Scalene muscles: Difference between revisions
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{{Short description|Muscles on the sides of the neck}} |
{{Short description|Muscles on the sides of the neck}} |
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{{Use mdy dates|date = January 2019}} |
{{Use mdy dates|date = January 2019}} |
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{{Infobox muscle |
{{Infobox muscle |
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| Name = Scalene muscles |
| Name = Scalene muscles |
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| Latin = |
| Latin = mm. scalenii |
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| Image = Scalenus.png |
| Image = Scalenus.png |
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| Caption = The anterior vertebral muscles. |
| Caption = The anterior vertebral muscles. |
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| Antagonist = |
| Antagonist = |
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}} |
}} |
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The '''scalene muscles''' are a group of three |
The '''scalene muscles''' are a group of three [[muscle]]s on each side of the [[neck]], identified as the anterior, the middle, and the posterior. They are innervated by the third to the eighth cervical [[spinal nerves]] (C3-C8). |
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The anterior and middle scalene muscles lift the [[first rib]] and bend the [[neck]] to the |
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. |
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The muscles are named {{ety|grc|σκαληνός ( |
The muscles are named {{ety|grc|σκαληνός (skalēnós)|uneven}}. |
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==Structure== |
==Structure== |
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The scalene muscles |
The scalene muscles are attached at one end to [[transverse processes|bony protrusions]] on [[cervical vertebrae|vertebrae]] C2 to C7 and at the other end to the first and second [[rib]]s.<ref>{{cite book|url=https://archive.org/details/anatomydescript08graygoog|title=Anatomy: Descriptive and Applied|publisher=Lea & Febiger|author=Henry Gray|year=1913}}</ref>[[File:Scalenus anterior01.png|thumb|left|120x120px|Anterior scalene|alt=]] |
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===Anterior scalene=== |
===Anterior scalene=== |
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| ⚫ | The '''anterior scalene muscle''' ({{langx|la|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 third, fourth, fifth, and sixth [[cervical vertebrae]], and descending, almost vertically, is inserted by a narrow, flat tendon into the [[scalene tubercle]] on the inner border of the [[first rib]], and into the ridge on the upper surface of the [[second rib]] in front of the [[subclavian groove]]. It is supplied by the [[anterior ramus]] of [[cervical nerve]] 5 and 6.[[File:Gray385 - Scalenus medius muscle.png|thumb|left|129x129px|Middle scalene|alt=]] |
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| ⚫ | The '''anterior scalene muscle''' ({{ |
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===Middle scalene=== |
=== Middle scalene === |
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| ⚫ | The '''middle scalene''', ({{langx|la|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 [[brachial plexus]] and the [[subclavian artery]] pass anterior to it. |
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[[File:Gray385 - Scalenus medius muscle.png|thumb|left|140px|Middle scalene]] |
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| ⚫ | The '''middle scalene''', ({{ |
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{{Clear}} |
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===Posterior scalene=== |
===Posterior scalene=== |
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| ⚫ | The '''posterior scalene''', ({{langx|la|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 lower two or three cervical vertebrae, and is inserted by a thin tendon into the outer surface of the second rib, behind the attachment of the anterior scalene. It is supplied by cervical nerves C5, C6 and C7. It is occasionally blended with the middle scalene. |
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[[File:Scalenus posterior04.png|thumb|left|160px|Posterior scalene]] |
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| ⚫ | The '''posterior scalene''', ({{ |
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===Variation=== |
===Variation=== |
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==Function== |
==Function== |
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The anterior and middle scalene muscles |
The anterior and middle scalene muscles lift the [[first rib]] and bend the [[neck]] to the same side as the acting muscle;<ref>{{cite journal |author1=Buford JA |author2=Yoder SM |author3=Heiss DG |author4=Chidley JV |title=Actions of the scalene muscles for rotation of the cervical spine in macaque and human |journal=J Orthop Sports Phys Ther |volume=32 |issue=10 |pages=488–96 |date=Oct 2002 |pmid=12403200 |doi= 10.2519/jospt.2002.32.10.488|doi-access=free }}</ref> the posterior scalene lifts the second rib and tilts the neck to the same side. |
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Because they elevate the upper ribs they also act as [[accessory muscles of respiration]], along with the [[sternocleidomastoids]]. |
Because they elevate the upper ribs, they also act as [[accessory muscles of respiration]], along with the [[sternocleidomastoids]]. |
