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Describe Branches Of Brachial Artery With Their Course And Area Of Supply. 5 marks

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Branches of the Brachial Artery — Course and Area of Supply

Introduction

The brachial artery is the major artery of the arm. It begins as a continuation of the axillary artery at the lower border of teres major and terminates in the cubital fossa (just distal to the elbow joint) by dividing into the radial and ulnar arteries. It travels down the anterior compartment of the arm, initially on the medial side, then moves laterally to lie midway between the two epicondyles. It is accompanied by the median nerve throughout.
Brachial artery and its branches — anterior view of the arm

Branches of the Brachial Artery

Branches of the brachial artery showing collateral vessels and terminal bifurcation

1. Profunda Brachii Artery (Deep Artery of the Arm)

Largest branch of the brachial artery; arises from its posteromedial aspect near the top of the arm.
Course:
  • Winds posteriorly with the radial nerve through the triangular interval (bounded by the shaft of humerus, inferior margin of teres major, and lateral head of triceps).
  • Passes through the radial (spiral) groove on the posterior surface of the humerus, deep to the lateral head of triceps.
  • Terminates as two collateral vessels: the radial collateral artery and the middle collateral artery.
Area of supply:
  • Posterior compartment of arm — all three heads of triceps brachii
  • Anastomoses with the posterior circumflex humeral artery proximally
  • Contributes to the periarticular anastomosis around the elbow (radial collateral → anastomoses with radial recurrent; middle collateral → anastomoses with recurrent interosseous)

2. Superior Ulnar Collateral Artery

Course:
  • Arises from the brachial artery at about mid-arm level.
  • Accompanies the ulnar nerve, pierces the medial intermuscular septum to enter the posterior compartment.
  • Descends behind the medial epicondyle to anastomose with the posterior ulnar recurrent artery and the inferior ulnar collateral artery.
Area of supply:
  • Medial arm muscles; contributes to the medial side of the periarticular anastomosis around the elbow.

3. Inferior Ulnar Collateral Artery (Supratrochlear Artery)

Course:
  • Arises approximately 5 cm above the medial epicondyle.
  • Passes medially between the median nerve and the brachialis muscle.
  • Divides into anterior and posterior branches around the medial epicondyle.
  • Anastomoses with the anterior ulnar recurrent artery anteriorly and with the superior ulnar collateral posteriorly.
Area of supply:
  • Lower part of the brachialis; contributes to the periarticular anastomosis around the elbow joint.

4. Nutrient Artery to the Humerus

Course:
  • A small branch arising from the brachial artery in the middle of the arm.
  • Enters the nutrient foramen on the anteromedial surface of the humeral shaft.
Area of supply:
  • Supplies the medullary cavity and cortical bone of the humerus.

5. Muscular Branches

Multiple small unnamed branches arise along the course of the brachial artery.
Area of supply:
  • Coracobrachialis, biceps brachii, and brachialis muscles (anterior compartment).

6. Terminal Branches — Radial and Ulnar Arteries

Course:
  • The brachial artery bifurcates at the level of the neck of the radius (in the cubital fossa), just deep to the bicipital aponeurosis.
  • The radial artery runs laterally to supply the forearm, wrist, and hand (deep palmar arch).
  • The ulnar artery runs medially; gives off the common interosseous artery and supplies the forearm and hand (superficial palmar arch).
Area of supply:
  • Together, the terminal branches supply the entire forearm, wrist, and hand.

Angiographic Correlation

Angiograms showing brachial artery branches — frontal and lateral views

Summary Table

BranchOriginCourseArea of Supply
Profunda brachiiUpper brachial artery (posteromedial)Triangular interval → radial groove with radial nervePosterior arm (triceps), elbow anastomosis
Superior ulnar collateralMid-brachial arteryWith ulnar nerve → behind medial epicondyleMedial arm, elbow anastomosis
Inferior ulnar collateral~5 cm above medial epicondyleAround medial epicondyleLower arm, elbow anastomosis
Nutrient artery to humerusMid-brachial arteryNutrient foramen of humerusHumeral cortex and medulla
Muscular branchesAlong entire courseDirect to anterior compartment musclesCoracobrachialis, biceps, brachialis
Radial artery (terminal)Cubital fossaLateral forearm → wristForearm, wrist, hand (deep arch)
Ulnar artery (terminal)Cubital fossaMedial forearm → handForearm, wrist, hand (superficial arch)
Key clinical point: The brachial artery is the site of blood pressure auscultation (Korotkoff sounds) in the cubital fossa, and is compressible against the humerus in the proximal arm. Injury or iatrogenic damage (e.g., supracondylar fractures in children) can compromise blood flow to the entire forearm and hand.
— Gray's Anatomy for Students; Imaging Anatomy: Bones, Joints, Vessels and Nerves; THIEME Atlas of General Anatomy and Musculoskeletal System
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