Levator Scapulae

Description

Levator scapulae is a posterior Axio-appenducular muscle that connects the upper limb to the vertebral column and lies in the posterior triangle of the neck. The superior aspect of the levator scapulae is covered by sternocleidomastoid, and its inferior part by trapezius.[1]

Levator scapulae muscle animation small2.gif

Origin

The levator scapulae originates on the posterior tubercle of transverse process of cervical vertebrae 1 to 4.[2]

Insertion

The levator scapulae inserts on to the vertebral margin of the scapula between the superior angle and the root of the spine.[3]

Position

The superior third of the strap-like levator scapulae lies deep to the sternocleidomastoid while the inferior third is deep to the trapezius. From the transverse processes of the upper cervical vertebrae, the fibers of the levator of the scapula pass inferiorly to the superomedial border of the scapula.[1]

Nerve Supply

The levator scapulae is innervated by cervical nerve (C3-C4) and dorsal scapular nerve (C5).[4]
Levator-scapulae.gif

Blood Supply

Descending scapular artery[5]

Function

The levator scapulae functions to elevate the scapula and tilt the glenoid cavity inferiorly by rotating the scapula downward. [6]

If the scapula is fixed, a contraction of the levator scapulae leads to the lateral flexion of the cervical vertebral column to the side and stabilizes the vertebral column during rotation.

Clinical Relevance

Forward head posture puts increased tension on the levator scapulae muscles to co-contract for cervical extension in an elongated position.[7] Increased tightness in the levator scapulae due to increased activity from a forward head posture can lead to cervicogenic headaches.

Assessment

The levator scapulae length and tension can be assessed by placing the patient in supine, stabilizing the ipsilateral scapula, and contralateraly side bend and rotate the head. Also, trigger points are common in this muscle and can be palpated for in both the superior attachment and inferior attachment.

Treatment

Pain or discomfort caused by the levator scapulae can be relieved by various modalities and active movements to provide relief.

References

  1. 1.0 1.1 Keith, L., Arthur, F. and Anne, M. (n.d.). Moore Clinically Oriented Anatomy. 7th ed.
  2. http://www.anatomyexpert.com/structure_detail/5502/
  3. Marieb EN, Hoehn K. Human anatomy & physiology. 10th ed. Boston, Ma: Pearson; 2016.
  4. Gray, Henry. Anatomy of the Human Body. Philadelphia: Lea & Febiger, 1918; Bartleby.com, 2000. www.bartleby.com/107/121.html
  5. Joseph P Iannotti, Richard Parker.fckLRThe Netter Collection of Medical Illustrations: Musculoskeletal System, Volume 6, Part I - Upper Limb. Elsevier Health Sciences. 2012
  6. Paine R, Voight ML. The role of the scapula. International journal of sports physical therapy. 2013 Oct;8(5):617. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811730/ (last accessed 30.1.2020)
  7. Kim E-K, Kim JS. Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture. J Phys Ther Sci [Internet]. 2016 Oct [cited 2018 Jul 4];28(10):2929–32. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088155/