Posterior Scalene Muscle Beneath the Skin, Posterior View

Description

Presented from a posterior perspective with the skin removed, the posterior scalene muscle (scalenus posterior) lies deep in the lateral neck, posterior to the middle scalene and anterolateral to the levator scapulae. Its fibers run inferolaterally from the transverse processes of the lower cervical vertebrae (classically C4 to C6) toward the external surface of the second rib, a relationship that places its superior attachments partly obscured by overlying splenius cervicis, splenius capitis, and the posterior border of sternocleidomastoid as they wrap laterally. Inferiorly, the muscle occupies the interval between the cervical vertebral column medially and the scapular elevators laterally, with the upper thoracic spinous processes and paraspinal musculature providing midline orientation. Bony landmarks anchor the view. Posterior scalenes matter when you need to teach or plan access to the deep lateral neck without losing the three dimensional logic of the scalene triangle and costovertebral junctions. Tightness, spasm, or hypertrophy in this compartment can contribute to thoracic outlet type symptoms, and a posterior view clarifies why scapular position and rib motion can change perceived neural tension along the lower brachial plexus even when the primary compression is anterior. For regional anesthesia, this anatomy helps explain why spread during an interscalene block can track along fascial planes near the scalene muscles and why needle trajectory must respect the deeper muscular layering. Use it in gross anatomy courses covering the posterior triangle of the neck, in physical therapy materials on accessory respiratory muscles and cervicothoracic mechanics, or in surgical education where posterior cervical approaches require reliable muscular landmarks over the cervical spine and upper ribs. Anatomical accuracy verified by SciePro's Medical Advisory Board.