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===Relations=== |
===Relations=== |
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==Clinical significance== |
==Clinical significance== |
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The anterior and middle scalene muscles can be involved in certain forms of [[thoracic outlet syndrome]] as well as [[myofascial pain syndrome]], the symptoms of which may mimic a [[spinal disc herniation]] of the [[cervical vertebrae]].<ref>{{cite journal | pmc = 3216145 | pmid=22135529 | volume=17 | title=Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases | journal=Malays J Med Sci | pages=60–6 | last1 = Abd Jalil | first1 = N | last2 = Awang | first2 = MS | last3 = Omar | first3 = M}}</ref> |
The anterior and middle scalene muscles can be involved in certain forms of [[thoracic outlet syndrome]] as well as [[myofascial pain syndrome]], the symptoms of which may mimic a [[spinal disc herniation]] of the [[cervical vertebrae]].<ref>{{cite journal | pmc = 3216145 | pmid=22135529 | volume=17 | title=Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases | journal=Malays J Med Sci | pages=60–6 | last1 = Abd Jalil | first1 = N | last2 = Awang | first2 = MS | last3 = Omar | first3 = M| year=2010 | issue=1 }}</ref> |
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Since the nerves of the brachial plexus pass through the space between the anterior and middle scalene muscles, that area is sometimes targeted with the administration of regional anesthesia by |
Since the nerves of the brachial plexus pass through the space between the anterior and middle scalene muscles, that area is sometimes targeted with the administration of regional anesthesia by an anesthesia provider. The nerve block, called an [[Brachial plexus block|interscalene block]], may be performed prior to arm or shoulder surgery.<ref>{{cite web|last=Graber|first=Raymound|title=Interscalene Nerve Block|url=http://emedicine.medscape.com/article/2000151-overview#showall|work=WebMD, LLC.|publisher=Medscape|access-date=10 December 2012}}</ref> |
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According to the medical codes in the 2016 Procedural Coding Expert, published by the [[American Academy of Professional Coders]], for [[Current Procedural Terminology]] (CPT) and other medical codes, the scalenus anticus muscle can be divided by reparative or reconstructive surgery, with (# 21705) or without (# 21700) resection of the [[cervical rib]]. |
According to the medical codes in the 2016 Procedural Coding Expert, published by the [[American Academy of Professional Coders]], for [[Current Procedural Terminology]] (CPT) and other medical codes, the scalenus anticus muscle can be divided by reparative or reconstructive surgery, with (# 21705) or without (# 21700) resection of the [[cervical rib]]. |
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===Etymology=== |
===Etymology=== |
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The muscles are named from [[Greek language|Greek]] σκαληνός, or '' |
The muscles are named from [[Greek language|Greek]] σκαληνός, or ''skalēnós'', meaning uneven<ref>[[Mosby's Medical, Nursing & Allied Health Dictionary]], Fourth Edition, Mosby-Year Book Inc., 1994, p. 1395</ref> as the pairs are all of differing length.<ref name=Davies>{{cite book|last=Davies|first=Clair|title=The Trigger Point Therapy Workbook|year=2013|publisher=New Harbinger Publications|isbn=9781608824960|url=https://books.google.com/books?id=DLb7ShX-gskC&q=scalene+muscles+uneven&pg=PA126|edition=Third|author2=Davies, Amber }}</ref> |
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==Additional images== |
==Additional images== |
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<gallery> |
<gallery> |
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File:Musculi coli base.svg|Musculi |
File:Musculi coli base.svg|Musculi colli base |
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File:Slide1ABBA.JPG|Scalene muscles. Muscles of the neck. Lateral view. |
File:Slide1ABBA.JPG|Scalene muscles. Muscles of the neck. Lateral view. |
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File:Slide2ABBA.JPG|Scalene muscles. Muscles of the neck. Lateral view. |
File:Slide2ABBA.JPG|Scalene muscles. Muscles of the neck. Lateral view. |
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File:Gray384.png|Section of the neck at about the level of the sixth cervical vertebra. Showing the arrangement of the [[fascia |
File:Gray384.png|Section of the neck at about the level of the sixth cervical vertebra. Showing the arrangement of the [[fascia colli]]. |
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</gallery> |
</gallery> |
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{{Muscles of neck}} |
{{Muscles of neck}} |
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{{Authority control}} |
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[[Category:Human anatomy]] |
[[Category:Human anatomy]] |
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Latest revision as of 07:27, 18 November 2024
| Scalene muscles | |
|---|---|
 The anterior vertebral muscles. | |
| Details | |
| Origin | Cervical vertebrae (CII-CVII) |
| Insertion | First and second ribs |
| Artery | Ascending cervical artery (branch of Inferior thyroid artery) |
| Nerve | Cervical nerves (C3-C8) |
| Actions | Elevation of first and second ribs |
| Identifiers | |
| Latin | mm. scalenii |
| FMA | 64829 |
| Anatomical terms of muscle | |
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 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 muscles are named from Ancient Greek σκαληνός (skalēnós) 'uneven'.
