Brachial artery of A.Griguolo

Generality

The brachial artery is the most important artery of the upper limb.

With the support of numerous branches, both collateral and terminal, the brachial artery supplies the arm, forearm and hand muscles, the humerus, the elbow joint and some bone elements of the wrist with oxygenated blood.

The course of the brachial artery begins at the level of the inferior margin of the large round muscle of the shoulder and ends shortly after the elbow, with the division into the terminal branches known as radial artery and ulnar artery.

The brachial artery can be a victim of injury or a somewhat unusual phenomenon, called a pseudo-aneurysm.

In the clinical diagnostic field, the brachial artery is important because it allows the measurement of systolic blood pressure (brachial pulse).

Short review of what an artery is

In human anatomy, any blood vessel used for transporting blood from the heart to the body's various tissues and organs is included in the list of arteries .

Contrary to what many people think, only oxygenated blood (ie "load" of oxygen) does NOT flow in the arteries; to demonstrate what has just been stated is the existence of the pulmonary artery and its branches, ie the arterial vessels destined to transport oxygen-poor blood from the heart to the lungs, in order to provide oxygenation of the aforementioned blood.

What is the Brachial Artery?

The brachial artery is the most important artery of the upper limb . The brachial artery, in fact, is the arterial vessel from which the various minor arteries originate, destined to supply the bones and soft tissues of the arm, forearm and hand with oxygenated blood.

Using a parallelism, the brachial artery is equivalent to the trunk of a large tree, from which numerous branches branch off.

In the lower limb, the artery equivalent to the brachial artery is ...

In the lower limb, the artery equivalent to the brachial artery is the femoral artery .

Anatomy

Introduction: in human anatomy, the description of the course of arteries and veins is based on the direction of blood flow; in practical terms, this means that the description of the route of an artery will start from the heart or from the end closest to the heart, while the description of the route of a vein will start from the periphery.

The brachial artery is, in fact, a continuation of the axillary artery ; its precise point of origin is at the level of the inferior margin of the big round muscle, one of the 6 so-called intrinsic shoulder muscles.

The axillary artery is the main artery of the axilla region ; originating from the subclavian artery, with its various branches, has the task of supplying the axillary structures, the shoulder, the scapula and the upper part of the thorax with oxygenated blood.

Starting from the inferior margin of the big round muscle, therefore, the brachial artery starts a course in the direction of the elbow, which leads it to place side by side the humerus ( arm bone ), first, in a medial position and, subsequently, in front position. In other words, between the point of origin and the elbow, the brachial artery skirts the humerus, first on the inner side and then in front of the front surface.

Compared to the other non-bone anatomical elements present in the section considered above, the brachial artery is in a medial position with respect to the biceps brachialis muscle ; it is anterior to the triceps brachialis muscle ; side by side the basic vein for the entire route; finally, alongside the median nerve, first in a medial position and then in a lateral position.

The median nerve is one of the 5 important peripheral nerves originating from the so-called brachial plexus .

In the clinical-pathological field, the median nerve is known to be the protagonist of carpal tunnel syndrome, a set of symptoms and signs resulting from the compression of the nerve in question at the wrist.

The brachial artery concludes its path at the so-called cubital elbow ; located on the front of the elbow, the cubital fossa of the elbow is the triangular area resulting from the particular disposition of the epicondyles of the humerus, superiorly, of the pronator round, medially, and of the brachioradialis muscle, laterally.

In the cubital fossa, in addition to the brachial artery, there are: the radial nerve, the tendon of the biceps brachial muscle and the median nerve.

To mark the conclusion of the brachial artery is its subdivision, at the apex of the cubital fossa of the elbow, into two smaller arteries, which are the radial artery and the ulnar artery .

Branches of the brachial artery

The branches of an artery are its branches; these branches may originate during the course (preterminal or collateral branches) or at its conclusion (terminal branches).

The brachial artery is an artery that has both side branches and terminal branches .

