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The levator scapulae muscle is a large, slender muscle situated in the upper back and neck. It is responsible for elevating the scapula, or shoulder blade, and plays a crucial role in scapular motion. The levator scapulae works in conjunction with other muscles such as the trapezius, rhomboids, and pectoralis minor to produce downward rotation of the scapula and stabilize the spine. This muscle group is essential for maintaining proper shoulder and neck function, allowing for a wide range of motions and providing stability during various activities.
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What You'll Learn
The levator scapulae muscle
The levator scapulae is a long and slender muscle that is part of the superficial layer of extrinsic muscles of the back. It is located in the posterior triangle of the neck, forming part of the floor along with the splenius, scalenus, and anterior scalene muscles. The superior aspect of the levator scapulae is covered by the sternocleidomastoid muscle, while its inferior part is covered by the trapezius muscle.
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Rhomboid major and minor muscles
The rhomboid muscles, often simply called the rhomboids, are rhombus-shaped muscles associated with the scapula. There are two rhomboid muscles on each side of the upper back: the rhomboid major and the rhomboid minor. These muscles are localised on the second layers of muscles of the shoulder girdle, underneath the trapezius muscle. Their main actions are scapula adduction, elevation, and rotation.
The rhomboid major muscle connects the superior medial margin of the scapula with the cervical and thorax tract of the spine. It is innervated by the dorsal scapular nerve (C4-C5). The rhomboid minor muscle plays a crucial role in the movement and stability of the scapula. It connects the superior medial margin of the scapula with the cervical and thorax tract of the spine. The rhomboid minor muscle is also innervated by the dorsal scapular nerve (C4-C5).
Both the rhomboid major and minor muscles are essential for activities like pulling movements, such as rowing or pulling a heavy object towards you. They are also involved in pushing movements, such as push-ups and press-ups, which require scapula stabilization, elevation, and rotation. These muscles work in coordination with other muscles of the upper back and shoulder to facilitate proper shoulder movement and stability.
The most common sports injuries of the rhomboid major and minor muscles are caused by repetitive movement or overuse of the shoulder girdle and arms. Poor posture could also be a cause of rhomboid muscle injury, as it can place constant stress on these muscles.
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Serratus anterior and serratus posterior superior and inferior muscles
The serratus anterior is a fan-shaped muscle that originates on the superolateral surfaces of the first to eighth or ninth ribs at the lateral wall of the thorax. Its main part lies deep under the scapula and the pectoral muscles. It acts on the scapula and is the prime mover in both scapular protraction and scapular upward rotation. It is a key scapular stabiliser, keeping the shoulder blades against the ribcage when at rest and during movement. The serratus anterior is also known as the "boxer's muscle", as it is largely responsible for protracting the scapula during punching. It is also an accessory inspiratory muscle, lifting the ribcage and supporting breathing.
The serratus posterior muscle is an intermediate layer of back muscles, consisting of the serratus posterior superior and serratus posterior inferior. The serratus posterior superior originates from the C7-T3 vertebrae spinous process and nuchal ligament, inserting at the upper border of the 2nd-5th ribs. It is an accessory muscle of inspiration, elevating the ribs during inhalation. The serratus posterior inferior originates from the T11-L2 vertebrae spinous process, inserting at the lower border of the 9th-12th ribs. It is an accessory muscle of expiration, depressing the ribs during exhalation.
The serratus posterior superior is located superficial to the thoracic part of the thoracolumbar fascia covering the splenius cervicis. It lies deep to the rhomboids and the trapezius muscle. The serratus posterior inferior lies superficial to the erector spinae muscle group and the thoracolumbar fascia and deep to the latissimus dorsi muscle. It is pierced by the lateral branches of the T7-T12 spinal thoracic nerves.
Both the serratus posterior superior and serratus posterior inferior may contribute to myofascial pain syndrome, particularly in the shoulder. This pain may be caused by improper posture or inappropriate use of the muscle, such as holding a phone between the ear and shoulder, which can also lead to scapulocostal syndrome. This condition is characterised by pain and paresthesia along the medial border of the scapula, radiating to the neck, chest, and upper extremities.
