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The scalene muscles are a group of three pairs of muscles in the lateral neck, namely the anterior, middle, and posterior scalene muscles. Sometimes, a fourth muscle, the scalenus minimus, is present in 30% to 71% of individuals. The scalene muscles are accessory breathing muscles that help you inhale. They contract when you breathe in, opening space for the lungs to expand in the thorax by lifting the top ribs. When the scalenes are healthy, they help support the upright posture of your cervical spine.
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What You'll Learn
- The scalene muscles are a group of three pairs of muscles in the lateral neck
- They help elevate the first and second ribs, increasing intrathoracic volume
- They act as accessory muscles of respiration for patients with respiratory distress
- The scalenes are prone to tension, which can cause torticollis or wry neck
- The scalenes can be targeted with regional anaesthesia before arm or shoulder surgery
The scalene muscles are a group of three pairs of muscles in the lateral neck
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 anterior scalene muscle is located deep to the sternocleidomastoid on the lateral aspect of the neck. It originates from the anterior tubercles of the transverse processes of C3-C6 and attaches to the scalene tubercle on the inner border of the first rib. The middle scalene is the largest and longest of the three scalene muscles. It originates from the posterior tubercles of the transverse processes of C2-C7 and attaches to the superior aspect of the first rib. The posterior scalene is the smallest and deepest of the scalene muscles. It originates from the posterior tubercles of the transverse processes of C5-C7 and attaches to the second rib.
The scalene muscles can be targeted with specific exercises to strengthen them and increase the stability of the cervical spine, reducing the risk of future injuries. One such exercise involves placing the palm of the right hand on the right side of the head and then moving the right ear towards the right shoulder while maintaining resistance with the hand. This can be repeated 8 to 12 times on each side.
In addition to the three pairs of scalene muscles, a fourth muscle, the scalenus minimus, is present in approximately 30% to 71% of individuals. This muscle arises from the anterior tubercle of the transverse process of the 7th cervical vertebra and inserts on the first rib and the Sibson fascia.
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They help elevate the first and second ribs, increasing intrathoracic volume
The scalene muscles are a group of three pairs of muscles in the lateral neck: scalenus anterior, scalenus medius, and scalenus posterior. Sometimes, a fourth muscle, the scalenus minimus, is present behind the lower portion of the scalenus anterior.
The scalene muscles collectively act to elevate the first and second ribs, increasing intrathoracic volume. The scalenus anterior and medius lift the first rib and bend the neck to the side they are on. The scalenus posterior 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 3rd to 6th cervical vertebrae and inserts on the scalene tubercle of the superior surface of the 1st rib. The scalenus medius 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 and inserts into the upper surface of the 1st rib. The 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 4th to 6th cervical vertebrae and is inserted by a thin tendon into the outer surface of the 2nd rib.
The scalene muscles are accessory breathing muscles that help with inhalation. They contract when you breathe in, opening space for the lungs to expand in the thorax by lifting the top ribs. In patients with respiratory distress, the scalene muscles may be used as 'accessory muscles of respiration' to aid with breathing. By increasing intrathoracic volume, the patient can ventilate their lungs more effectively.
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They act as accessory muscles of respiration for patients with respiratory distress
The scalene muscles are three paired muscles (anterior, middle and posterior) located in the lateral aspect of the neck. In some individuals, a fourth muscle, the scalenus minimus, is also present. The scalene muscles form part of the floor of the posterior triangle of the neck.
The scalene muscles act as accessory muscles of respiration for patients with respiratory distress. In healthy individuals, the scalene muscles are not required for respiration. However, in cases of respiratory distress, the scalene muscles can be used to aid with breathing. By elevating the first and second ribs, the scalene muscles increase the intrathoracic volume, allowing for more effective ventilation of the lungs. This increase in intrathoracic volume is particularly beneficial for patients with respiratory distress as it helps them to breathe more easily.
The scalenus anterior, medius, and posterior are all considered accessory inspiratory muscles. They are helpful in expanding the thoracic cavity, which is necessary for inhalation. The scalene muscles are particularly prominent during inspiration, and their contraction can produce substantial changes in lung volume.
