Stair Muscles

Stair muscles - mm. Scalenii Raise upper ribs, acting as inspiratory muscles. With fixed ribs, contracting from both sides, they bend the cervical part of the spine, and with one-sided contraction - bend and turn it to their side.

[1], [2], [3], [4]

The front staircase is m.scalenus anterior

Beginning: anterior tubercles of transverse processes of III-VI cervical vertebrae

Attachment: Tuberculum m. Scaleni anterioris I ribs

Innervation: spinal nerves C5-C7 - muscular branches of the cervical plexus

Diagnosis: Stair muscles according to the frequency of their defeat by myofascial TK are distributed as follows: anterior, middle, posterior and least. TK in the anterior staircase is detected by palpation of the muscle under the posterior edge of the lateral head of the sternocleidomastoid muscle. At the level of the intersection of its external jugular vein, which appears prominently under the skin when it is squeezed with a finger directly above the collarbone. Local convulsive response in the stair muscles is rare. The presence of active trigger zones in the stair muscles is always accompanied by a point soreness in the middle part of the subclavian fossa when pressure is applied to it. This specific for the lesion of the stair muscles is a painful point lying over the small pectoral muscle or somewhat medial to it. Sometimes this painful point can be associated with the activity of trigger zones, pectoral muscles. If the pectoral muscles are not affected, the painful point disappears immediately after the inactivation of the trigger zones in the stair muscles.

Reflected pain: Active trigger zones located in any of the stair muscles can cause pain in the chest, arm, medial blade and interblade area. Zones of persistent blunt pain in the area of the breast, resembling the shape of two fingers, drop to the level of the nipple. The source of this pain pattern is usually the trigger zones localized in the lower part of the middle staircase or in the back staircase. The reflected pain in the anterior deltoid region with lesion of the stair muscles is not felt by the patients deeply in the joint, as happens when the subacute muscle is affected. The pain extends down the anterior and posterior regions of the shoulder; further it, without grasping the elbow, extends to the radial part of the forearm, and also to the thumb and index finger. The source of such a painful pattern, which grasps the arm, is the trigger zones localized in the upper part of the anterior staircase and in the middle staircase. Pain in the upper aunt of the medial edge of the scapula and in the adjacent interblade abdomen usually cause trigger zones localized in the front staircase.

The average ladder is m. Scalenus medius

Beginning: transverse processes of I (II) - VII cervical vertebrae

Attachment: I rib, posterior to Sulcus a. Subclaviae

Innervation: spinal nerves С3-С8 - muscular branches of the brachial plexus

Diagnosis: The average staircase lies deep, in front of the free edge of the upper tufts of the trapezius muscle. When palpation, it can be pressed against the posterior tubercles of the transverse processes of the cervical vertebrae.

Reflected pain: see above

The back staircase is m. Scalenus posterior

Beginning: posterior tubercles of transverse processes of V (VI) - VII cervical vertebrae

Attachment: 2nd Edge

Innervation: spinal nerves С7-С8 - muscular branches of the brachial plexus

Diagnosis: The back stair is poorly accessible by palpation. It lies behind the middle staircase and its fibers are directed more horizontally than the fibers of the latter. For the convenience of palpation of the posterior staircase, the muscle lifting the scapula that lies above it is displaced to the side where it emerges from under the front free edge of the upper fasciculus of the trapezius muscle.

Reflected pain: see above