{"id":3887,"date":"2021-01-16T23:58:13","date_gmt":"2021-01-16T22:58:13","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/upper-limb\/shoulder\/axio-appendicular-muscles\/posterior-axio-appendicular-muscles\/"},"modified":"2021-02-09T09:19:49","modified_gmt":"2021-02-09T08:19:49","slug":"posterior-axio-appendicular-muscles","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/upper-limb\/shoulder\/axio-appendicular-muscles\/posterior-axio-appendicular-muscles\/","title":{"rendered":"Posterior axio-appendicular muscles"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><div class=\"intro\">The posterior axio-appendicular muscles consist of the extrinsic muscles of the back along with the muscles of the shoulder.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This group can be divided into the <strong>superficial posterior axio-appendicular muscles<\/strong>, <strong>deep posterior axio-appendicular muscles<\/strong>, and the <strong>scapulohumeral muscles<\/strong>.<\/div><\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" id=\"Superficial_posterior_axio-appendicular_muscles\" class=\"wp-block-heading\" id=\"Superficial_posterior_axio-appendicular_muscles\" class=\"title_collection title1\">Superficial posterior axio-appendicular muscles<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">The superficial posterior axio-appendicular muscles are the superficial part of the extrinsic shoulder muscles. They include the&nbsp;<strong>trapezius&nbsp;<\/strong>and&nbsp;<strong>latissimus dorsi muscles<\/strong>.<\/p>\n\n\n\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/superficial-back-1024x778.png\" alt=\"\" class=\"wp-image-3881\" width=\"580\" height=\"440\" srcset=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/superficial-back-1024x778.png 1024w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/superficial-back-300x228.png 300w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/superficial-back-768x584.png 768w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/superficial-back.png 1216w\" sizes=\"auto, (max-width: 580px) 100vw, 580px\" \/><figcaption><strong>Superficial posterior axio-appendicular muscles<\/strong>&nbsp;(Credit: OpenStax, CC BY-SA 4.0)<\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" id=\"Trapezius\" class=\"wp-block-heading\" id=\"Trapezius\" class=\"title_collection title2\">Trapezius<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">The trapezius is a large, paired, triangular muscle extending from the neck to the shoulders and lower thorax, providing a direct attachment of the pectoral girdle to the trunk.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Its fibers are divided into three parts, each differs in actions at the physiological scapulothoracic joint between the scapula and thoracic wall:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Descending&nbsp;(superior)&nbsp;fibers&nbsp;<\/strong>elevate the scapula (e.g., when squaring the shoulders).<\/li><li><strong>Middle fibers<\/strong>&nbsp;or when all parts work together: retract the scapula (i.e., pull it posteriorly).<\/li><li><strong>Ascending&nbsp;(inferior)&nbsp;fibers&nbsp;<\/strong>depress the scapula and lower the shoulder.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The left and right trapezius muscles together form a diamond or trapezoid shape, from which the name is derived.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The proximal attachment is the skull and vertebrae:<ul><li>The medial third of the superior nuchal line and the external occipital protuberance<\/li><li>C1-C8: attaches to the vertebrae through the nuchal ligament<\/li><li>C7\u2013T12: attaches to the spinous processes of vertebrae<\/li><\/ul><\/li><li>The distal attachment is the clavicle and scapula:<ul><li>Lateral third of the clavicle<\/li><li>Acromion and spine of the scapula<\/li><\/ul><\/li><li>The trapezius is a powerful elevator of the shoulder, it also rotates the scapula and pulls it posteriorly and superiorly (knowing the action of each of the three parts of the trapezius is a must; see above).<\/li><li>It is innervated by the spinal accessory nerve and the anterior rami of C3 cervical nerve.