322 



THE AKTICULATIONS OE JOINTS. 



accessory structure, the ligamentum coracohumerale (Fig. 302). By its proximal 

 end, which is situated immediately above the glenoid cavity, but subjacent to the 

 coraco-acromial ligament, it is attached to the lateral border of the root of the 

 coracoid process, while its distal end is attached to the humeral neck close to the 

 greater tubercle. This ligament forms a flattened band, having its posterior and 

 inferior border fused with the articular capsule, but its anterior and superior margin 

 presents a free edge, slightly raised above the level of the capsule. This structure 

 is believed to represent that portion of the pectoralis minor to which reference 

 has already been made in connexion with the coraco-acromial ligament (p. 320). 



The coraco-glenoid ligament is another accessory structure, which is not always present. It 

 springs from the coracoid process along with the former ligament, and extends to the superior 

 and posterior margin of the head of the scapula. 



Gleno-humeral Ligaments (Fig. 303). If the articular capsule is opened from behind, and the 

 head of the humerus removed, it will be seen that the longitudinal fibres of the anterior part 

 of the fibrous stratum are specially developed in the form of thick flattened bands which extend 

 from the anterior border of the glenoid cavity to the anterior aspect of the neck of the humerus. 

 These gleno -humeral ligaments are three in number, and occupy the following positions : the 



Coraco- ^ Conoid 

 clavicular ^Trapezoid 

 ligament J 

 Coraco-acromial ligament S^""" ^-^ 



Coracoid process 



Superior gleno- 

 humeral ligament 



Acromio- 

 clavicular 

 ligament 



Bursal perforation in 

 articular capsule 



Inferior gleno- 

 humeral ligament 



Glenoid cavity 



Capsule of 

 ' ' ftfff shoulder-joint 



m 



\ La brum 

 glenoidale 



FIG. 303. CAPSULAR LIGAMENT OP SHOULDER- JOINT CUT ACROSS AND HUMERUS REMOVED. 



superior is placed above the aperture in the front of the capsule ; the middle and inferior on th< 

 antero-inferior aspect of the capsule, and below the aperture mentioned. 



The superior gleno-humeral ligament, which some believe to represent the ligamentum tei 

 of the hip-joint, springs, along with the middle gleno-humeral band, from the superior part < 

 the cavity. The inferior ligament is the strongest of the three, and springs from the inferio : 

 part of the anterior margin of the glenoid. 



Intra-capsular Structures. 1. The labrum glenoidale, already described. 

 The long tendon of the biceps passes laterally from its attachment to the apex 

 the glenoid cavity and the adjoining part of the labrum glenoidale, above the h( 

 and neck of the humerus, to escape from the interior of the capsule by the openinj 

 between the tubercles of the humerus, subjacent to the transverse humeral ligament 



A synovial stratum (Fig. 304) lines the fibrous stratum of the capsule, and e: 

 tends from the margin of the glenoid cavity to the humeral attachments of the fibroi 

 stratum, where it is reflected towards the margin of the articular cartilage. It i 

 therefore important to note that the inferior aspect of the humeral neck has tl 

 most extensive clothing of the synovial stratum. Further, the synovial strati 

 envelops the intra-capsular part of the tendon of the biceps, and although tl 

 tubular sheath is prolonged upon the tendon into the proximal part of 



