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ScalenesMusculi scaleni

Three paired muscles (anterior, middle and posterior) at the side of the neck that side-bend the neck and lift the first two ribs in deep breathing.

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LatinMusculi scaleni
Origin
  • Anterior scalene: anterior tubercles of the transverse processes of C3–C6
  • Middle scalene: posterior tubercles of the transverse processes of C2–C7
  • Posterior scalene: posterior tubercles of the transverse processes of C4–C6
Insertion
  • Anterior scalene: scalene tubercle and upper surface of the first rib, in front of the subclavian groove
  • Middle scalene: upper surface of the first rib, behind the subclavian groove
  • Posterior scalene: outer surface of the second rib
Action
  • One side: laterally flexes the neck to the same side
  • Both sides: slightly flex the neck
  • Anterior and middle scalenes: lift the first rib (accessory muscles of breathing)
  • Posterior scalene: lifts the second rib
NerveVentral rami of the cervical spinal nerves (C3–C8)
NameGreek skalenos, 'uneven'; the three muscles on each side are different lengths.

Palpation

  1. Client supine; sit at the head of the table and turn the head slightly away from the side you are working.
  2. Find the back edge of the sternocleidomastoid just above the clavicle, then slide the fingertips back off it into the posterior triangle.
  3. Feel gently for firm bands running down towards the first rib, in front of the levator scapulae and trapezius.
  4. Ask the client to sniff in sharply; feel the scalenes tighten as they lift the first rib.

The scalenes lie at the side of the neck, behind Sternocleidomastoid and in front of Levator scapulae. Because they lift the upper ribs, they work with the sternocleidomastoid as accessory muscles of breathing, especially during deep or effortful breaths.

Local precaution: the brachial plexus (the nerves to the arm) and the subclavian artery pass between the anterior and middle scalenes. Keep pressure light and brief. If the client feels tingling down the arm, or you feel a pulse under your fingers, move off the spot.

The sources disagree on the details. Wikipedia gives the nerve supply as C3–C8, while Gray’s (1918) gives C2–C7. For the posterior scalene’s origin, Wikipedia gives C4–C6, while Gray’s gives “the lower two or three cervical vertebrae”.

Sources

  1. Wikipedia, Scalene muscles
  2. Gray's Anatomy (1918), IV. Myology 5e: The Lateral Vertebral Muscles (Public domain; Bartleby edition read via the Internet Archive.)