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The scalene muscles have an important relationship to other structures in the neck.
It's really an injury with small amounts of tearing within the scalene muscles.
It also acts as an accessory muscle of inspiration, along with the scalene muscles of the neck.
The Scalenus medius, also known as the middle scalene, is the largest and longest of the three scalene muscles in the human neck.
The sternocleidomastoid (elevated sternum) and the scalene muscles (anterior, middle and posterior scalene) are typically considered accessory muscles of breathing .
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 physicians.
In cases where the first rib is compressing a vein, artery, or the nerve bundle, the first rib and scalene muscles and any compressive fibrous tissue can be removed.
It includes the prevertebral muscles (longus colli and longus capitis), vertebral artery, vertebral vein, scalene muscles, phrenic nerve and part of the brachial plexus.
The brachial plexus emerges between the anterior and middle scalene muscles, superior to the first rib, and passes obliquely and inferiorly, underneath the clavicle, into the shoulder and then the arm.
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 interscalene block is performed by injecting local anesthetic to the nerves of the brachial plexus as it passes through the groove between the anterior and middle scalene muscles, at the level of the cricoid cartilage.
Thoracic outlet syndrome (TOS) is a syndrome involving compression at the superior thoracic outlet wherein excess pressure placed on a neurovascular bundle passing between the anterior scalene and middle scalene muscles.
From its origin, the subclavian artery travels laterally, passing between anterior and middle scalene muscles, with the anterior scalene (scalenus anterior) on its anterior side and the middle scalene (scalenus medius) on its posterior.
It crosses in front of the phrenic nerve and the scalene muscles, and in front of or between the divisions of the brachial plexus, and is covered by the platysma and sternocleidomastoid muscles, and crossed by the omohyoid and trapezius.
Signs which occur during an asthma attack include the use of accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck), there may be a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest.
The action of the anterior and middle scalene muscles is to elevate the first rib and laterally flex (bend) the neck to the same side; the action of the posterior scalene is to elevate the second rib and tilt the neck to the same side.
This procedure is called a first rib resection and scalenectomy and involves going through the underarm area or back of the neck area and removing the first rib, scalene muscles, and any compressive fibrous tissue to open the area to allow increased blood flow and/or reduce nerve compression.