Sternoclavicular Joint: Difference between revisions

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[[Image:Grays325.jpg|thumb|right|Anterior view sternoclavicular joint.]]  
[[Image:Grays325.jpg|thumb|right|Anterior view sternoclavicular joint.]]  
== Description  ==
== Description  ==


The sternoclavicular joint (SC joint) is formed from the articulation of the medial aspect of the clavicle and the manubrium of the sternum.&nbsp; It is one of four joints that compose the [[Shoulder|shoulder]] complex.&nbsp; The SC joint is generally classified as a plane style synovial joint, and has a fibrocartilage joint disk.<ref>Levangie, P.K. and Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.</ref>&nbsp; The ligamentous reinforcements of this joint are very strong, often resulting a fracture of the clavicle before a dislocation of the SC joint.<ref>Allman, F.L. (1967). Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg. 49A:774-784.</ref>
The sternoclavicular joint (SC joint) is formed from the articulation of the medial aspect of the clavicle and the manubrium of the sternum.&nbsp; It is one of four joints that compose the [[Shoulder|shoulder]] complex.&nbsp; The SC joint is generally classified as a plane style synovial joint, and has a fibrocartilage joint disk.<ref>Levangie, P.K. and Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.</ref>&nbsp; The ligamentous reinforcements of this joint are very strong, often resulting a fracture of the clavicle before a dislocation of the SC joint.<ref>Allman, F.L. (1967). Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg. 49A:774-784.</ref>  


== Motions Available  ==
== Motions Available  ==


*'''Protraction and retraction:<ref>Conway, A.M. (1961). Movements at the sternoclavicular and acromioclavicular joints. Phys Ther Rev. 41: 421-432.</ref>''' During protraction, the concave surface of the medial clavicle moves on the convex sternum, producing an anterior glide of the clavicle, and an anterior rotation of the lateral clavicle.&nbsp; With retraction, the medial clavicle articulates with a flat surface and tilts or swings, causing an anterolateral gapping, and a posterior rotation at the lateral end.&nbsp; These movements are usually associated with abduction (protraction) and adduction (retraction) of the scapula, since the scapula is attached to the distal end of the clavicle.<ref>Levangie, P.K. &amp;amp; Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.</ref>  
*'''Protraction and retraction:<ref>Conway, A.M. (1961). Movements at the sternoclavicular and acromioclavicular joints. Phys Ther Rev. 41: 421-432.</ref>''' During protraction, the concave surface of the medial clavicle moves on the convex sternum, producing an anterior glide of the clavicle, and an anterior rotation of the lateral clavicle.&nbsp; With retraction, the medial clavicle articulates with a flat surface and tilts or swings, causing an anterolateral gapping, and a posterior rotation at the lateral end.&nbsp; These movements are usually associated with abduction (protraction) and adduction (retraction) of the scapula, since the scapula is attached to the distal end of the clavicle.<ref>Levangie, P.K. &amp;amp;amp; Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.</ref>  
*'''Elvation and depression:<ref>Brody, L.T.:Shoulder. In: Wadsworth, C.(ed.)(2001). Current concepts of orthopedic physical therapy: Home study course. LaCrosse, WI: Orthopaedic Secion, APTA, Inc.</ref> '''During elevation, the clavicle rotates upward on the manubrium, and produces and inferior glide to maintain joint contact.&nbsp; The reverse actions happen when the clavicle is depressed.&nbsp; The motions are usually associated with elevation and depression of the scapula.
*'''Elvation and depression:<ref>Brody, L.T.:Shoulder. In: Wadsworth, C.(ed.)(2001). Current concepts of orthopedic physical therapy: Home study course. LaCrosse, WI: Orthopaedic Secion, APTA, Inc.</ref> '''During elevation, the clavicle rotates upward on the manubrium, and produces and inferior glide to maintain joint contact.&nbsp; The reverse actions happen when the clavicle is depressed.&nbsp; The motions are usually associated with elevation and depression of the scapula.


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'''Joint Capsule:'''  
'''Joint Capsule:'''  


The SC joint capsule is fairly strong but is dependent on the ligaments noted above for the majority of its support.
The SC joint capsule is fairly strong but is dependent on the ligaments noted above for the majority of its support.  


== Muscles  ==
== Muscles  ==
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There are no muscles that act directly on the SC joint.&nbsp; However, the SC joint motions closely mimic the reciprical motions of the scapula.&nbsp; In addition, the following muscles have an attachment of the clavicle and therefore may produce movement of the clavicle:  
There are no muscles that act directly on the SC joint.&nbsp; However, the SC joint motions closely mimic the reciprical motions of the scapula.&nbsp; In addition, the following muscles have an attachment of the clavicle and therefore may produce movement of the clavicle:  


*[http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/deltoid Deltoid] <br>
*[http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/deltoid Deltoid] <br>  
*[http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/pectoralis-major Pectoralis Major] (Clavicular head)  
*[http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/pectoralis-major Pectoralis Major] (Clavicular head)  
*[http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/trapezius Trapezius]  
*[http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/trapezius Trapezius]  
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== Closed Packed Position  ==
== Closed Packed Position  ==


Maximum shoulder elvation
Maximum shoulder elvation  


== Open Packed Position  ==
== Open Packed Position  ==


Open-packed position of the SC joint is when the arm is resting by the side.
Open-packed position of the SC joint is when the arm is resting by the side.  