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius.png\" target=\"_blank\" title=\"Posterior axio-appendicular muscles\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius-1024x1024.png\" alt=\"\" class=\"wp-image-3877\" srcset=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius-1024x1024.png 1024w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius-300x300.png 300w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius-150x150.png 150w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius-768x768.png 768w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius-1536x1536.png 1536w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius-50x50.png 50w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/01\/trapezius.png 1600w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/a><figcaption><strong>The parts of the trapezius muscle<\/strong>&nbsp;(Credit: Anatomography, CC BY-SA 2.1)<\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" id=\"Latissimus_dorsi\" class=\"wp-block-heading\" id=\"Latissimus_dorsi\" class=\"title_collection title2\">Latissimus dorsi<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">The latissimus dorsi (from Latin: the widest of the back) is a large, fan-shaped muscle that extends from the trunk to the humerus, acting directly on the glenohumeral joint and indirectly on the pectoral girdle (scapulothoracic joint).<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The proximal attachment points are along the vertebrae, pelvis, and lower ribs:<ul><li>T6-T12: Spinous processes<\/li><li>Thoracolumbar fascia<\/li><li>Iliac crest<\/li><li>3-4 lower ribs<\/li><\/ul><\/li><li>The distal attachment is the intertubercular sulcus of the humerus.<\/li><li>The latissimus dorsi acts on the humerus (extension, retraction, and medial rotation), and together with the pectoralis major it adducts the humerus (having an important role in downward rotation of the scapula) and restores the upper limb from abduction superior to the shoulder (e.g., due ing climbing).<\/li><li>It is innervated by the thoracodorsal nerve (a branch of the posterior cord of the brachial plexus).<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h3 class=\"wp-block-heading\" id=\"Deep_posterior_axio-appendicular_muscles\" class=\"wp-block-heading\" id=\"Deep_posterior_axio-appendicular_muscles\" class=\"title_collection title1\">Deep posterior axio-appendicular muscles<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">The deep posterior axio-appendicular muscles are the deep part of the extrinsic shoulder muscles. They include the&nbsp;<strong>levator scapulae&nbsp;<\/strong>and<strong>&nbsp;rhomboid<\/strong>&nbsp;<strong>muscles<\/strong>.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" id=\"Levator_scapulae\" class=\"wp-block-heading\" id=\"Levator_scapulae\" class=\"title_collection title2\">Levator scapulae<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">The levator scapulae is a long and thin muscle spanning between the upper cervical vertebrae and the scapula. Its superior third lies deep to the sternocleidomastoid, while its inferior third lies deep to the trapezius.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Proximal attachment: Transverse process of C1-C4 (posterior tubercle)<\/li><li>Distal attachment: Above the root of the scapular spine (medial border)<\/li><li>Together with the descending part of the trapezius, the levator scapulae elevates the scapula (as its name suggests) and fixes it (resists depressing forces such as when carrying a load).<\/li><li>Together with rhomboids and pectoralis minor, the levator scapulae rotates the scapula, depressing the glenoid cavity (tilting it inferiorly by rotation of the scapula). It may also act bilaterally (also with the trapezius) to extend the neck, and unilaterally to contribute to the lateral neck flexion.<\/li><li>It is innervated by the dorsal scapular nerve and directly from C3 and C4 spinal nerves.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" id=\"Rhomboid_muscles\" class=\"wp-block-heading\" id=\"Rhomboid_muscles\" class=\"title_collection title2\">Rhomboid muscles<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">The rhomboid muscles (or simply rhomboids) are two pairs of rhombus-shaped muscles spanning between the scapula and the vertebral column. Each side consists of a superior&nbsp;<strong>rhomboid minor&nbsp;<\/strong>and an inferior&nbsp;<strong>rhomboid major<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Proximal attachment:<ul><li>Nuchal ligament and spinous processes of C7-T1 (minor)<\/li><li>T2-T5: spinous processes (major)<\/li><\/ul><\/li><li>Distal attachment:<ul><li>Medial end of the scapular spine (minor)<\/li><li>Medial border of the scapula between the spine and the inferior angle (major)<\/li><\/ul><\/li><li>Retract and rotate the scapula, depressing the glenoid cavity, and assist the serratus anterior in holding the scapula against the thoracic wall, fixing it during movements of the upper extremity.<\/li><li>They are innervated by the dorsal scapular nerve, a branch of the brachial plexus (C4, and mostly C5).