BRACHIAL ARTERY

 FEATURES:

   Brachial artery is the continuation of the axillary artery. It extends from the lower border of the teres major muscle to a point in front of the elbow, at the level of the neck of the radius, just medial to the tendon of the Diceps brachii.

BEGINNING, COURSE AND TERMINATION:

Brachial artery begins at the lower border of teres major muscle as continuation of axillary artery. It runs downwards and laterally in the front of arm and crosses the elbow joint. It ends at the level of the neck of radius in the cubital fossa by dividing into its two terminal branches, the radial and ulnar arteries.

The course and relations of the brachial artery. 

RELATION:

1 It runs downwards and laterally, from the medial side of the arm to the front of the elbow.

2 It is superficial throughout its extent and is accompanied by two venae comitantes.

3 Anteriorly, in the middle of the arm, it is crossed by the median nerve from the lateral to the medial side, and in front of the elbow, it is covered by the bicipital aponeurosis and the median cubital vein 

4 Posteriorly, it is related to: i. The triceps brachii. 

ii. The radial nerve and the profunda brachii artery.                                                            5Medially, in the upper part, it is related to the ulnar nerve and the basilic vein, and in the lower part to the median nerve. 

6 Laterally, it is related to the coracobrachialis, the biceps brachii and the median nerve in its upper part; and to the tendon of the biceps brachii at the elbow                                                  7 At the elbow, the structures from the medial to the  lateral side are:       

i. Median nerve

ii. Brachial artery

iii. Biceps brachii tendon

iv. Radial nerve on a deeper plane (MBBR).

BRANCHES:

1 Unnamed muscular branches.

2 The profunda brachii artery arises just below the teres major and accompanies the radial nerve.                                                                          3 The superior ulnar collateral branch arises in the upper part of the arm and accompanies the ulnar nerve

4 A nutrient artery is given off to the humerus.

5 The inferior ulnar collateral (or supratrochlear) branch arises in the lower part and takes part in the anastomoses around the elbow joint.                                                                6 The artery ends by dividing into two terminal branches, the radial and ulnar arteries.

Branches

ANASTOMOSES AROUND THE

   Anastomoses around the elbow joint link the brachial artery with the upper ends of the radial and ulnar arteries They supply the ligaments and bones of the joint. The anastomoses can be subdivided into the following parts.

    In front of the lateral epicondyle of the humerus, the anterior descending (radial collateral) branch of the profunda brachii anastomoses with the radial recurrent branch of the radial artery 

Anastomoses around the elbow joint

   Behind the lateral epicondyle of the humerus, the posterior descending branch of the profunda brachii artery (middle collateral) anastomoses with the interosseous recurrent branch of the posterior interosseous artery.

     In front of the medial epicondyle of the humerus, the inferior ulnar collateral branch of the brachial artery anastomoses with the anterior ulnar recurrent branch of the ulnar artery.                                                                   Behind the medial epicondyle of the humerus, the superior ulnar collateral branch of the brachial artery anastomoses with the posterior ulnar recurrent branch. 

CLINICAL ANATOMY:

  Brachial pulsations are felt or auscultated in front of the elbow just medial to the tendon of biceps for recording the blood pressure 

 Although the brachial artery can be compressed anywhere along its course, it can be compressed most favourably in the middle of the arm, where it lies on the tendon of the coracobrachialis.

  Blood for blood gas analysis is collected from brachial artery.

Clinical anatomy