Posterior Scalene, Posterior View

Description

Running along the posterolateral cervical spine, the posterior scalene is isolated in red and tracked from the posterior tubercles of the transverse processes of the mid to lower cervical vertebrae (classically C4 to C6) to its distal attachment on the superior surface of the second rib. Anterior to it, the scalenus medius and scalenus anterior occupy the interscalene space region, while posteriorly it blends into the deeper plane approaching levator scapulae and the prevertebral fascia. Superiorly, the muscle lies deep to the occipital region and upper cervical soft tissues, and inferiorly it approaches the thoracic inlet near the clavicle and medial scapular border. Bony landmarks include the mandible and cranial base, the hyoid, cervical vertebrae, clavicle, and the superomedial scapula. Posterior scalene anatomy matters because it frames the posterior boundary of the interscalene interval and sits adjacent to the roots and trunks of the brachial plexus as they emerge between scalenus anterior and medius at the base of the neck. Small variations in scalene bulk or fibrous bands can contribute to neurogenic thoracic outlet syndrome, and posterior approaches for scalene muscle injection or botulinum toxin treatment rely on a clear mental map of where the posterior scalene lies relative to the cervical transverse processes and the first rib. A tight space. The posterior perspective also clarifies how scalene attachments relate to the second rib, a frequent point of confusion when learners assume all scalenes insert on the first rib. Use this artwork for gross anatomy and regional anatomy teaching of the neck, for thoracic outlet syndrome chapters in clinical texts, or to support pain medicine and anesthesiology discussions of landmark based needle paths around the scalene musculature. Anatomical accuracy verified by SciePro's Medical Advisory Board.