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The scalene muscles are a group of muscles in the neck that play an important role in various bodily functions and have significant surgical implications. There are three scalene muscles: the anterior scalene, middle scalene, and posterior scalene. These muscles are involved in neck movement, respiration, and the positioning of the ribs. They also have a close relationship with other structures in the neck, such as the brachial plexus and subclavian artery, which pass between them. The scalene muscles receive their blood supply from the ascending cervical branch of the inferior thyroid artery and are named after the Greek word skalēnós, meaning uneven, due to their varying lengths.
| Characteristics | Values |
|---|---|
| Location | Lateral part of the neck |
| Posture | Behind the sternocleidomastoid muscle |
| Origin | Anterior tubercles of the transverse processes of the third, fourth, fifth, and sixth cervical vertebrae |
| Insertion | Flat tendon into the scalene tubercle on the inner border of the first rib |
| Nerve Supply | Anterior rami of the spinal nerves C4-C6 |
| Blood Supply | Ascending cervical branch of inferior thyroid artery |
| Function | Elevates the first rib, fixes or lifts the first rib superiorly, accessory respiratory muscle |
| Surgical Importance | Yes |
| Exercises | Strengthening exercises to increase stability of the cervical spine |
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What You'll Learn
- The scalene muscle group consists of three muscles: the anterior, middle, and posterior scalene
- The anterior scalene is the anteriormost of the three scalene muscles, arising from the anterior tubercles of the cervical vertebrae
- The scalene muscles are important in central venous catheterization and other surgeries due to their proximity to major vessels and nerves
- The scalene muscles receive their blood supply from the ascending cervical branch of the inferior thyroid artery
- The scalene muscles can be targeted with specific exercises and stretches to strengthen them and increase cervical spine stability
The scalene muscle group consists of three muscles: the anterior, middle, and posterior scalene
The scalene muscles are a group of three muscles located in the neck: the anterior, middle, and posterior scalene. These muscles play an important role in neck and shoulder movements and have significant surgical implications.
The anterior scalene muscle, or scalenus anterior, is the most anterior of the three scalene muscles. It originates from the anterior tubercles of the transverse processes of the third to sixth cervical vertebrae and inserts into the scalene tubercle on the inner border of the first rib. This muscle is important as it serves as a landmark for identifying nearby structures such as the subclavian artery, brachial plexus, and phrenic nerve.
The middle scalene muscle, or scalenus medius, is the largest and longest of the three scalene muscles. It arises from the transverse processes of the lower six cervical vertebrae and inserts into the upper surface of the first rib. The anterior and middle scalene muscles define the posterior interscalene gap, through which the brachial plexus passes.
The posterior scalene muscle, 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 to sixth cervical vertebrae and inserts into the outer surface of the second rib. This muscle is occasionally blended with the middle scalene.
The scalene muscles have an important relationship with other structures in the neck. The brachial plexus and subclavian artery pass between the anterior and middle scalene muscles, forming the scalene hiatus. Additionally, the scalene muscles elevate the first and second ribs during forced inspiration, functioning as secondary respiratory muscles.
These muscles also have surgical significance. For example, in cases of thoracic outlet syndrome (TOS), compression of the subclavian vessels or brachial plexus can cause symptoms like fatigue, pain, and paresthesias in the upper extremity. Treatment may involve resection of the anterior or middle scalene muscle to relieve neurovascular compression.
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The anterior scalene is the anteriormost of the three scalene muscles, arising from the anterior tubercles of the cervical vertebrae
The scalene muscles are a group of three deep muscles in the neck: the anterior scalene, the middle scalene, and the posterior scalene. The anterior scalene is the foremost of these three muscles, arising from the anterior tubercles of the transverse processes of the third to sixth cervical vertebrae. It takes an inferior, almost vertical, course towards the thoracic cage, giving off a single flat tendon that inserts into the scalene tubercle and superior border of the first rib. The anterior scalene is thickest at the level of the cricoid cartilage and thinner at its origin and insertion.
The scalene muscles are named from the Greek "skalenos", meaning uneven, as the pairs are all of differing lengths. The anterior scalene is supplied by the anterior rami of the spinal nerves C4-C6 and receives its blood supply from the ascending cervical branch of the inferior thyroid artery. The brachial plexus and subclavian artery pass between the anterior and middle scalene muscles, and the subclavian vein and phrenic nerve pass anteriorly to the anterior scalene as it crosses over the first rib. The phrenic nerve is oriented vertically, while the subclavian vein is oriented horizontally as they pass in front of the anterior scalene.
The scalene muscles have significant surgical importance. The anterior scalene serves as a key landmark for identifying the subclavian artery, the brachial plexus, and the phrenic nerve. It may be surgically divided or resected during TOS decompression surgery to relieve neurovascular compression. The scalene muscles are also relevant in central venous catheterization via the subclavian approach, as their proximity to major vessels increases the risk of vascular or nerve injury.
The scalene muscles function as secondary respiratory muscles, elevating the first and second ribs during forced inspiration. The anterior scalene can produce flexion of the neck, either bilaterally when the costal attachment is fixed or unilaterally when the head is in an anatomical position. When their attachment to the vertebral column is fixed, the scalene muscles can fix or lift the first rib superiorly, expanding the antero-posterior diameter of the thorax during forced respiration.
