Applied Anatomy of Brachial Artery
Compression of the Brachial Artery
- The brachial artery, being superficial throughout its course, can be compressed against the shaft of the humerus anywhere along its length.
- The most favourable site for compression is at the level of insertion of coracobrachialis (mid-arm), where the artery lies directly on the bone.
- Used to control hemorrhage from any artery distal to it — e.g., bleeding wounds of the palmar arterial arches.
Brachial Pulse and Blood Pressure Measurement
- The brachial pulse is palpated in the cubital fossa, just medial to the tendon of biceps brachii.
- The biceps tendon serves as a palpable landmark — easily felt on flexing the elbow.
- This site is used for auscultation of Korotkoff sounds during blood pressure measurement with a sphygmomanometer.
Rupture in Supracondylar Fracture of the Humerus
- The brachial artery may be injured or compressed in a supracondylar fracture of the humerus, particularly by the displaced proximal fragment.
- This can lead to Volkmann’s ischemic contracture — ischemic necrosis and subsequent fibrosis of the forearm flexor muscles (especially flexor digitorum profundus and flexor pollicis longus), resulting in a clawed, contracted hand and fingers.
- Early recognition (absent radial pulse, pain on passive finger extension, pallor, paraesthesia) is critical to prevent this complication.
Relation to Median Nerve — Vasomotor Supply
- The median nerve gives off vasomotor branches to the brachial artery during its course in the arm, contributing to autonomic regulation of arterial tone.
Venepuncture Considerations
- In the cubital fossa, the brachial artery lies deep to the bicipital aponeurosis and the median cubital vein.
- The bicipital aponeurosis protects the artery and median nerve from accidental injury during venepuncture of the median cubital vein — a key reason venepuncture at this site is considered relatively safe when performed correctly.
Summary — Clinical Correlations
| Clinical Scenario | Relevant Anatomical Basis |
|---|---|
| Hemorrhage control in upper limb | Compression against humerus at coracobrachialis insertion |
| Blood pressure measurement | Brachial pulse medial to biceps tendon in cubital fossa |
| Volkmann’s ischemic contracture | Arterial injury/compression in supracondylar fracture |
| Safe venepuncture at cubital fossa | Bicipital aponeurosis shields artery and median nerve |