Anatomical Variations of the Trapezius Muscle: Biomechanical and Functional Implications

Main Article Content

Anna Puchalska-Sarna
https://orcid.org/0000-0003-2208-9109
Ewa Lenart-Domka
Jadwiga Trzeciak
Grzegorz Domino
Michał Sarna
Katarzyna Walicka-Cupryś

Abstract

Abstract


The trapezius muscle is a large, superficial muscle of the posterior thoracic region that plays a fundamental role in scapular stabilization, upper limb movement, and cervical spine biomechanics. Numerous anatomical studies have demonstrated that the trapezius exhibits considerable morphological variability in its origin, insertion, fiber arrangement, innervation patterns, and muscular segmentation.


Different researchers have reported variations including accessory muscle slips, partial absence of specific portions (particularly the lower or middle fibers), asymmetry between sides, atypical attachments to the clavicle or scapula, and deviations in the course of the spinal accessory nerve. Some cadaveric and imaging-based studies have also described variations in muscle thickness, fascicle orientation, and aponeurotic structure, which may influence force transmission and scapulothoracic mechanics.


From a biomechanical perspective, these anatomical differences may alter scapular kinematics, shoulder elevation patterns, and load distribution across the cervical and thoracic spine. Functional implications include potential predisposition to shoulder impingement, scapular dyskinesis, neck pain syndromes, and altered postural control. Furthermore, anatomical variability has important clinical relevance in surgical procedures, reconstructive techniques, nerve repair, and rehabilitation planning.


Overall, the available literature suggests that anatomical variations of the trapezius muscle are more common than traditionally assumed and may significantly influence both normal movement patterns and pathological conditions. Recognition of these variations is essential for anatomists, clinicians, surgeons, and physiotherapists to ensure accurate diagnosis, effective treatment, and optimized functional outcomes.


 


Article Details

How to Cite
Puchalska-Sarna, A., Lenart-Domka, E., Trzeciak, J., Domino, G., Sarna, M., & Walicka-Cuprys, K. (2026). Anatomical Variations of the Trapezius Muscle: Biomechanical and Functional Implications. Technium BioChemMed, 14, 7–16. https://doi.org/10.47577/biochemmed.v14i.13504
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Articles

References

[1] Bochenek A, Reicher M, Bilikiewicz T, Łasiński W, Sieńkowski E, Dzierżykray Rogalski T, Zawistowski S, Zegarska Z (eds). Human anatomy. Volume 1: General anatomy, bones, joints and ligaments, muscles. Warsaw: Wydawnictwo Lekarskie PZWL; 2016. ISBN: 978 8320043235.

[2] Schunke M, Schulte E, Schumacher U; eds. Gielecki JS, Żurada A. Prometeusz Atlas of Human Anatomy. Volume 1: General Anatomy and the Musculoskeletal System . Latin and Polish Nomenclature . 3rd edition. Wrocław: MedPharm ; 2022. ISBN: 978 8378461319.

[3] Leon X, Maranillo E, Quer M, et al. Case report: cleidocervical or levator claviculae muscle . A new one embryological explanation as to its origin. J Anat. 1995;187(2):503‒504.

[4] Noussios G. The variational anatomy of the trapezius muscle : A review of the literature . The Internet Journal of Human Anatomy . 2014:3(1).

[5] Badura M, Grzonkowska M, Baumgart M, et al. Quantitative anatomy of the trapezius muscle in the human fetus . Adv Clin Exp Med. 2016;25(4):605‒609.

[6] Johnson G, Bogduk N, Nowitzke A, et al. Anatomy and actions of the trapezius muscle . Clin Biomech (Bristol, Avon) . 1994;9(1):44‒50.

[7] Mehra L, Tuli A, Raheja S. Dorsoscapularis triangularis : embryological and phylogenetic characterization of a rare variation of trapezius . Anat Cell Biol. 2016;49(3):213‒216.

[8] Miyamoto RT, Yune HY, Rosevear WH. Klippel-Feil syndrome and associated ear deformities . Am J Otol . 1983;5(2):113‒119.

