Brachial Artery

The brachial artery provides the main arterial supply to the arm and is the continuation of the axillary artery. It begins at the inferior border of the teres major, and ends in the cubital fossa opposite the neck of the radius where, under cover of the bicipital aponeurosis, it divides into the radial and ulnar arteries.

The brachial artery, relatively superficial and palpable throughout its course, lies anterior to the triceps and brachialis. At first it lies medial to the humerus where its pulsations are palpable in the medial bicipital groove. It then passes anterior to the medial supra-epicondylar ridge and trochlea of the humerus.

As it passes inferolaterally, the brachial artery accompanies the median nerve, which crosses anterior to the artery. During its course through the arm, the brachial artery gives rise to many unnamed muscular branches, and the humeral nutrient artery, which arise from its lateral aspect. The unnamed muscular branches are often omitted from illustrations, but they are evident during dissection.

The main named branches of the brachial artery arising from its medial aspect are the profunda brachii artery (deep artery of the arm) and the superior and inferior ulnar collateral arteries. The collateral arteries help form the peri-articular arterial anastomoses of the elbow region. Other arteries involved are recurrent branches, sometimes double, from the radial, ulnar, and interosseous arteries, which run superiorly anterior and posterior to the elbow joint. These arteries anastomose with descending articular branches of the deep artery of the arm and the ulnar collateral arteries.

Profunda Brachii Artery

The profunda brachii artery (deep artery of the arm) is the largest branch of the brachial artery and has the most superior origin. The profunda brachii accompanies the radial nerve along the radial groove as it passes posteriorly around the shaft of the humerus. The profunda brachii terminates by dividing into middle and radial collateral arteries, which participate in the peri-articular arterial anastomoses around the elbow.

Humeral Nutrient Artery

The main humeral nutrient artery arises from the brachial artery around the middle of the arm, and enters the nutrient canal on the anteromedial surface of the humerus. The artery runs distally in the canal toward the elbow. Other smaller humeral nutrient arteries also occur.

Superior Ulnar Collateral Artery

The superior ulnar collateral artery arises from the medial aspect of the brachial artery near the middle of the arm, and accompanies the ulnar nerve posterior to the medial epicondyle of the humerus. Here it anastomoses with the posterior ulnar recurrent artery and the inferior ulnar collateral artery, participating in the peri-articular arterial anastomoses of the elbow.

Inferior Ulnar Collateral Artery

The inferior ulnar collateral artery arises from the brachial artery approximately 5 cm proximal to the elbow crease. It then passes inferomedially anterior to the medial epicondyle of the humerus, and joins the peri-articular arterial anastomoses of the elbow region by anastomosing with the anterior ulnar recurrent artery.