The Scalenus medius, the largest and longest of the three scalene muscles, arises from the posterior tubercles of the transverse processes of the lower six cervical vertebræ. It descendes along the side of the vertebral column to insert by a broad attachment into the upper surface of the first rib, between the tubercle and the subclavian groove. The brachial plexus and the subclavian artery pass anterior to it. Because it elevates the upper ribs, the middle scalene muscle is also one of the accessory muscles of respiration. [WP,unvetted]. [ http://en.wikipedia.org/wiki/Scalenus_medius ]