Posterior Superior Serratus, Posterior View

Description

Seen from a posterior perspective in a male, the upper thoracic wall is anchored by the thoracic spinous processes and posterior ribs, with the scapulae lying posterolateral to the vertebral column and the proximal humeri at the lateral margins. Deep to the scapular plane, the posterior superior serratus (serratus posterior superior) spans inferolaterally from the midline ligamentum nuchae and spinous processes of C7 to T3 toward the upper ribs, classically inserting onto ribs 2 to 5 near their angles. Rhomboid minor and rhomboid major occupy a more superficial, medial scapular layer, running from the lower cervical and upper thoracic spine to the medial border of the scapula, partially obscuring the deeper rib attachments. Posterior superior serratus is a frequent source of confusion in teaching because it sits at the junction of the intrinsic back musculature and the thoracic wall, and its respiratory contribution remains debated, with many clinicians considering it primarily proprioceptive. That ambiguity becomes practical during posterior thoracic approaches and scapulothoracic dissections, where distinguishing rhomboids from the deeper serratus posterior superior prevents mislabeling and clarifies the layered pathway toward the costovertebral joints and upper intercostal spaces. Short. Clear. Use this plate for anatomy lab manuals covering the posterior thorax, for exam-prep materials on extrinsic back muscles, and for surgical education modules discussing posterior access routes to the upper ribs and paravertebral region in the male. It also supports radiology correlation when orienting learners to the rib angles and upper thoracic landmarks on CT or MRI. Anatomical accuracy verified by SciePro's Medical Advisory Board.