<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Scapulohumeral muscles<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">The scapulohumeral muscle group (also known as the <strong>intrinsic shoulder muscles<\/strong>) is composed of six muscles that span between the scapula and humerus:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Deltoid<\/li><li>Teres major<\/li><li>Supraspinatus<\/li><li>Infraspinatus<\/li><li>Teres minor<\/li><li>Subscapularis<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Four of the scapulohumeral muscles (supraspinatus, infraspinatus, teres minor, and subscapularis; the <strong>SITS muscles<\/strong>) are known as the <strong>rotatory cuff muscles<\/strong> as they form a musculotendinous rotator cuff around the glenohumeral joint.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Deltoid<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n\n<p class=\"wp-block-paragraph\">The deltoid is a&nbsp;large, triangular muscle that forms the majority of the bulk of the shoulder. Its base attaches to the scapula, while the apex attaches to the humerus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It can be divided into three parts:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Unipennate anterior (clavicular) part<\/strong><\/li><li><strong>Unipennate posterior (spinal) part<\/strong><\/li><li><strong>Multipennate middle (acromial) part<\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The different parts can act separately or as a single entity.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Origin:<ul><li>Lateral third of the clavicle<\/li><li>Scapula (acromion and spine)<\/li><\/ul><\/li><li>Inserts on the deltoid tuberosity of the humerus.<\/li><li>Actions:<ul><li>Abduction of the arm (middle\/acromial part) or when all 3 parts contract simultaneously.<\/li><\/ul><ul><li>The anterior and posterior parts act to steady the arm as it is abducted, as well as swinging the arm during walking.<\/li><\/ul><ul><li>The anterior part assists the pectoralis major in flexing and medially rotating the arm.<\/li><li>The posterior part assists the latissimus dorsi in extending and laterally rotating the arm.<\/li><li>In full arm adduction: stabilization of the glenohumeral joint, holding the head of the humerus in the glenoid cavity during movements of the upper limb (i.e., prevents inferior displacement of the head of the humerus from the cavity during heavy lifting).<\/li><\/ul><\/li><li>The deltoid is most effective after the initial 15\u00b0 of abduction (by contraction of the supraspinatus or arm movement by the influence of gravity).<\/li><li>It is innervated by the axillary nerve (a branch of the posterior cord of the brachial plexus).<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Teres major<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<p class=\"wp-block-paragraph\">The teres major is a thick, rounded, broad cord-like muscle running from the posterior surface of the scapula and the anterior humerus. Its inferior margin forms the inferior border of the lateral part of the posterior wall of the axilla.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Originates from a large oval region on the posterior surface of the inferior angle of the scapula.<\/li><li>Inserts as a flat tendon attaching the crest of lesser tubercle of the intertubercular sulcus on the anterior surface of the humerus.<\/li><li>The teres major abducts the arm and rotates it medially.<\/li><li>It is innervated by the lower subscapular nerve (a branch of the posterior cord of the brachial plexus).<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Supraspinatus<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<p class=\"wp-block-paragraph\">The supraspinatus resides in the supraspinous fossa of the scapula; its tendon pass under the acromion, where it is separated from the bone by a subacromial bursa, passes over the glenohumeral joint, and inserts on the superior facet of the greater tubercle.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Originates from the supraspinatus fossa of the scapula<\/li><li>Inserts onto the greater tubercle of the humerus (superior facet)<\/li><li>The supraspinatus is one of the rotator cuff muscles, contributing to the abduction of the arm together with the deltoid.<\/li><li>It is innervated by the suprascapular nerve (a branch of the superior trunk of the brachial plexus).<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Infraspinatus<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<p class=\"wp-block-paragraph\">The infraspinatus occupies the medial three-quarters of the infraspinatous fossa and is in part covered by the deltoid and trapezius. Its tendon passes posterior to the glenohumeral joint to insert on the middle facet of the greater tubercle.