Dominic Stone
The scalene muscles are a group of three muscles on each side of the neck, identified as the anterior, middle, and posterior. They are involved in lifting the first two ribs and are accessory respiratory muscles. The scalene muscles also play a role in neck movement and maintaining head posture. They are positioned deeply and laterally to the cervical tract. The scalene muscles have a complex innervation, with contributions from both the brachial plexus and the cervical plexus. These muscles can be targeted with specific exercises and stretches to improve their strength and flexibility.
| Characteristics | Values |
|---|---|
| Definition | A group of three muscles on each side of the neck, identified as the anterior, the middle, and the posterior |
| Location | Deep in relation to the sternocleidomastoid muscle, lateral to the cervical spine, connecting the vertebrae to the first two ribs |
| Innervation | The third to the eighth cervical spinal nerves (C3-C8) |
| Function | Accessory breathing muscles, important for the movement of the neck and the head, and maintaining the posture between the neck and the head |
| Dysfunction | Can create pathological patterns, such as thoracic outlet syndrome, decreased ventilatory capacity, and cervical pain |
| Exercises | Strengthening exercises include placing the palm of your right hand on the right side of your head and moving your right ear toward your right shoulder while maintaining resistance |
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What You'll Learn
- The scalene muscles are a group of three muscles on each side of the neck
- The scalene muscles are involved in lifting the first two ribs
- They are important for the movement of the neck and the head
- Dysfunction of the scalene muscles can create pathological patterns like thoracic outlet syndrome and decreased ventilatory capacity
- The scalene muscles are always electrically active
The scalene muscles are a group of three muscles on each side of the neck
The anterior scalene muscle, or scalenus anterior, lies deeply at the side of the neck, behind the sternocleidomastoid muscle. It arises from the anterior tubercles of the transverse processes of the cervical vertebrae, from the third to the sixth vertebrae. It is inserted into the scalene muscle tubercle of the upper face of the first rib. The middle scalene, or scalenus medius, is the largest and longest of the three scalene muscles. The middle scalene arises from the posterior tubercles of the transverse processes of the lower six cervical vertebrae. It descends along the side of the vertebral column to insert by a broad attachment into the upper surface of the first rib, posterior to the subclavian groove. The posterior scalene, or scalenus posterior, is the smallest and most deeply seated of the scalene muscles. It arises from the posterior tubercles of the transverse processes of the fourth, fifth, and sixth cervical vertebrae and is inserted by a thin tendon into the outer surface of the second rib, behind the attachment of the anterior scalene.
The scalene muscles have an important relationship to other structures in the neck. The brachial plexus and subclavian artery pass between the anterior and middle scalenes. The subclavian vein and phrenic nerve pass anteriorly to the anterior scalene as the muscle crosses over the first rib. The scalene muscles play the role of accessory breathing muscles but are also important for the movement of the neck and the head and maintaining the posture between the neck and the head. Their dysfunction creates several pathological patterns, such as thoracic outlet syndrome, decreased ventilatory capacity, and cervical pain.
There are exercises to strengthen the scalene muscles. One such exercise involves sitting in a comfortable chair and placing the palm of your right hand on the right side of your head. This hand acts as a stabilizer. Begin to move your right ear toward your right shoulder while maintaining the resistance provided by your right hand. Repeat 8 to 12 times on each side. Another exercise involves sitting or standing up straight with a resistance band looped around your head. Hold the ends of the band firmly to one side, ensuring there is some tension in the band. Pull the band away from your head, resisting the movement by keeping your head in a neutral position. Hold this position, relax, and repeat.
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The scalene muscles are involved in lifting the first two ribs
The scalene muscles are a group of three muscles on each side of the neck, namely the scalenus anterior (anterior scalene), scalenus medius (middle scalene), and scalenus posterior (posterior scalene). They are involved in lifting the first two ribs, increasing the intrathoracic volume and aiding breathing in patients with respiratory distress. They are therefore considered secondary or accessory respiratory muscles.
The scalene muscles are always electrically active, even when they are not engaged as respiratory muscles. They are then active in the supine position with the arm raised. They act as postural muscles, maintaining the position of the cervical tract and playing an active role in the movement of the neck. They can incline the neck and intervene in the first degrees of rotation of the head. A bilateral contraction of the scalene allows a neck flexion.
The scalene muscles are innervated by the third to the eighth cervical spinal nerves (C3-C8). The anterior and middle scalene muscles lift the first rib and bend the neck to the side they are on. The posterior scalene lifts the second rib and tilts the neck to the same side. The scalene muscles are attached at one end to bony protrusions on vertebrae C2 to C7 and at the other end to the first and second ribs.
The scalenus anterior originates from the anterior tubercles of the transverse processes of the cervical vertebrae, from the third to the sixth vertebrae. It is inserted into the scalene muscle tubercle of the upper face of the first rib. The scalenus medius is the largest and longest of the three scalene muscles. It originates from the posterior tubercles of the transverse processes of the lower six cervical vertebrae and inserts into the upper surface of the first rib. The scalenus posterior is the smallest and most deeply seated of the scalene muscles. It arises by two or three separate tendons from the posterior tubercles of the transverse processes of the fourth, fifth, and sixth cervical vertebrae and is inserted into the outer surface of the second rib.