Structure
[edit]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.[1]
Anterior scalene
[edit]The anterior scalene muscle (Latin: 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 third, fourth, fifth, and sixth cervical vertebrae, and descending, almost vertically, is inserted by a narrow, flat tendon into the scalene tubercle on the inner border of the first rib, and into the ridge on the upper surface of the second rib in front of the subclavian groove. It is supplied by the anterior ramus of cervical nerve 5 and 6.
Middle scalene
[edit]The middle scalene, (Latin: 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 brachial plexus and the subclavian artery pass anterior to it.
Posterior scalene
[edit]The posterior scalene, (Latin: 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 lower two or three cervical vertebrae, and is inserted by a thin tendon into the outer surface of the second rib, behind the attachment of the anterior scalene. It is supplied by cervical nerves C5, C6 and C7. It is occasionally blended with the middle scalene.
Variation
[edit]A fourth muscle, the scalenus minimus (Sibson's muscle), is sometimes present behind the lower portion of the anterior scalene.[2]
Function
[edit]The anterior and middle scalene muscles lift the first rib and bend the neck to the same side as the acting muscle;[3] the posterior scalene lifts the second rib and tilts the neck to the same side.
Because they elevate the upper ribs, they also act as accessory muscles of respiration, along with the sternocleidomastoids.
Relations
[edit]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.[4] 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 as it passes in front of the anterior scalene muscle.[4]
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 term "scalene fissure" is also used). The region in which this lies is referred to as the scaleotracheal fossa. It is bounded by the clavicle inferior anteriorly, the trachea medially, posteriorly by the trapezius, and anteriorly by the platysma muscle.
Clinical significance
[edit]The anterior and middle scalene muscles can be involved in certain forms of thoracic outlet syndrome as well as myofascial pain syndrome, the symptoms of which may mimic a spinal disc herniation of the cervical vertebrae.[5]
Since the nerves of the brachial plexus pass through the space between the anterior and middle scalene muscles, that area is sometimes targeted with the administration of regional anesthesia by an anesthesia provider. The nerve block, called an interscalene block, may be performed prior to arm or shoulder surgery.[6]
According to the medical codes in the 2016 Procedural Coding Expert, published by the American Academy of Professional Coders, for Current Procedural Terminology (CPT) and other medical codes, the scalenus anticus muscle can be divided by reparative or reconstructive surgery, with (# 21705) or without (# 21700) resection of the cervical rib.
History
[edit]The scalenes used to be known as the lateral vertebral muscles.[7]
Etymology
[edit]The muscles are named from Greek σκαληνός, or skalēnós, meaning uneven[8] as the pairs are all of differing length.[2]
Additional images
[edit]-
Musculi colli base -
Scalene muscles. Muscles of the neck. Lateral view. -
Scalene muscles. Muscles of the neck. Lateral view. -
Section of the neck at about the level of the sixth cervical vertebra. Showing the arrangement of the fascia colli.
References
[edit]- ^ Henry Gray (1913). Anatomy: Descriptive and Applied. Lea & Febiger.
- ^ a b Davies, Clair; Davies, Amber (2013). The Trigger Point Therapy Workbook (Third ed.). New Harbinger Publications. ISBN 9781608824960.
- ^ Buford JA; Yoder SM; Heiss DG; Chidley JV (October 2002). "Actions of the scalene muscles for rotation of the cervical spine in macaque and human". J Orthop Sports Phys Ther. 32 (10): 488–96. doi:10.2519/jospt.2002.32.10.488. PMID 12403200.
- ^ a b Albertine, David A. Morton, K. Bo Foreman, Kurt H. (2011). "Chapter 25: Overview of the Neck, Muscles of the Neck". Gross anatomy: the big picture. New York: McGraw-Hill. ISBN 978-0071476720.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ Abd Jalil, N; Awang, MS; Omar, M (2010). "Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases". Malays J Med Sci. 17 (1): 60–6. PMC 3216145. PMID 22135529.
- ^ Graber, Raymound. "Interscalene Nerve Block". WebMD, LLC. Medscape. Retrieved December 10, 2012.
- ^ Henry Gray (1913). Anatomy: Descriptive and Applied.
- ^ Mosby's Medical, Nursing & Allied Health Dictionary, Fourth Edition, Mosby-Year Book Inc., 1994, p. 1395