BRANCI COLLATERALI OF THE BRACHIAL ARTERY

Proceeding from top to bottom (therefore in order of origin), the side branches of the brachial artery are:

The deep brachial artery . Originating in the very first tract of the brachial artery, this branch crosses over the whole humerus and wedges itself into the so-called radial groove, a characteristic lateral sulcus of the humerus in which the radial nerve also flows.
Through some of its branches, the deep brachial artery supplies the deltoid muscle, the triceps brachialis muscle and the anconeus muscle with oxygenated blood.
The upper ulnar collateral artery . This branch is born, exactly, just below the central portion of the arm.
The upper ulnar collateral artery supplies the elbow joint with oxygenated blood.
The inferior ulnar collateral artery . This branch is born, exactly, 5 centimeters above the elbow joint.
The inferior ulnar collateral artery supplies the brachialis muscle, the biceps brachialis and the coracobrachialis muscle with oxygenated blood.

It should be noted that, along the vascular tract including the aforementioned collateral arteries, the brachial artery also gives rise to numerous small vessels designed to nourish the bone tissue of the humerus; in anatomy, these small important vessels are called nourishing vessels .

TERMINAL BRANCHE OF THE BRACHIAL ARTERY

The terminal branches of the brachial artery are the aforementioned radial artery and ulnar artery:

The radial artery is the main arterial vessel of the forearm; looking at the forearm with the palm facing the observer, this terminal branch of the brachial artery runs along the entire upper surface of the radius (one of the two bones of the forearm), thus occupying a lateral (external) position. Its course ends in the hand, where it meets with the ulnar artery and forms the so-called deep palmar arch .
Flanked by the radial nerve and provided with various branches, the radial artery has the task of supplying oxygenated blood: the elbow joint, the muscles of the lateral and posterior portions of the forearm, the radial nerve, the carpal bones and the joints interposed between them, the thumb and the lateral region of the index finger.

The ulnar artery is the second most important arterial vessel of the forearm; observing the forearm with the palm facing the observer, this terminal branch of the brachial artery runs over the upper surface of the ulna (the second of the two bones of the forearm), thus occupying a medial position (internal). Its course ends in the hand, where the aforementioned encounter with the radial artery takes place, an encounter that leads to the constitution of the deep palmar arch.
Flanked by the ulnar nerve and provided with various branches, the ulnar artery has the task of supplying oxygenated blood: the elbow joint, the medial and anterior muscles of the forearm, the median nerve and the ulnar nerve .

At the level of the elbow, the terminal branches of the brachial artery form, through some of their branches, a complex network of anastomoses (connections between blood vessels), which make the blood circulation of the nearby joint even more efficient.

Function

To sum up, through its numerous branches and minor branches, the brachial artery nourishes with oxygenated blood:

The deltoid muscle of the shoulder;
The arm muscles biceps brachialis, brachialis, triceps brachialis, coracobrachialis and anconeus (*);
The muscles of the forearm of the anterior and posterior compartment (eg, brachioradial, round pronator, extensor long radial carpus, pronator squared, long palmar, radial flexor of the carpus, flexor carpi ulnar, superficial flexor of the carpus, radial extensor short of the carpus etc.);
The muscles of the hand;
The elbow joint;
Carpal bones and their joints;
The median, ulnar and radial nerves.

(*) NB : according to some anatomical visions, the anconeal muscle would be a muscle of the arm; according to other anatomical visions, instead, it would belong to the forearm.

diseases

The brachial artery can be a victim of injury or a particular phenomenon called a pseudo-aneurysm .

Brachial artery injury

When it suffers an injury, the brachial artery loses its natural continuity and this compromises the blood supply to the forearm and, above all, towards the wrist.

Among the main causes of brachial artery injury, there are more severe humerus fractures.

Pseudo-aneurysm of the brachial artery

A pseudo-aneurysm is an unusual collection of blood between the most external tissues (muscular tunic and adventitious frock) of an artery.

The formation of a pseudo-aneurysm in the brachial artery is a very rare phenomenon, which can arise mainly due to: an infection, polyarteritis nodosa, a congenital arterial defect or a perforating trauma (due, for example, to when inserting a needle or a needle-cannula).

Clinical Use

Being rather superficial, the brachial artery tract that passes through the anterior portion of the elbow allows the blood flow passing through the artery in question to be checked by palpation and to measure the systolic blood pressure using a stethoscope and sphygmomanometer.