Posterior Scalene

Description

Running along the posterolateral neck, the posterior scalene is shown as a paired muscle mass arising from the posterior tubercles of the lower cervical transverse processes (typically C4 to C6) and descending inferiorly to its insertion on the outer surface of the second rib. Medial to it, the cervical spinous processes and laminae form the midline contour of the posterior neck, while the upper thoracic vertebrae continue inferiorly into the upper back. Laterally, the muscle lies deep to the trapezius region and relates to the superior angle and medial border of the scapula where the levator scapulae sits more medial and posterior, creating a useful comparison of these often-confused cervical elevators. Bony landmarks, including the occiput, upper ribs, and scapulae, anchor the spatial relationships. Posterior scalenes matter when you want to explain cervicothoracic mechanics without defaulting to the more frequently illustrated anterior and middle scalene interval. Hypertrophy or spasm can contribute to lateral neck pain and altered rib motion during forced inspiration, and it is a frequent target in manual therapy discussions about cervical side-bending and rotation coupling at the lower cervical segments. This posterior view also supports teaching on why scapular elevation complaints are not always levator scapulae driven, since the posterior scalene can bias rib position and change the resting length of periscapular muscles. Small muscle, large consequences. Use this artwork in gross anatomy and kinesiology courses, in physiotherapy and sports medicine texts covering neck pain patterns, and in clinical handouts that contrast levator scapulae strain with scalene-related cervicobrachial symptoms and thoracic outlet region biomechanics. Anatomical accuracy verified by SciePro's Medical Advisory Board.