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Posterior superior dentate muscle and posterior inferior dentate muscle
Last reviewed: 04.07.2025
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Posterior superior serratus muscle - m. serratus posterior superior
Raises the II, III, IV, V ribs.
Origin: from the spinous processes of the last two cervical vertebrae and the first two thoracic vertebrae
Attachment: II - V rib
Innervation: nn. intercostales Thl-Th4
Diagnosis: The patient sits slightly forward with the arm on the side being examined hanging freely; the hand can be placed in the opposite axilla to further abduct the scapula. The scapula should be displaced laterally and retracted to expose trigger points located in the muscle. The serratus posterior superior is palpated through the trapezius and rhomboid muscles. Vigorous palpation evokes a localized twitch response in the trapezius fibers, which are recognizable by their horizontal orientation. Trigger points located in the serratus posterior superior are evident as areas of extreme tenderness in the muscle band when pressed against the underlying rib. Pressure on these trigger points clearly evokes a characteristic pattern of referred pain.
Referred pain: Trigger zones of this muscle often cause pain in the scapula and shoulder area. A dull, deep pain under the upper edge of the scapula is characteristic of damage to the posterior superior serratus muscle. The pain is localized deeper than the pain pattern caused by the trigger zone of the middle portion of the trapezius muscle. Along with this, quite intense pain is felt over the posterior edge of the elm and long head of the triceps brachii. Often, it captures the entire area of the triceps muscle with the epicenter in the area of the "morning epicondyle of the shoulder", and then spreads along the ulnar surface of the forearm and metacarpus, including the entire little finger. Anteriorly, the pain can spread across the chest.
Posterior inferior serratus muscle - m. serratus posterior inferior
Moves the lower ribs backwards and downwards, thereby promoting expansion of the chest in the lower part (deep inhalation).
Origin: from the spinous processes of the 12th thoracic vertebra and the first three lumbar vertebrae.
Attachment: IX - XII rib.
Innervation: nn. intercostales T9-T12
Diagnostics: Painful trigger zones are identified by superficial palpation at the sites of muscle attachment to the ribs.
Referred pain: An active trigger point in the serratus posterior inferior muscle causes pain in the lower back and lower rib area.