Scalenus medius muscle

Musculus scalenus medius

  • Synonym: Middle scalene muscle
  • Related terms: Scalenus medius; Middle scalene

Definition

Muhammad A. Javaid

Scalenus medius muscle

Origin

Transverse process of C2-C6

Insertion

First rib

Blood supply

Ventral rami of C3 to C7 nerves

Innervation

Action

Elevate 1st rib, rotate the neck to the opposite side

The middle scalene muscle is the largest and longest of the three scalene muscles (anterior, middle, posterior) and forms the floor of the posterior triangle of the neck. It lies posterior to the anterior scalene.

Anatomical details

1. Origin

Posterior tubercles of the transverse processes of cervical vertebrae C2–C7

2. Insertion

Fibres descend to insert onto the upper surface of the first rib, posterior to the groove for the subclavian artery

Innervation

Ventral rami of the third to eighth cervical spinal nerves (C3 to C7).

Blood supply

All scalene muscles receive their arterial blood supply from the ascending cervical branch of the inferior thyroid artery. The posterior scalene receives an additional supply from the superficial cervical artery.

Relations

Aspect

Structures Related

Anterior

Brachial plexus and subclavian artery (pass between anterior and middle scalenes)

Posterior

Posterior scalene and levator scapulae muscles

Medial

Anterior scalene muscle and longus colli

Actions

  • Elevates the first rib during inspiration (accessory inspiratory muscle).

  • Laterally flexes the neck to the same side (acting unilaterally).

  • Stabilizes the cervical spine during neck movements.

References

  • Gray, H. (2016) Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 41st edn. Edited by S. Standring. New York: Elsevier. Chapter 29: Neck, pp. 451.

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