orthop Relat Res. 1980;(146):37–41.

    Google Scholar 

  78. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010. p. 675–82. ISBN: 978-0-8089-2406-7.

    Google Scholar 

  79. Gaskill TR, Braun S, Millett PJ. Multimedia article. The rotator interval: pathology and management. Arthroscopy. 2011;27(4):556–67. https://doi.org/10.1016/j.arthro.2010.10.004.

    Article  PubMed  Google Scholar 

  80. Petchprapa CN, Beltran LS, Jazrawi LM, Kwon YW, Babb JS, Recht MP. The rotator interval: a review of anatomy, function, and normal and abnormal MRI appearance. AJR Am J Roentgenol. 2010;195(3):567–76. https://doi.org/10.2214/AJR.10.4406.

    Article  PubMed  Google Scholar 

  81. Frank RM, Taylor D, Verma NN, Romeo AA, Mologne TS, Provencher MT. The rotator interval of the shoulder: implications in the treatment of shoulder instability. Orthop J Sports Med. 2015;3(12):2325967115621494. https://doi.org/10.1177/2325967115621494.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Itoi E, Berglund LJ, Grabowski JJ, Naggar L, Morrey BF, An KN. Superior-inferior stability of the shoulder: role of the coracohumeral ligament and the rotator interval capsule. Mayo Clin Proc. 1998;73(6):508–15. https://doi.org/10.4065/73.6.508.

    Article  CAS  PubMed  Google Scholar 

  83. Harryman DT 2nd, Sidles JA, Harris SL, Matsen FA 3rd. The role of the rotator interval capsule in passive motion and stability of the shoulder. J Bone Joint Surg Am. 1992;74(1):53–66.

    PubMed  Google Scholar 

  84. Huri G, Paschos NK. The shoulder. Cham: Springer International Publishing AG; 2017. p. 9–11. ISSN: 2520-1115.

    Google Scholar 

  85. Johnson EO, Vekris M, Demesticha T, Soucacos PN. Neuroanatomy of the brachial plexus: normal and variant anatomy of its formation. Surg Radiol Anat. 2010;32:291–7.

    PubMed  Google Scholar 

  86. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 721–6. ISBN: 978-1-4511-1945-9.

    Google Scholar 

  87. Kam AW, Lam PH, Murrell GAC. Brachial plexus injuries during shoulder arthroplasty: what causes them and how to prevent them. Tech Should Surg. 2014;15:109–14.

    Google Scholar 

  88. Nagda SH, Rogers KJ, Sestokas AK, et al. Neer Award 2005: peripheral nerve function during shoulder arthroplasty using intra-operative nerve monitoring. J Shoulder Elbow Surg. 2007;16:S2–8.

    PubMed  Google Scholar 

  89. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 715–8. ISBN: 978-1-4511-1945-9.

    Google Scholar 

  90. Netter FH. Atlas of human anatomy. 4th ed. Philadelphia, PA: Saunders; 2006. p. 427. ISBN: 978-0-8089-2379-4.

    Google Scholar 

  91. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 992–5. ISBN: 978-1-4511-1945-9.

    Google Scholar 

  92. Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010. p. 682. ISBN: 978-0-8089-2406-7.

    Google Scholar 

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Acknowledgments

We would like to express our deepest gratitude to Dr. Huri, who has trusted us with such a great responsibility and provided us with this opportunity of partaking in this project. His patience and willingness to meticulously guide us throughout this project have been greatly appreciated. We would also like to thank Hasan Furkan Özkan and Ahmet Kasım Özkan, who have relentlessly drawn the images that we needed throughout the chapter.

Finally, we would like to thank HÜTBAT (Hacettepe University Medical School Scientific Research Organization) and its members for striving to promote scientific research among medical students with the aim of raising a new generation of physician researchers.

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Yılmaz, S., Vayısoğlu, T., Çolak, M.A. (2020). Shoulder Anatomy. In: Huri, G., Familiari, F., Moon, Y.L., Doral, M.N., Marcheggiani Muccioli, G.M. (eds) Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-030-19285-3_1

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