[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/) › Rhomboid major [Muscular system](https://durgical.com/en/anatomy/system/muscular-system/) · [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/) # Rhomboid major The rhomboid major is a flat muscle between the upper [spine](https://durgical.com/en/anatomy/region/spine/) and the inner edge of the shoulder blade; it pulls the shoulder blade toward the spine. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=upper_limb&select=rhomboid_major&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A flat muscle from the upper back spine to the inner edge of the shoulder blade. ## What it does Pulls the shoulder blade toward the spine. ## Key points - The dorsal scapular nerve (C5) and artery run on its deep surface, along the medial border of the scapula, after supplying the [levator scapulae](https://durgical.com/en/anatomy/levator-scapulae/) - The dorsal scapular nerve comes straight off the C5 root: rhomboid weakness in a [brachial plexus](https://durgical.com/en/anatomy/roots-of-brachial-plexus/) injury means a lesion close to the [spinal cord](https://durgical.com/en/anatomy/spinal-cord/) - With the medial border of the scapula it forms the lateral side of the triangle of auscultation ## Key facts **Origin** Spinous processes T2–T5 **Insertion** Medial border of the scapula below the spine **Action** Retracts the scapula, rotates the glenoid down **Nerve** Dorsal scapular nerve (C4–C5) **Blood supply** Dorsal scapular artery ## Relations **Superficial** [Middle trapezius](https://durgical.com/en/anatomy/trapezius-middle-part/) and [lower trapezius](https://durgical.com/en/anatomy/trapezius-lower-part/) **Deep** [Serratus posterior](https://durgical.com/en/anatomy/serratus-posterior-superior-muscle/) superior, the erector spinae and the posterior [ribs](https://durgical.com/en/anatomy/ribs/); the [dorsal scapular nerve](https://durgical.com/en/anatomy/dorsal-scapular-nerve/) and artery near the [scapula](https://durgical.com/en/anatomy/scapula/) **Above** [Rhomboid minor](https://durgical.com/en/anatomy/rhomboid-minor/), often separated only by a thin fascial cleft **Below** [Latissimus dorsi](https://durgical.com/en/anatomy/latissimus-dorsi-muscle/); the triangle of auscultation opens at its lower lateral corner ## How to find it With the back of the hand resting on the lower back, pushing the hand away from the back against resistance makes the [rhomboids](https://durgical.com/en/anatomy/rhomboid-major-muscle/) contract under the [trapezius](https://durgical.com/en/anatomy/trapezius-muscle/), felt as an oblique band along the medial border of the scapula. ## Examination - Rhomboid test (hand on the lower back, pushing backward against resistance): weakness, with the medial border of the scapula drifting away from the spine, points to the dorsal scapular nerve or the C5 root ## On imaging Axial CT or MRI shows it deep to the trapezius, between the spinous processes and the medial border of the scapula. Imaging is seldom needed: MRI shows a strain as oedema, and atrophy points to dorsal scapular nerve injury. Ultrasound shows it as the layer between the trapezius and the ribs along the medial border of the scapula. ## Clinical notes - The dorsal scapular nerve pierces the middle scalene; compression there causes aching between the shoulder blades and mild winging - In brachial plexus injury, normal rhomboids and [serratus anterior](https://durgical.com/en/anatomy/serratus-anterior/) suggest the roots are intact close to the spinal cord, which matters when nerve repair or transfer is planned - Isolated rhomboid palsy is rare and gives subtle winging, easy to miss beside the more obvious serratus anterior and trapezius patterns ## Anatomical variants - The two rhomboids are sometimes fused into one sheet; rarely an extra rhomboid muscle is found ## Development Like the levator scapulae and serratus anterior, the rhomboids arise from premuscle tissue at lower cervical levels and migrate onto the back, keeping their cervical nerve, the dorsal scapular nerve (C5). ## Related conditions - [Winged scapula](https://durgical.com/en/conditions/winged-scapula/) ## Test yourself Think of the answer, then tap the question to see it. ## What nerve supplies the rhomboid major, and where does it run? The dorsal scapular nerve (C5), with its artery, on the deep surface of the muscle along the medial border of the scapula. ## In a brachial plexus injury, what does rhomboid major weakness mean? A lesion close to the spinal cord, because the dorsal scapular nerve comes straight off the C5 root. ## Where can the dorsal scapular nerve be compressed, and with what symptoms? Where it pierces the middle scalene; aching between the shoulder blades and mild winging. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/rhomboid-major/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** musculus rhomboideus major TA2 2232 **Official Spanish (DeCS)** Músculo romboides mayor **English (TA2)** Rhomboid major ## Related - [Dorsal scapular nerve](https://durgical.com/en/anatomy/dorsal-scapular-nerve/) - [Scapula](https://durgical.com/en/anatomy/scapula/) Sources: Terminologia Anatomica (TA2); [Anatomy, Back, Rhomboid Muscles](https://www.ncbi.nlm.nih.gov/books/NBK534856/); Anatomy of the Human Body (20th ed.): Development of the Muscles (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/rhomboid-major/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/rhomboid-major/