The posterior scalene inserts on the second rib (unlike the others which insert on the first rib) and is the deepest and most posterior of the three. It forms the posterior wall of the posterior cervical triangle.
| Origin | Posterior tubercles of transverse processes of C4-C6 |
|---|---|
| Insertion | Outer surface of the second rib |
| Nerve Supply | Ventral rami of C6-C8 |
| Blood Supply | Transverse cervical artery |
| Actions | Elevates the second rib; Assists lateral neck flexion; The smallest and deepest scalene |
|---|
The posterior scalene is the reference muscle for the cervical plexus block — the plexus is anaesthetised just posterior to the posterior scalene border. In thoracic outlet surgery, the posterior scalene is occasionally resected alongside the anterior and middle scalenes.
Not individually palpable from the middle scalene.
The posterior scalene posterior border serving as the anatomical reference for superficial cervical plexus block injection.
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