Relations
The scalene muscles have an important relationship to other structures in the neck. The brachial plexus and subclavian artery pass between the anterior and middle scalenes. The subclavian vein and phrenic nerve pass anteriorly to the anterior scalene as the muscle crosses over the first rib. The phrenic nerve is oriented vertically as it passes in front of the anterior scalene, while the subclavian vein is oriented horizontally as it passes in front of the anterior scalene muscle.
The passing of the brachial plexus and the subclavian artery through the space of the anterior and middle scalene muscles constitute the scalene hiatus (the term "scalene fissure" is also used). The region in which this lies is referred to as the scaleotracheal fossa. It is bound by the clavicle inferior anteriorly, the trachea medially, posteriorly by the trapezius, and anteriorly by the platysma muscle.
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