46 THE UPPER EXTREMITY 



The rhomboideus minor is a narrow, ribbon -like fleshy 

 band which runs parallel to the upper border of the major 

 rhomboid. It springs from the lower part of the ligamentum 

 nuchae, the spine of the seventh cervical vertebra, and frequently 

 also from the spine of the first thoracic vertebrae. It is in- 

 serted into the base of the scapula opposite the triangular 

 surface at the root of its spine (Fig. 24, p. 55). It is entirely 

 covered by the trapezius. 



The rhomboideus major arises from the upper four or five 

 thoracic spines, and the corresponding parts of the supraspinous 

 ligaments. Its fibres run obliquely downwards and laterally, 

 and end in a tendinous cord, which receives insertion into the 

 base of the scapula close to the inferior angle. From this 

 point, up to the commencement of the spine, the tendinous 

 cord is firmly bound to the base of the scapula by areolar 

 tissue (Fig. 24, p. 55). The greater part of the rhomboideus 

 major is covered by the trapezius ; only a small portion near 

 the inferior angle of the scapula lies immediately subjacent to 

 the deep fascia. 



M. Levator Scapulas (O.T. Levator Anguli Scapulae). 

 This is an elongated muscle which arises by four more or less 

 tendinous slips from the posterior tubercles of the transverse 

 processes of the upper four cervical vertebrae, and passes 

 downwards and backwards to be inserted into the base 

 of the scapula from the medial angle to the spine. It is 

 supplied by branches from the third and fourth cervical nerves. 



Dissection. In cleaning the levator scapulae muscle care must be 

 taken of the nerves which pass to it from the cervical plexus, and also 

 of the dorsalis scapulae nerve and the descending branch of the transverse 

 cervical artery which lie under cover of it near the base of the scapula. 

 The dissector of the head and neck has an interest in the levator scapulae, 

 and when it has been studied by both dissectors it should be divided midway 

 between its origin and insertion, and the lower portion should be turned 

 laterally. The dorsalis scapulae nerve has already been secured in the 

 interval between the rhomboideus minor and the levator scapulae, and it has 

 still further been exposed by the reflection of the latter muscle. It may now 

 be displayed in its whole length, together with the descending branch of the 

 transverse cervical artery, which it accompanies, by reflecting the rhomboidei 

 muscles. These should be detached from the ligamentum nuchae and 

 the vertebral spines, and be thrown laterally towards the base of the 

 scapula. In doing this care must be taken of the serratus posterior 

 superior, a thin muscle which lies subjacent, and is apt to be injured. 



Nervus Dorsalis Scapulae (O.T. Nerve to the Rhomboids). 

 This is a long slender twig which arises in the neck from the 

 fifth cervical nerve, usually in common with the upper root 



