Middle Scalene Muscle

Description

Posteriorly, the middle scalene muscle (musculus scalenus medius) is rendered along the lateral cervical spine, arising from the posterior tubercles of the transverse processes of the mid cervical vertebrae and descending inferolaterally to the superior surface of the first rib. Medial to it, the cervical spinous processes and posterior elements of the vertebrae establish the midline, while the scapulae and clavicles frame the lower field and the upper ribs arc laterally from the thoracic vertebrae. Portions of sternocleidomastoid are suggested more anterolaterally near the mastoid region, but the emphasis stays on the deep lateral neck and its bony attachments. Clean bony landmarks anchor the muscle’s line of pull. Middle scalene anatomy matters because it defines a major portion of the interscalene triangle, the corridor between anterior and middle scalene over the first rib that transmits the brachial plexus trunks and the subclavian artery. That relationship underpins clinical patterns in neurogenic thoracic outlet syndrome, where hypertrophy, spasm, or fibrous bands can contribute to paresthesia and weakness, and it explains why image guided scalene blocks target fascial planes in this region while avoiding the pleura at the cupola of the lung. Small space. High stakes. Use this artwork to teach deep neck musculature in gross anatomy, physical therapy, and anesthesia curricula, or to support figures on thoracic outlet syndrome, brachial plexus relationships, and first rib landmarks in surgical and radiology publications. It also fits patient education for posture related cervical pain when you need a clear posterior orientation. Anatomical accuracy verified by SciePro's Medical Advisory Board.