04/06/2026
Serratus dorsalis
Recently, I was asked about the serratus dorsalis, and I realised it’s one of those muscles we all “know” from books, but rarely really look at in the body.
If we stay with the textbook first, the serratus dorsalis is described as a segmental muscle with multiple semi-separated bellies. It originates from the thoracolumbar fascia and attaches to the ribs, sitting under the latissimus dorsi and covered by the superficial layer of the thoracolumbar fascia. It is divided into a cranial and caudal part, both arising from the deeper layer of the thoracolumbar fascia, but with different fibre directions and rib attachments. The cranial part runs caudoventrally and attaches roughly from the 5th to the 11th or 12th rib, while the caudal part runs cranioventrally and attaches to the last ribs. Functionally, both are described as respiratory muscles—the cranial part assisting inspiration by drawing the ribs forward and outward, and the caudal part assisting expiration by drawing them back. Innervation comes from the thoracic spinal nerves.
All good, all neat, all very logical.
But when you actually look at it in the body, things start to feel a bit less simple.
Across multiple dissections I keep seeing the same pattern. The cranial part has noticeably shorter fibres, but more interesting is that the first two or three bellies are not behaving like the rest of the muscle. They are partially separated, and their aponeurosis blends very specifically with the cranial extension of the thoracolumbar fascia—the structure often referred to as the dorsoscapular ligament. And then there is another detail that keeps catching my eye: those same cranial bellies attach to ribs 5 to 8… exactly the same ribs as the serratus ventralis thoracis.
That makes me pause a bit.
Because now we are no longer just in a “respiratory muscle sitting on the ribs” situation. We are right in the middle of the thoracic sling, in a region where the limb is suspended from the trunk purely by soft tissue—the synsarcosis. And this area is anything but simple.
Under the scapula, the fascia is not just a wrapping layer. It is a highly organised system where collagenous and elastic components transition into each other. You can see it clearly in dissection—the tissue changes character depending on what is needed. Support in one place, compliance in another, but always continuity.
The dorsoscapular ligament, as the cranial continuation of the thoracolumbar fascia, reflects this very well. It is not just a dense sheet. It has a collagenous part, but also elastic components that extend laterally toward the medial surface of the scapula and interdigitate with the serratus ventralis thoracis. When you remove the muscle fibres of the serratus ventralis, those elastic laminae become visible, and you start to see that this is not just “a muscle on a rib”, but a layered system. There is also a continuation back into more collagenous tissue attaching to the cranial ribs, forming what feels like an inner fascial envelope for the serratus ventralis.
And the serratus ventralis itself sits right between these layers. Short fibres, enclosed, supported from both sides. It starts to look much more like a structure designed for controlled load transfer and fine adjustment rather than just simple contraction.
So when I go back to the serratus dorsalis cranialis, especially those first few bellies blending into this system and sharing rib attachments with the serratus ventralis, I can’t help but wonder if calling it purely a respiratory muscle is just… incomplete.
I don’t have an answer for that yet, and I haven’t found anything in the literature that clearly supports another role, so this remains an observation, not a conclusion.
But this is exactly why I love dissection. Because even though we are separating structures, it is the best way to start understanding their continuity. And in this region especially, the body doesn’t behave in isolated parts—it behaves as a connected, adaptive system.