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Other Terms: Brachial part of trunk of subclavian artery, Arteria brachialis, Artère brachiale
The brachial artery is the continuation of the axillary artery. It begins opposite the lower border of the tendon of the teres major. It passes down the ulnar side of the arm, and is overlapped for fully two-thirds of its course by the medial border of the coracobrachialis and biceps brachii muscles. It then curves medially in front of the elbow-joint, along the medial border of the tendon of the biceps, to a point opposite the neck of the radius. Here, it divides into the radial and ulnar arteries. The artery is comparatively superficial throughout its entire extent, being covered by skin and superficial and deep fascia, except in the middle of its course, where the median nerve lies in front, and at its distal end, where the bicipital fascia and the median basilic vein are in front of it. The branches of the brachial artery are: the deep brachial artery, the superior ulnar collateral, the nutrient, the inferior ulnar collateral, the muscular, and occasionally vasa abberantia. The deep brachial artery is the largest branch. It arises from the medial and dorsal aspect of the upper end of the brachial artery. Turning backward, it enters the radial groove with the radial nerve. In the groove, it passes behind the humerus, between the medial and the lateral heads of the triceps to the radial side of the arm. It then pierces the lateral intermuscular septum and continues downward between the brachialis and the brachioradialis muscles to the elbow. Here, it anastomoses with the radial recurrent. In its course it sends branches to supply the deltoid, the coracobrachialis, and the triceps muscles, and one branch to anastomose with the circumflex arteries. This branch plays an important part in the collateral circulation after ligation of the main vessel in this locality. It gives off a large posterior articular branch which passes straight down the humerus from the radial groove to the back of the elbow-joint. It is accompanied by the branch of the radial nerve supplying the anconeus muscle. It anastomoses with the interosseous recurrent, the inferior ulnar collateral, and the posterior ulnar arteries. The superior ulnar collateral artery is a small vessel which arises from the brachial near the insertion of the coracobrachialis. It passes downward and medially on the surface of the medial head of the triceps. It pierces the medial intermuscular septum and accompanies the ulnar nerve between the medial epicondyle and the olecranon, where it anastomoses with the posterior ulnar recurrent and the inferior ulnar collateral. In front of the medial epicondyle, it also sends a small branch downward that anastomoses with the anterior ulnar recurrent and the inferior ulnar collateral. Sometimes, it arises with the deep brachial artery by a common trunk. The nutrient artery leaves the brachial in the middle of the arm. It can be derived from one of its muscular branches. Passing downward, it pierces the tendon of the coracobrachialis to enter the nutrient canal of the humerus below the insertion of that muscle. Here, it divides into ascending and descending branches which anastomose with the nutrient vessels of the periosteum. Entering the bone with it, is a filament of the musculocutaneous nerve. The inferior ulnar collateral artery is given off about six centimeters above the elbow. Then, it passes medially over the brachialis and pierces the medial intermuscular septum. It then winds around the humerus between the triceps and the bone. It anastomoses above the olecranon with the posterior articular branch of the deep brachial artery and the interosseous recurrent. In its passage across the brachialis, it gives off an anastomotic branch which also pierces the medial intermuscular septum to join the posterior ulnar recurrent, between the olecranon and the medial epicondyle. Ascending and descending branches are also given off to join the superior ulnar collateral above, and the anterior ulnar recurrent in front of the medial epicondyle. Muscular branches arise from the lateral side of the brachial artery and supply the coracobrachialis, the biceps, and the brachialis muscles. Vasa aberrantia are long, narrow arteries which are occasionally found connecting the brachial or the axillary artery with some of the main arteries of the forearm, usually the radial. The vasa aberrantia offer channels for collateral circulation of the blood in case its flow through the radial, the ulnar, or the lower part of the brachial arteries is prevented.