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Trapezius and latissimus dorsi muscles
The trapezius and latissimus dorsi muscles are both involved in scapular motion. The trapezius muscle is a large, superficial back muscle that resembles a trapezoid. It has three fibre groups: upper, middle, and lower. The upper fibres of the trapezius muscle elevate and upwardly rotate the scapula, while the middle fibres adduct the scapula, and the lower fibres depress it and aid the upper fibres in upward rotation. The trapezius muscle is innervated by the spinal accessory nerve (cranial nerve XI).
The latissimus dorsi muscle is a broad, flat muscle that covers most of the lower posterior thorax and stretches to the sides, behind the arm. It is partly covered by the trapezius muscle. The name "latissimus dorsi" comes from Latin and means "broadest of the back". The muscle pulls the inferior angle of the scapula in various directions, producing movements on the shoulder joint, including internal rotation, adduction, and extension of the arm. The latissimus dorsi is also considered a respiratory accessory muscle, active during deep inspiration and forceful respiratory functions like coughing and sneezing.
The trapezius and latissimus dorsi muscles work together with other muscles to produce a full range of motion in the scapula and shoulder. For example, the latissimus dorsi works with the teres major and pectoralis major muscles to produce smooth and fluid movements in the upper extremities. Similarly, the trapezius muscle works with the deltoid muscle to enable the scapula to rotate against the levator scapulae and the rhomboid muscles, which is essential for throwing objects.
Both the trapezius and latissimus dorsi muscles can be trained and strengthened through various exercises. For example, exercises for the latissimus dorsi, or "lats", often involve elbow flexion and recruit the biceps brachii, brachialis, and brachioradialis. Exercises that recruit the trapezius muscles include horizontal pulling movements such as rows, which also heavily recruit the latissimus dorsi.
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Pectoralis major and minor muscles
The pectoral region is located on the anterior chest wall and contains four muscles that exert a force on the upper limb: the pectoralis major, pectoralis minor, serratus anterior, and subclavius. The pectoralis major is the most superficial muscle in the pectoral region. It is a powerful adductor of the arm and assists in internal rotation and flexion at the shoulder joint. It is composed of a sternal head and a clavicular head. The sternal head originates from the anterior surface of the sternum, the superior six costal cartilages, and the aponeurosis of the external oblique muscle. The clavicular head originates from the anterior surface of the medial clavicle.
The pectoralis minor lies underneath the pectoralis major. It originates from the 3rd to 5th ribs and inserts into the coracoid process of the scapula. The pectoralis minor stabilizes the scapula by drawing it anteroinferiorly against the thoracic wall. It is innervated by the medial pectoral nerve. The serratus anterior is located more laterally in the chest wall and forms the medial border of the axilla region. It consists of several strips that originate from the lateral aspects of ribs 1 to 8 and attach to the costal surface of the medial border of the scapula. The serratus anterior rotates the scapula, allowing the arm to be raised over 90 degrees.
The subclavius is a small muscle located directly underneath the clavicle, running horizontally. It originates from the junction of the 1st rib and its costal cartilage and inserts onto the inferior surface of the middle third of the clavicle. The subclavius anchors and depresses the clavicle and affords some minor protection to the underlying neurovascular structures. It is innervated by the nerve to the subclavius.
Understanding the anatomy of the pectoral region is important for various medical procedures, such as reconstructive breast surgery, and for diagnosing and treating injuries related to these muscles.
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Frequently asked questions
The main function of the levator scapulae muscle is to elevate the scapula, or shoulder blade.
'Levator scapulae' means 'to raise the shoulder' in Latin.
The levator scapulae is a large, superficial muscle located at the back and side of the neck.
The levator scapulae muscle also helps in retracting the shoulder girdle, stabilising the spine, and rotating the glenoid cavity.
The levator scapulae muscle works in conjunction with the trapezius, latissimus dorsi, rhomboids, pectoralis major and pectoralis minor muscles.
