Anatomy Atlas

Rhomboid major and minor

Musculi rhomboidei major et minor
Also: Rhomboids · Dorsal scapular nerve
MuscledraftMSK

Two flat muscles between the upper thoracic spine and the medial border of the scapula that retract the scapula. They are supplied by the dorsal scapular nerve (C5).

Core anatomy

Location

Deep to trapezius, between the vertebral column and the medial border of the scapula.

Group

Superficial extrinsic back muscles (deep to trapezius), with levator scapulae.

Origin

Minor: nuchal ligament and spinous processes of C7–T1. Major: spinous processes of T2–T5.

Insertion

Medial border of the scapula: minor at the level of the scapular spine; major from the spine to the inferior angle.

Innervation

Dorsal scapular nerve (C5, often with C4), from the C5 root of the brachial plexus.

Blood supply

Dorsal scapular artery (or the deep branch of the transverse cervical artery) and posterior intercostal branches.

Action
  • Retract the scapula (squeeze the shoulder blades together)
  • Rotate the glenoid downward; hold the scapula against the thoracic wall
Relations

The dorsal scapular nerve pierces the middle scalene and descends deep to levator scapulae and the rhomboids with the dorsal scapular artery.

Posterior view of the back: trapezius and latissimus dorsi on the left; on the right, trapezius removed to show levator scapulae, rhomboid minor and major and serratus posterior inferior; the lumbar triangle is labelled
On the right of the figure trapezius has been removed to show rhomboid minor and major and levator scapulae.
Henry Vandyke Carter, Gray's Anatomy of the Human Body, 20th ed. (1918), Fig. 409. Source · Public domain (Public domain in the US: published before January 1, 1931 (per Wikimedia Commons))

Clinical correlations

Dorsal scapular nerve injury or entrapment

Mechanism / lesion

Entrapment in the middle scalene, or injury in the neck.

Classic presentation

Aching along the medial border of the scapula, weak retraction, and mild winging of the medial border (less marked than with serratus paralysis).

Interscapular (rhomboid) muscle pain

Mechanism / lesion

Postural strain and overuse. Interscapular pain can also be referred from cervical disease, gallbladder, or thoracic aortic pathology.

Classic presentation

Aching between the shoulder blades with tender trigger points; always consider referred causes.

High-yield PANCE pearls

  • Rhomboids: retraction; dorsal scapular nerve (C5) from the root.
  • Scapular winging: medial (long thoracic/serratus) vs lateral (CN XI/trapezius); rhomboid weakness gives only mild medial-border prominence.

Imaging anatomy

MRI

Muscle atrophy with chronic denervation.

Key views & landmarks
  • EMG for dorsal scapular neuropathy

Physical exam

Surface landmarks

Between the medial borders of the scapulae and the spinous processes of C7–T5.

Strength / function testing

Resisted retraction — hands on hips, the patient pushes the elbows backward against resistance while the examiner palpates the rhomboids medial to the scapula.

Self-quiz

Q1.

Which nerve supplies the rhomboid muscles?

Show answer

B

The dorsal scapular nerve (C5), arising directly from the C5 root, supplies both rhomboids and levator scapulae (with C3–C4).

Q2.

What is the main action of the rhomboids?

Show answer

B

The rhomboids retract the scapula and rotate the glenoid downward. Serratus anterior protracts and upwardly rotates.

Q3.

Rhomboid major attaches to the spinous processes of which vertebrae?

Show answer

C

Rhomboid major arises from T2–T5; rhomboid minor from C7–T1 (and the nuchal ligament).

Flashcards

See also