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They are important for the movement of the neck and the head
The scalene muscles are a group of three muscles on each side of the neck: the anterior, the middle, and the posterior. They are important for the movement of the neck and the head, as well as maintaining the posture between the two. They are involved in lifting the first two ribs in a forced inspiratory act as secondary respiratory muscles.
The anterior scalene muscle is the anteriormost of the three scalene muscles. It originates from the anterior tubercles of the transverse processes of the cervical vertebrae, from the third to the sixth vertebrae. It is inserted into the scalene muscle tubercle of the upper face of the first rib. The anterior and middle scalene muscles lift the first rib and bend the neck to the side they are on.
The middle scalene is the largest and longest of the three scalene muscles. It arises from the posterior tubercles of the transverse processes of the lower six cervical vertebrae. It descends along the side of the vertebral column to insert by a broad attachment into the upper surface of the first rib, posterior to the subclavian groove. The middle scalene, along with the anterior scalene, is involved in the movement of the neck and the head. A bilateral contraction of these muscles allows for neck flexion.
The posterior scalene is the smallest and most deeply seated of the scalene muscles. It arises from the posterior tubercles of the transverse processes of the fourth, fifth, and sixth cervical vertebrae. It is inserted into the outer surface of the second rib. The posterior scalene lifts the second rib and tilts the neck to the same side.
The scalene muscles are very active in the supine position and with the arm raised. They can incline the neck and intervene in the first degrees of rotation of the head. Their dysfunction can create several pathological patterns, such as thoracic outlet syndrome, decreased ventilatory capacity, and cervical pain.
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Dysfunction of the scalene muscles can create pathological patterns like thoracic outlet syndrome and decreased ventilatory capacity
The scalene muscles are a group of three muscles on each side of the neck: the anterior, the middle, and the posterior. They are involved in lifting the first two ribs and are electrically active during breathing. They also play a role in neck movement and maintaining the posture between the neck and the head.
Dysfunction of the scalene muscles can create pathological patterns. One such pattern is thoracic outlet syndrome (TOS). TOS is a collection of abnormalities in the same anatomical area that elicit similar symptoms. It can be classified into three groups: osseous, traumatic, and non-traumatic. Trauma to the scalene muscles can cause fibrotic changes, which are a significant cause of symptoms in traumatic TOS. This can lead to compression at various sites, such as the interscalene triangle and the costoclavicular space, resulting in TOS.
Another consequence of scalene muscle dysfunction is decreased ventilatory capacity. The scalene muscles act as accessory breathing muscles, so abnormal tension or pain in these muscles can reduce respiratory function. This can be further exacerbated by conditions such as asthma or emphysema.
To diagnose TOS, tests are performed to stress the neurovascular structures within the thoracic outlet. Electrodiagnostic testing, including nerve conduction velocity (NCV) and electromyography (EMG), plays a crucial role in evaluating suspected neurogenic TOS. Imaging techniques, such as duplex ultrasound and CT angiography, are also used for diagnosis and surgical planning.
Treatment for scalene muscle dysfunction aims to reduce muscle tone and improve physiological length and contractile strength. Stretching exercises, such as those described by Physio-pedia, can be performed to target specific scalene muscles. Strengthening exercises, such as those outlined by Physio-pedia, can also help improve cervical spine stability and reduce the risk of future injuries.
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The scalene muscles are always electrically active
The scalene muscles are a group of three muscles on each side of the neck, identified as the anterior, the middle, and the posterior. They are named from the Ancient Greek "skalēnós", meaning "uneven", as the pairs are all of differing lengths. The scalene muscles are always electrically active, even for non-forced breaths. They act as accessory breathing muscles but are also important for the movement of the neck and the head and maintaining the posture between the neck and the head.
The scalene muscles are involved in lifting the first two ribs in a forced inspiratory act as secondary respiratory muscles. When not engaged as respiratory muscles, they are very active in the supine position and with the arm raised. They act as postural muscles in maintaining the position of the cervical tract or playing an active role in the movements of the neck. They can incline the neck and intervene in the first degrees of rotation of the head. A bilateral contraction of the scalene allows a neck flexion.
The scalene muscles have an important relationship to other structures in the neck. The brachial plexus and subclavian artery pass between the anterior and middle scalenes. The subclavian vein and phrenic nerve pass anteriorly to the anterior scalene as the muscle crosses over the first rib. The phrenic nerve is oriented vertically as it passes in front of the anterior scalene, while the subclavian vein is oriented horizontally. The passing of the brachial plexus and the subclavian artery through the space of the anterior and middle scalene muscles constitute the scalene hiatus.
The scalene muscles are deep and positioned laterally to the cervical tract. Their innervation is complex, as both the brachial plexus and the cervical plexus are involved in their function. They are multi-articular muscles, and their actions are just as complex and vital. Their dysfunction creates several pathological patterns, such as thoracic outlet syndrome, decreased ventilatory capacity, and cervical pain.
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