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Trapezius

Contents

Anatomy

General information

  • This section is strictly limited to anatomy, you might be looking for clinical relevant information which is found under the clinical chapters -- muscles section, click here to go to that page

Position

  • Superficial

Origin

  • Processus spinosi C7-T12
  • Ligamentum nuchae
  • Protuberantia externa occipitale

Insertion

  • Clavicula
    • Lateral 1/3
  • Acromion
  • Spina scapula

Main function

  • Neck
    • Lateral flexion
    • Extension
    • Contralateral rotation
  • Scapula
    • Elevation
    • Retraction
    • Depression

Secondary function

  • Scapula
    • Upward rotation
  • Trunk
    • Extension

Nerve innervation

  • Segmental
    • C2-C4

Arterial supply

  • Transverse cervical artery
  • Dorsal scapular artery

Palpation

  • Patient position
    • Prone
  • The trapezius muscle covers a large area while it is superficial in both the neck and back, so the muscle is easy to palpate
  • Place your hand on top of the upper part of trapezius
  • Ask the patient to abduct the arm while the scapula is pulled backwards (retraction)
  • This causes an upper limitation of trapezius which is easily visible

Muscle length test

  • Patient position
    • Supine
  • Support the patient's head, and move the patient's head into lateral flexion
  • Stabilize the patient's shoulder by fixating the shoulder girdle during the movement

Strength test upper trapezius

  • Patient position
    • Seated
  • Place the patient's head in a posterolateral extension position while the neck is rotated to the contralateral side
  • Have the patient lift the shoulder on the ipsilateral side (same side the head is lateral flexed towards)
  • The therapist places a hand on the shoulder which is elevated and pushes in a caudal direction (depression), while the other hand is placed in a posteromedially on the head and giving force in an anterolateral direction
  • The patient gives counter resistance to maintain the position

Strength test middle trapezius

  • Patient position
    • Prone
  • The scapula is placed in a adducted and upward rotated position (this places the scapulas lower angle in a lateral rotation)
  • Place the patient's arm in 90° abduction and lateral rotation
  • Give resistance towards the patient's lower arm in a caudal direction down towards the floor
  • The patient gives counter resistance to maintain the position

Strength test lower trapezius

  • Patient position
    • Prone
  • The scapula is positioned in adduction and depression, with lateral rotation of the lower part of the scapula
  • The patient's arm is placed in line with the lower fibers of trapezius
  • Give pressure towards the patient's lower arm in a caudal postion down towards the floor