What muscle group lies directly superior to the scapula?

Muscle Group Superior to the Scapula

The trapezius (upper fibers) and levator scapulae muscles constitute the primary muscle group located directly superior to the scapula.

Anatomical Organization

The muscles superior to the scapula are organized in distinct layers:

Superficial Layer

• The trapezius muscle forms the most superficial layer above the scapula, with its descending (upper) fibers originating from the occipital bone and cervical vertebrae and inserting onto the lateral third of the clavicle and acromion 1
• When the trapezius is reflected, a prominent triangular area of white connective tissue is revealed, which varies in mass between individuals 2

Intermediate Layer

• The levator scapulae muscle lies deep to the trapezius and attaches to the superior angle and upper medial border of the scapula 1
• The levator scapulae inserts via a double fold at the scapular end, with the posterior fold attaching to the dorsal surface of the medial border opposite the supraspinous fossa 3
• The rhomboid minor muscle is anatomically and functionally united with the levator scapulae through interconnecting connective tissue containing fat, forming a unified functional entity 2
• The rhomboid minor attaches at the root of the spine of the scapula, with its posterior fold on the dorsal surface and anterior flap on the costal surface 3

Functional Synergy

• The upper trapezius and levator scapulae act synergistically during shoulder elevation, working together to elevate the scapula and control its descent back to the resting position 4
• During shoulder retraction and protraction, these muscles remain relatively inactive 4
• The unified levator scapulae-rhomboid minor complex connects cranially to the splenius capitis at the midline and caudally overlaps with the rhomboid major dorsally 2

Clinical Relevance

• Pain over the superior angle of the scapula is a common musculoskeletal complaint that often radiates to the neck, head, and shoulder, and may be explained by tension on the unified levator scapulae-rhomboid minor entity 2
• The scapulotrapezial bursa is located between the superomedial scapula and the overlying trapezius, positioned approximately 2.7 cm lateral to the superomedial angle 1
• Understanding the fascial connections and unified nature of the levator scapulae and rhomboid minor may help explain idiopathic superior scapular pain patterns and guide treatment approaches 2