== Other Important Information  ==
== Other Important Information  ==


'''Joint Disk:<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref><ref>Levangie, P.K. and Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.</ref> '''The SC joint is surprisingly incongruent, and because of this incongruency a joint disk is present to enhance joint curvature and contact of the joint surfaces.&nbsp;Similar to the meniscus of the knee, the SC joint disk increases joint congruence and acts to absorb foces that may be transmitted along the clavicle. The disk is attached to the upper and perior margin of the the clavicle, and to the cartilage of the first rib, and functions to help prevent medial displacement of the clavicle. This orientation divides the joint into seperate cavities.&nbsp; Greater movement occurs between the disk and the clavicle than between the disk and the manubrium.&nbsp;&nbsp;
'''Joint Disk:<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref><ref>Levangie, P.K. and Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.</ref> '''The SC joint is surprisingly incongruent, and because of this incongruency a joint disk is present to enhance joint curvature and contact of the joint surfaces.&nbsp;Similar to the meniscus of the knee, the SC joint disk increases joint congruence and acts to absorb foces that may be transmitted along the clavicle. The disk is attached to the upper and perior margin of the the clavicle, and to the cartilage of the first rib, and functions to help prevent medial displacement of the clavicle. This orientation divides the joint into seperate cavities.&nbsp; Greater movement occurs between the disk and the clavicle than between the disk and the manubrium.&nbsp;&nbsp;  


== Resources  ==
== Resources  ==
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<references />
<references />
[[Category:Anatomy]]
[[Category:Shoulder]]

Revision as of 16:01, 24 March 2009

File:Grays325.jpg
Anterior view sternoclavicular joint.

Description[edit | edit source]

The sternoclavicular joint (SC joint) is formed from the articulation of the medial aspect of the clavicle and the manubrium of the sternum.  It is one of four joints that compose the shoulder complex.  The SC joint is generally classified as a plane style synovial joint, and has a fibrocartilage joint disk.[1]  The ligamentous reinforcements of this joint are very strong, often resulting a fracture of the clavicle before a dislocation of the SC joint.[2]

Motions Available[edit | edit source]

  • Protraction and retraction:[3] During protraction, the concave surface of the medial clavicle moves on the convex sternum, producing an anterior glide of the clavicle, and an anterior rotation of the lateral clavicle.  With retraction, the medial clavicle articulates with a flat surface and tilts or swings, causing an anterolateral gapping, and a posterior rotation at the lateral end.  These movements are usually associated with abduction (protraction) and adduction (retraction) of the scapula, since the scapula is attached to the distal end of the clavicle.[4]
  • Elvation and depression:[5] During elevation, the clavicle rotates upward on the manubrium, and produces and inferior glide to maintain joint contact.  The reverse actions happen when the clavicle is depressed.  The motions are usually associated with elevation and depression of the scapula.

Ligaments and Joint Capsule[6][7]
[edit | edit source]

Ligaments:

  • Interclavicular: This ligament connects the medial ends of each clavicle with the capsular ligaments and the upper manubrium, which in turn produces a bilateral depression force. This ligament also resists excessive depression or downward glide of the clavicle.
  • Costoclavicular: This ligament connects the first rib on either side to the inferior surface of the clavicle.  This orientation allows this ligamen to act as the primary restraint for the SC joint.  This ligament acts as the fulcrum for elevation-depression and protration-retraction.  The ligament also checks clavicular elevation and superior glide of the clavicle.
  • Anterior Sternoclavicular: This ligament covers the anterior aspect of the joint, running obliquely from the proximal clavicle to the sternum in a downward and medail direction.  This ligament checks anterior movement of the head of the clavicle.
  • Posterior Sternoclavicular:This ligament covers the posterior aspect of the SC joint.  It is weaker than the anterior SC ligament.  This ligament checks posterior movement of the head of the clavicle.

Joint Capsule:

The SC joint capsule is fairly strong but is dependent on the ligaments noted above for the majority of its support.

Muscles[edit | edit source]

There are no muscles that act directly on the SC joint.  However, the SC joint motions closely mimic the reciprical motions of the scapula.  In addition, the following muscles have an attachment of the clavicle and therefore may produce movement of the clavicle:

Closed Packed Position[edit | edit source]

Maximum shoulder elvation

Open Packed Position[edit | edit source]

Open-packed position of the SC joint is when the arm is resting by the side.

Other Important Information[edit | edit source]

Joint Disk:[8][9] The SC joint is surprisingly incongruent, and because of this incongruency a joint disk is present to enhance joint curvature and contact of the joint surfaces. Similar to the meniscus of the knee, the SC joint disk increases joint congruence and acts to absorb foces that may be transmitted along the clavicle. The disk is attached to the upper and perior margin of the the clavicle, and to the cartilage of the first rib, and functions to help prevent medial displacement of the clavicle. This orientation divides the joint into seperate cavities.  Greater movement occurs between the disk and the clavicle than between the disk and the manubrium.  

Resources[edit | edit source]

  • Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  • Levangie, P.K. & Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.

References
[edit | edit source]

  1. ↑ Levangie, P.K. and Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.
  2. ↑ Allman, F.L. (1967). Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg. 49A:774-784.
  3. ↑ Conway, A.M. (1961). Movements at the sternoclavicular and acromioclavicular joints. Phys Ther Rev. 41: 421-432.
  4. ↑ Levangie, P.K. &amp;amp; Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.
  5. ↑ Brody, L.T.:Shoulder. In: Wadsworth, C.(ed.)(2001). Current concepts of orthopedic physical therapy: Home study course. LaCrosse, WI: Orthopaedic Secion, APTA, Inc.
  6. ↑ Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  7. ↑ Levangie, P.K. and Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.
  8. ↑ Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  9. ↑ Levangie, P.K. and Norkin, C.C. (2005). Joint structure and function: A comprehensive analysis (4th ed.). Philadelphia: The F.A. Davis Company.
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