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Originates from the supraspinatus fossa of the scapula<\/li><li>Inserts onto the greater tubercle of the humerus (middle facet)<\/li><li>The infraspinatus is one of the rotator cuff muscles, contributing to the lateral rotation of the arm.<\/li><li>It is innervated by the suprascapular nerve.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_12\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Teres minor<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_12\">\n\n\n<p class=\"wp-block-paragraph\">The teres minor muscle is a narrow, elongate, cord-like muscle, covered entirely by the deltoid.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Originates from the lateral border of the scapula (middle part).<\/li><li>Inserts onto the greater tubercle of the humerus (inferior facet).<\/li><li>The teres major is one of the rotator cuff muscles, contributing to the lateral rotation of the arm.<\/li><li>It is innervated by the axillary nerve (a terminal branch of the brachial plexus).<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_13\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Subscapularis<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_13\">\n\n\n<p class=\"wp-block-paragraph\">The subscapularis is a thick, triangular muscle that lies on the costal surface of the scapula, and forms the largest component of the posterior wall of the axilla.<\/p>\n\n\n\n<ul class=\"wp-block-list\" id=\"block-331859b1-4197-4f4d-beb2-6f53593b06db\"><li>Originates from the subscapular fossa of the scapula.<\/li><li>Inserts onto the lesser tubercle of the humerus.<\/li><li>The subscapularis is one of the rotator cuff muscles, contributing to the medial rotation of the arm and the stabilization of the glenohumeral joint.<\/li><li>It is innervated by the upper and lower subscapular nerves.<\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" id=\"Superficial_posterior_axio-appendicular_muscles\" class=\"wp-block-heading\" id=\"Superficial_posterior_axio-appendicular_muscles\">Superficial posterior axio-appendicular muscles<\/h3><h4 class=\"wp-block-heading\" id=\"Trapezius\" class=\"wp-block-heading\" id=\"Trapezius\">Trapezius<\/h4><h4 class=\"wp-block-heading\" id=\"Latissimus_dorsi\" class=\"wp-block-heading\" id=\"Latissimus_dorsi\">Latissimus dorsi<\/h4><h3 class=\"wp-block-heading\" id=\"Deep_posterior_axio-appendicular_muscles\" class=\"wp-block-heading\" id=\"Deep_posterior_axio-appendicular_muscles\">Deep posterior axio-appendicular muscles<\/h3><h4 class=\"wp-block-heading\" id=\"Levator_scapulae\" class=\"wp-block-heading\" id=\"Levator_scapulae\">Levator scapulae<\/h4><h4 class=\"wp-block-heading\" id=\"Rhomboid_muscles\" class=\"wp-block-heading\" id=\"Rhomboid_muscles\">Rhomboid muscles<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Scapulohumeral muscles<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Deltoid<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Teres major<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Supraspinatus<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Infraspinatus<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Teres minor<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Subscapularis<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Superficial posterior axio-appendicular muscles The superficial posterior axio-appendicular muscles are the superficial part of the extrinsic shoulder muscles. They include the&nbsp;trapezius&nbsp;and&nbsp;latissimus dorsi muscles. Trapezius The trapezius is a large, paired, triangular muscle extending from the neck to the shoulders and lower thorax, providing a direct attachment of the pectoral girdle to the trunk. Its fibers [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3590,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3887","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Posterior axio-appendicular muscles &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/upper-limb\/shoulder\/axio-appendicular-muscles\/posterior-axio-appendicular-muscles\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/upper-limb\\\/shoulder\\\/axio-appendicular-muscles\\\/posterior-axio-appendicular-muscles\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/upper-limb\\\/shoulder\\\/axio-appendicular-muscles\\\/posterior-axio-appendicular-muscles\\\/\",\"name\":\"Posterior axio-appendicular muscles &#8211; 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