Abstract
For some years we have been interested in the role that the scalene muscles play in the work of respiration and in the value of determining their size and activity in evaluation of conditions of disturbed ventilation. These muscles were selected for particular study from the group of so-called accessory respiratory muscles because our clinical experience indicated, and anatomical evidence supported the conclusion, that the scalenes are the most important "accessory" muscles of respiration. We have found them to be more consistently used in the various respiratory disease syndromes than are the sternomastoids, upper trapezius, or pectoralis muscles. Other accessory muscles, sometimes listed, are of less clear importance. We have many times noted in patients with definite, but moderate, use of the scalenes that there is minimal or no palpable activity of the other accessories, and this is sometimes true even where there is marked use of the scalenes. We
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