The scalene muscles are an important anatomical landmark in the neck, with several structures passing between them, including the brachial plexus and subclavian artery. Additionally, the subclavian vein and phrenic nerve pass anteriorly to the anterior scalene. The scalene muscles receive their blood supply from the first portion of the subclavian artery.
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The scalenes are prone to tension, which can cause torticollis or wry neck
The scalene muscles are a group of three pairs of muscles in the lateral neck: scalenus anterior, scalenus medius, and scalenus posterior. A fourth muscle, the scalenus minimus, is present in 30% to 71% of individuals. The scalene muscles are deep and positioned laterally in the neck. They form part of the floor of the posterior triangle of the neck.
The scalenes are prone to tension due to their role in neck posture and movement. They help support the upright posture of the cervical spine, which is the upper part of the spine. When the scalenes are tight and in a forward head position, they can't counterbalance tension in the back of the neck, perpetuating a posture problem. This tension can be caused by whiplash injuries, excessive coughing, gasping for air (especially in people with asthma, emphysema, bronchitis, or pneumonia), pulling or lifting with arms at waist level, working for long periods with the head turned to one side, sleeping on the stomach with the head turned to one side, carrying a heavy backpack or purse, or wearing a tight collar or tie.
Scalene tension may compress the brachial plexus nerve complex branches, which pass through the scalene triangle, and this can be a sign of thoracic outlet syndrome (TOS). TOS can also be caused by the presence of the scalenus minimus muscle, which reduces space for the brachial plexus, subclavian artery, and subclavian vein. TOS is associated with a hypertrophic anterior scalene muscle, and in some cases, resection of the anterior or middle scalene muscle is necessary.
Torticollis, also known as wry neck, is a condition in which the neck muscles stay contracted in chronically shortened positions. All of the scalene muscles are involved in torticollis, which is characterized by a twisted neck position that is very difficult to release. The head also tilts to the opposite side. Torticollis can also develop due to trauma or drugs, and in some cases, it can be managed with Botox injections.
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The scalenes can be targeted with regional anaesthesia before arm or shoulder surgery
The scalene muscles are a group of three pairs of muscles in the lateral neck: scalenus anterior, scalenus medius, and scalenus posterior. The scalenes are named after the Ancient Greek word "skalēnós", meaning "uneven", as the pairs are all of differing lengths. The scalene muscles are accessory breathing muscles that help with inhalation. They contract when you breathe in, creating space for the lungs to expand in the thorax by lifting the top ribs.
The scalenus anterior is the muscle located closest to the front. It originates from the anterior tubercles of the transverse processes of the third to sixth cervical vertebrae and is inserted by a narrow, flat tendon into the scalene tubercle on the inner border of the first rib. The scalenus medius 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 and is inserted into the upper surface of the first rib. The scalenus posterior is the smallest and deepest 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 into the outer surface of the second rib.
The scalenes can be stretched and targeted through various exercises and movements. To target the scalenus posterior, turn your face toward the arm that is pulling. To target the scalenus anterior, turn your face away from the pulling arm. To target the scalenus medius, look straight up at the ceiling or slightly toward the pulling arm.
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Frequently asked questions
Scalene muscles are a group of three pairs of muscles in the lateral neck: scalenus anterior, scalenus medius, and scalenus posterior.
The scalene muscles collectively act to elevate the first and second ribs, increasing the intrathoracic volume. They also act as accessory muscles of respiration, aiding with breathing.
To stretch the scalene muscles, gently pull your head and neck so that your neck tilts to the opposite side. To target a specific scalene muscle, rotate your head accordingly: to target the posterior scalene, turn your face toward the arm that is pulling; to target the anterior scalene, turn your face away from the pulling arm; to target the middle scalene, look straight up at the ceiling or slightly toward the pulling arm.
Sit in a comfortable chair and place your palm on the side of your head. Begin to move your ear toward your shoulder while maintaining resistance with your hand. Repeat 8 to 12 times on each side.