[9] Emsley JG, Davis MD. Partial unilateral absence of the trapezius muscle in a human cadaver . Clin Anat. 2001;14(5):383‒386.

[10] . Mohammed Z Allouh , Adel Mohamed , Azedean Mhanni . Complete unilateral absence of trapezius muscle . McGill J Med. 2004;8:31‒33.

[11] ). Hug U, Burg D, Meyer VE. Cervical outlet syndrome due to an accessory part of the trapezius muscle in the posterior triangle of the neck . J Hand Surg Br. 2000;25(3):311‒313.

[12] Kwak HH, Kim HJ, Youn KH, et al. An anatomical variation of the trapezius muscle in a Korean : the cleido-occipitalis cervicalis . Yonsei Med J. 2003;44(6):1098‒1100.

[13] Newman CJ, Jacquemont S, Theumann N, et al. Familial aplasia of the trapezius muscle : clinical and MRI findings . Acta Paediatri . 2011;100(3):464‒466.

[14] Garbelotti Júnior SA, Rodrigues CF, Sgrott EA, et al. Unilateral absence of the thoracic part of the trapezius muscle . Surg Radiol Anat. 2001;23(2):131‒133.

[15] Nooij LS, Oostra RJ. Trapezius aplasia : indications for a dual developmental origin of the trapezius muscle . Clin Anat. 2006;19(6):547‒549.

[16] Gross- Kieselstein E, Shalev RS. Familial absence of the trapezius muscle with associated shoulder girdle abnormalities . Clin Genet. 1987;32(3):145‒147.

[17] Stacey RJ, O'Leary ST, Hamlyn PJ. An anomaly in the nerve supply of the trapezius muscle . Clin Anat. 1996;9(6):414‒416.

[18] Lindsay E Beaton , Barry J Anson. Variations in the origin of the M. trapezius . The Anatomical Record . 1942;83(1):41‒46.

[19] Bing R. Ueber angeborene Muskeldefecte . Virchow's Arch fpath Anat. 1902;170(2):175‒228.

[20] Adams SB Jr, Flynn JM, Hosalkar HS, et al. Torticollis in an infant caused by hereditary muscle aplasia . Am J Orthop ( Belle Mead NJ). 2003;32(11):556‒558.

[21] Debeer P, Brys P, De Smet L, et al. Unilateral absence of the trapezius and pectoralis major muscle : a variant of Poland syndrome . GenetCouns . 2002;13(4):449-453

[22] Keibel F, Mall FP. Manual of human embryology . Philadelphia: J. B. Lippincott Company; 1910.

[23] Lin ME, Kim C, Howard A, Kokot N. Variations of the trapezius branch of the accessory nerve : an anatomical study . Scientific Reports . 2023;13:22369. doi:10.1038/s41598-023-47031

[24] Anehosur V, Kulkarni K, Kumar N. Variations in the anatomy of spinal cord accessory nerve and its landmarks for identification in neck dissection : a clinical study . Journal of Maxillofacial and Oral Surgery . 2021;20(3):426–431

[25] Roberts SO, Cardozo A. A detailed review of the spinal accessory nerve and its anatomical variations with cadaveric illustration . Anatomical Science International . 2024;99(3):239–253.

[26] Melo ASC, Taylor JL, Ferreira R, Cunha B, Ascenção M, Fernandes M, Sousa V, Cruz EB, Vilas Boas JP, Sousa ASP. Differences in Trapezius Muscle H Reflex between Asymptomatic Subjects and Symptomatic Shoulder Pain Subjects . Sensors . 2023;23(9):4217.

[27] Banerjee M, Kantharia RA, Kantharia SR, Teli ZA. A rare one anatomical star shaped branching pattern of spinal accessory nerve : a case report with review of literature . IP Indian Journal of Anatomy and Surgery of Head , Neck and Brain . 2022;8(3):104–108.

[28] Quang TL, Nguyễn AH, Nguyễn TT. Proposed classification method of the branches of the accessory nerve innervating the trapezius muscle . Vietnam Medical Journal . 2025.

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