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Zentralbl Chir 2001; 126(3): 168-176
DOI: 10.1055/s-2001-12501
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J.A.Barth Verlag in Medizinverlage Heidelberg GmbH & Co.KG

Anatomie des Schultergelenkes

Anatomy of the shoulder jointT. Jansen1 , C. Thorns2 , H.-J. Oestern1
  • 1Klinik für Unfall- und Wiederherstellungschirurgie (Chefarzt: Prof. Dr. H.-J. Oestern), Allgemeines Krankenhaus Celle
  • 2Institut für Angewandte und Funktionelle Anatomie, Medizinische Hochschule Hannover
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Publikationsdatum:
31. Dezember 2001 (online)

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Anatomy of the shoulder joint

Summary

The shoulder joint and its associated joints form one of the most complex joint systems of the human locomotor apparatus. Its large range of motion is made possible by the interplay of 5 joints: sternoclavicular-joint, acromioclavicular-joint, glenohumeral joint, thoracoscapular joint and subacromial joint. The rotator cuff works mostly as an active stabilizer of the shoulder joint. The supraspinatus muscle causes a compression of the humerus in the glenoid mainly, furthermore it effects synergistic the abduction with the delta muscle. On the basis of its lever-arm the supraspinatus works between 0 and 60° abduction the most optimally. With failure of the supraspinatus, the deltoideus can almost completely take its function. The inferior glenohumeral ligament-complex is the main passive stabilizer. The blood supply of the humerus head is ensured mainly by the a. circumflexa anterior and its rami ascendentes, by several small branches from the a. circumflexa posterior and over intraosseous anastomoses. The most important vessel of the cap is the intraosseous a. arcuata out of the ramus ascendens lateralis of the a. circumflexa anterior.

Zusammenfassung

Eines der komplexesten Gelenke des Bewegungsapparates des Menschen ist das Schultergelenk. Der große Bewegungsraum des Arms wird durch das Zusammenspiel von 5 Gelenken (Sternoklavikulargelenk, Akromioklavikulargelenk, Glenohumeralgelenk, Thorakoskapulargelenk und subakromialer Raum) ermöglicht. Die Rotatorenmanschette wirkt hauptsächlich als aktiver Stabilisator des Schultergelenkes. Der M. supraspinatus bewirkt eine Kompression des Humerus im Glenoid, außerdem wirkt er synergistisch mit dem Delta bei der Abduktion. Aufgrund seines Hebelarmes arbeitet der Supraspinatus zwischen 0 und 60° Abduktion am optimalsten. Bei einem Ausfall des Supraspinatus kann der M.deltoideus seine Funktion fast vollständig übernehmen. Der inferiore glenohumerale Ligament-Komplex ist ein wichtiger Stabilisator. Die Blutversorgung des Humeruskopfes erfolgt hauptsächlich über die A. circumflexa anterior mit ihren Rami ascendentes, mehreren kleinen Ästen aus der A. circumflexa posterior und über intraossäre Anastomosen. Das wichtigste Versorgungsgefäß der Kalotte ist die intraossär verlaufende A.arcuata aus dem Ramus ascendens lateralis aus der A.circumflexa anterior.

Key words

Sternoclavicular joint - acromioclavicular joint - glenohumeral joint - labrum - rotator interval - glenohumeral ligaments - inferior glenohumeral ligament-complex - rotator cuff - subacromial joint - a. arcuata

Schlüsselwörter

Sternoklavikulargelenk - Akromioklavikulargelenk - Glenohumeralgelenk - Labrum - Rotatoren-Intervall - Ligg. glenohumeralia - Inferiorer glenohumeraler Ligament-Komplex - Rotatorenmanschette - Subakromiales Gelenk - A. arcuata

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Dr. T. Jansen

Klinik für Unfall- und Wiederherstellungschirurgie
Allgemeines Krankenhaus Celle

Siemensplatz 40

D-29223 Celle

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