The Upper Extremity 391
major appears to assist with extension (hyperextension) and adduction, even when resistance is not
present (Hamilton and Luttgens, 2002).
Palpation: Use the same movement as with the latissimus dorsi, only with the fingertips of your right
hand placed just lateral to the inferior angle of the scapula. You can feel the teres major contracting
under your right hand when you press down firmly with your left hand (shoulder extension).
Summary of Attachments and Actions
of the Muscles of the Shoulder Complex
A summary of the proximal and distal attachments of the muscles of the shoulder complex—the
scapular muscles, rotator cuff, and other glenohumeral muscles—is provided in table 7.2. Many of
these muscles and their attachments are shown in figures 7.17, A and B, and 7.18, A and B. From
these resources, deduce the line of pull and resultant possible actions of these muscles, and then
check for accuracy by referring to figures 7.17C and 7.18C for the larger muscles responsible for the
fundamental movements of the shoulder joint (e.g., “other glenohumeral muscles” category) and the
primary action(s) column in table 7.2 for the scapular muscles and rotator cuff muscles. Note that
figures 7.17 and 7.18 include the biceps brachii muscles and triceps brachii muscles to show their
relationship to the glenohumeral joint. However, they are discussed later in this chapter with the elbow,
and their attachments and actions are provided in table 7.6 (p. 420).
Attachments and Primary Actions of Teres Major
Muscle Proximal attachment(s) Distal attachment(s) Primary action(s)
Teres major
(TE-reez MAY-jer)
Inferior angle of scapula Medial lip of intertubercular
groove
Shoulder extension
Shoulder adduction
Shoulder horizontal abduction
Shoulder internal rotation
(Depression of humerus)
TABLE 7.2 Summary of Attachments and Primary Actions of the Muscles of the Shoulder Complex
Muscle Proximal attachment(s) Distal attachment(s) Primary action(s)
Scapular muscles
Trapezius
(trah-PEE-zee-us)
Base of skull
Ligament of neck
C7-T12 spinous processes
Outer third of clavicle
Upper acromion
Upper spine of scapula
Upper: Scapular elevation
Scapular upward rotation
Scapular adduction
Middle: Scapular adduction
Lower: Scapular depression
Scapular upward rotation
Scapular adduction
Levator scapulae
(le-VA-tor SKAP-u-le)
C1 to C4 or C5 transverse
processes (from spine to
superior border)
Medial border of scapulae Scapular elevation
Scapular downward rotation
Assists with scapular adduction
Rhomboids
(ROM-boidz)
C6 or C7 to T4 or T5
spinous processes
Medial border of scapula
from spine to inferior
angle
Scapular elevation
Scapular adduction
Scapular downward rotation
Serratus anterior
(ser-A-tus an-TEER-ee-or)
Lateral, outer aspect of
lower 8 to 9 ribs
Inferior angle and medial
border of scapula
Scapular abduction
Scapular upward rotation
Scapular depression (lower fibers)
Pectoralis minor
(pek-to-RA-lis MY-nor)
Outer surface of 2nd or
3rd to 5th ribs
Coracoid process of
scapulae
Scapular abduction
Scapular downward rotation
Scapular depression
(continued)