Trapezius

From Wikipedia, the free encyclopedia

Jump to navigationJump to search
Not to be confused with trapezium.
Trapezius
Trapezius.png
The trapezius muscle (plural: trapezei) is a surface muscle of back, shown in red
above and below
Trapezius Gray409.PNG
Details
Origin Medial one-third of superior nuchal line, external occipital
protuberance, spinous processes of vertebrae C7-T12, Nuchal ligament[1]
Insertion posterior border of the lateral one-third of the clavicle, acromion
process, and spine of scapula
Artery superficial branch of transverse cervical artery or superficial
cervical artery [2]
Nerve accessory nerve (motor)
cervical spinal nerves C3 and C4 (motor and sensation)[3]
Actions Rotation, retraction, elevation, and depression of scapula
Antagonist serratus anterior muscle, Latissimus dorsi, Pectoralis Major
Identifiers
Latin Musculus trapezius
TA98 A04.3.01.001
TA2 2226
FMA 9626
Anatomical terms of muscle
[edit on Wikidata]
The trapezius[4] is a large paired trapezoid-shaped surface muscle that extends
longitudinally from the occipital bone to the lower thoracic vertebrae of the spine
and laterally to the spine of the scapula. It moves the scapula and supports the
arm.

The trapezius has three functional parts: an upper (descending) part which supports
the weight of the arm; a middle region (transverse), which retracts the scapula;
and a lower (ascending) part which medially rotates and depresses the scapula.

Contents
1 Name and history
2 Structure
2.1 Innervation
3 Function
3.1 Scapular movements
3.2 Spinal movements
4 Clinical significance
4.1 Palsy
4.2 Facioscapulohumeral muscular dystrophy
4.3 Underdevelopment
5 Society and culture
5.1 Exercises
6 References
7 External links
Name and history
The trapezius muscle resembles a trapezium, also known as a trapezoid, or diamond-
shaped quadrilateral. The word "spinotrapezius" refers to the human trapezius,
although it is not commonly used in modern texts. In other mammals, it refers to a
portion of the analogous muscle. Similarly, the term "tri-axle back plate" was
historically used to describe the trapezius muscle.[citation needed]
Structure

Position of trapezius and its parts.

Superior fibers of the trapezius
Middle fibers of the trapezius
Inferior fibers of the trapezius
The superior or upper (or descending) fibers of the trapezius originate from the
spinous process of C7, the external occipital protuberance, the medial third of the
superior nuchal line of the occipital bone (both in the back of the head), and the
ligamentum nuchae. From this origin they proceed downward and laterally to be
inserted into the posterior border of the lateral third of the clavicle.

The middle fibers, or transverse of the trapezius arise from the spinous process of
the seventh cervical (both in the back of the neck), and the spinous processes of
the first, second, and third thoracic vertebrae. They are inserted into the medial
margin of the acromion, and into the superior lip of the posterior border of the
spine of the scapula.

The inferior or lower (or ascending) fibers of the trapezius arise from the spinous
processes of the remaining thoracic vertebrae (T4–T12). From this origin they
proceed upward and laterally to converge near the scapula and end in an
aponeurosis, which glides over the smooth triangular surface on the medial end of
the spine, to be inserted into a tubercle at the apex of this smooth triangular
surface.

At its occipital origin, the trapezius is connected to the bone by a thin fibrous
lamina, firmly adherent to the skin. The superficial and deep epimysia are
continuous with an investing deep fascia that encircles the neck and also contains
both sternocleidomastoid muscles.

At the middle, the muscle is connected to the spinous processes by a broad semi-
elliptical aponeurosis, which reaches from the sixth cervical to the third thoracic
vertebræ and forms, with that of the opposite muscle, a tendinous ellipse. The rest
of the muscle arises by numerous short tendinous fibers.

It is possible to feel the muscles of the superior trapezius become active by

holding a weight in one hand in front of the body and, with the other hand,
touching the area between the shoulder and the neck.[citation needed]

Images of the trapezius and the bones to which it attaches, with muscular
attachments shown in red

Trapezius muscle.

Occipital bone.

Left clavicle. Superior surface.

Left scapula. Posterior surface.

Innervation
Motor function is supplied by the accessory nerve.[5] Sensation, including pain and
the sense of joint position (proprioception), travel via the ventral rami of the
third (C3) and fourth (C4) cervical spinal nerves.[5] Since it is a muscle of the
upper limb, the trapezius is not innervated by dorsal rami, despite being placed
superficially in the back.

Function
Contraction of the trapezius muscle can have two effects: movement of the scapulae
when the spinal origins are stable, and movement of the spine when the scapulae are
stable.[5] Its main function is to stabilize and move the scapula.[5]

Scapular movements
The upper fibers elevate the scapulae, the middle fibers retract the scapulae, and
the lower fibers depress the scapulae.[5]

In addition to scapular translation, the trapezius induces scapular rotation. The

upper and lower fibers tend to rotate the scapula around the sternoclavicular
articulation so that the acromion and inferior angles move up and the medial border
moves down (upward rotation). The upper and lower fibers work in tandem with
serratus anterior to upwardly rotate the scapulae, and work in opposition to the
levator scapulae and the rhomboids, which effect downward rotation.

An example of trapezius function is an overhead press. When activating together,

the upper and lower fibers also assist the middle fibers (along with other muscles
such as the rhomboids) with scapular retraction/adduction.

The trapezius also assists in abduction of the shoulder above 90 degrees by

rotating the glenoid upward. Injury to cranial nerve XI will cause weakness in
abducting the shoulder above 90 degrees.

Spinal movements
When the scapulae are stable, a co-contraction of both sides can extend the neck.

Clinical significance
Dysfunction of the trapezius can result in winged scapula, sometimes further
specified as "lateral winging"[6] and in an abnormal mobility or function of the
scapula (scapular dyskinesia).[7] There are multiple causes of trapezius
dysfunction.

Palsy
Trapezius palsy, due to damage of the spinal accessory nerve, is characterized by
difficulty with arm adduction and abduction, and associated with a drooping
shoulder, and shoulder and neck pain.[8] Intractable trapezius palsy can be
surgically managed with an Eden-Lange procedure.

Facioscapulohumeral muscular dystrophy

The trapezius muscle is one of the commonly affected muscles in facioscapulohumeral
muscular dystrophy (FSHD). The lower and middle fibers are affected initially, and
the upper fibers are commonly spared until late in the disease.[9]

Underdevelopment
Although rare, underdevelopment or absence of the trapezius has been reported to
correlate to neck pain and poor scapular control that are not responsive to
physical therapy.[10] Absence of the trapezius has been reported in association
with Poland syndrome.[11]

Society and culture

Exercises
The upper portion of the trapezius can be developed by elevating the shoulders.
Common exercises for this movement are any version of the clean, particularly the
hang clean, and the shoulder shrug.
Middle fibers are developed by pulling shoulder blades together. This adduction
also uses the upper/lower fibers. The uppermost area can be trained through neck
extension.
The lower part can be developed by drawing the shoulder blades downward while
keeping the arms almost straight and stiff.