Levator scapulae: origin and scapular elevation

Levator scapulae is a small, strap-like muscle that begins in the neck and ends on the scapula (the shoulder blade). A levator is a lifter, so contracting it lifts the scapula, as in a shrug. Lifting the scapula is elevation, the action the muscle is named for.

For the origin (where it starts), think of the upper neck. The muscle starts on the transverse processes (the bony projections that stick out sideways from each vertebra) of the upper four cervical (neck) vertebrae, C1 to C4. It then runs down to the medial border of the scapula, the edge nearest the spine. Because it starts above the scapula and ends on it, its pull is upwards.

It also contributes a little downward rotation: it rotates the lower tip of the scapula towards the spine, which tilts the glenoid cavity (the shallow socket of the shoulder joint) downwards.

The muscle belongs to the deep layer of the posterior extrinsic shoulder muscles (muscles that start on the trunk and neck and move the shoulder girdle, meaning the scapula and collar bone), beneath trapezius, together with the two rhomboids. All three deep muscles are supplied by the dorsal scapular nerve.

Trapezius is the main look-alike, because its upper fibres also elevate the scapula. Use the origin to tell them apart. Trapezius starts on the skull, the ligamentum nuchae (the strong ligament down the back of the neck) and the spinous processes (the bony spikes at the back of the vertebrae) of C7 to T12. The rhomboids also start lower down, on spinous processes. Of these shoulder muscles, only levator scapulae comes from the upper cervical transverse processes.