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The scalene muscles are important in central venous catheterization and other surgeries due to their proximity to major vessels and nerves
The scalene muscles are a set of three muscles: the anterior scalene, the middle scalene, and the posterior scalene. They are located in the posterior triangle of the neck. The scalene muscles have an important relationship with other structures in the neck. The brachial plexus and subclavian artery pass between the anterior and middle scalene muscles. 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 scalene muscles also play a role in elevating the first and second ribs during forced inspiration, functioning as secondary respiratory muscles. They receive their blood supply from the ascending cervical branch of the inferior thyroid artery, which is a branch of the subclavian artery. The scalene muscles can be targeted with exercises to increase the stability of the cervical spine and reduce the risk of future injuries.
In some cases, surgical intervention involving the scalene muscles may be necessary. For example, partial or complete anterior scalene resection may be performed to relieve neurovascular compression during TOS decompression surgery. Additionally, a scalenectomy may be performed to create access for the removal of deeper tumors. Understanding the anatomy, function, and clinical significance of the scalene muscles is crucial for clinicians to effectively manage various conditions in the cervicothoracic area.
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The scalene muscles receive their blood supply from the ascending cervical branch of the inferior thyroid artery
The scalene muscles are a group of muscles in the neck that play a role in neck posturing, movement, and breathing. There are typically three scalene muscles: the anterior scalene, the middle scalene, and the posterior scalene. However, a fourth muscle, the scalenus minimus, is present in approximately 30% to 71% of individuals.
The ascending cervical branch of the inferior thyroid artery supplies blood to the scalene muscles, which is crucial for their function. These muscles have a significant relationship with other structures in the neck, such as the brachial plexus and subclavian artery, which pass between the anterior and middle scalene muscles. The scalene muscles also act as secondary respiratory muscles, elevating the first and second ribs during forced inspiration.
The blood supply to the scalene muscles is essential for maintaining their health and function. The inferior thyroid artery and its branches provide oxygenated blood to the muscles, ensuring their proper performance in neck posturing, movement, and breathing.
The scalene muscles have important surgical implications. The anterior scalene serves as a key landmark for identifying the subclavian artery, brachial plexus, and phrenic nerve. Additionally, the scalene muscles are relevant in central venous catheterization via the subclavian approach, as their proximity to major vessels increases the risk of vascular or nerve injury. Understanding the anatomy and blood supply of the scalene muscles is crucial for clinicians to effectively manage various conditions in the cervicothoracic area.
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![Scalene [Blu-ray]](https://m.media-amazon.com/images/I/61QT6PJGhKL._AC_UL320_.jpg)
The scalene muscles can be targeted with specific exercises and stretches to strengthen them and increase cervical spine stability
The scalene muscles are a group of muscles in the neck that elevate the first and second ribs during forced inspiration, acting as secondary respiratory muscles. They receive their blood supply from the first portion of the subclavian artery.
These muscles can be targeted with specific exercises and stretches to strengthen them and increase cervical spine stability, leading to a healthier, more flexible neck. Here are some examples:
Exercises
- Upright rows: This exercise targets the shoulders, upper back, biceps, and core. It helps improve upper body strength and muscle definition while enhancing posture, mobility, and mental well-being.
- Chin tucks: Sit or stand with good posture and look straight ahead. Tuck your chin towards your chest, creating a double chin effect, then release. Repeat for 10-15 repetitions. This exercise helps strengthen the anterior scalene muscles and improve neck alignment.
- Deep breathing exercises: These exercises help strengthen the scalene muscles and improve breathing. Take a deep breath in, expanding your chest and abdomen, then exhale slowly. Repeat for several breaths.
Stretches
- Chest opener: Clasp your hands behind your back with fingers intertwined. Rotate your palms toward your back, which will rotate your shoulders back and allow your chest, back, and shoulders to flex and open.
- Side stretch: Sit or stand with a straight back. Reach your arm up and over your head, bending to the side. Gently reach and stretch to the side, take deep breaths, and then return to a neutral position. Repeat on the other side.
- Scalene stretch: Sit or stand with good posture and look straight ahead. Place your hand on the top of your head and gently pull your head to the side, stretching the scalene muscle on the opposite side.
It is important to note that stretches should be gentle and relieve pressure. Do not push yourself beyond your limits. Always start with a warm-up and listen to your body. Consult a healthcare professional before starting any new exercise routine to ensure it is safe for you.
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Frequently asked questions
The scalene muscles are a group of muscles in the neck. There are three scalene muscles: the anterior scalene, the middle scalene, and the posterior scalene. A fourth muscle, the scalenus minimus, is present in 30% to 71% of individuals.
The scalene muscles elevate the first rib and bend the neck to the same side as the acting muscle. They also act as accessory muscles of respiration.
The anterior scalene originates from the anterior tubercles of the transverse processes of the third to sixth cervical vertebrae and inserts on the first rib. The middle scalene originates from the transverse processes of the last six cervical vertebrae and inserts on the first rib. The posterior scalene arises from the posterior tubercles of the transverse processes of the fourth, fifth, and sixth cervical vertebrae and inserts on the second rib.
The scalene muscles have an important relationship with other structures in the neck, such as the brachial plexus and subclavian artery. Knowledge of their anatomy is crucial in regional anesthesia and surgeries involving the arm or shoulder, such as TOS decompression surgery.
