Brachial Artery

What is the brachial artery?

Your brachial artery is the major blood vessel supplying blood to your upper arm, elbow, forearm and hand. It starts in your upper arm, just below your shoulder, and runs down to the crease in your inner elbow. It has several branches along its route.

You have a brachial artery in each of your arms — so, a right brachial artery and a left brachial artery. These vessels and their branches play an important role in supporting normal blood flow in your upper body.

What does the brachial artery do?

Your brachial artery and its branches carry oxygen-rich blood to the bones and soft tissues, like muscles, in your arm and hand. These parts all need a steady supply of blood to work as they should. Specific muscles that your brachial artery helps nourish include your biceps, triceps and coracobrachialis.

In a healthcare setting, your brachial artery also has several functions. These include:

• Blood pressure checks: The cuff your healthcare provider wraps around your upper arm measures blood pressure in your brachial artery.
• Ankle-brachial index (ABI) test: Your provider checks the blood pressure in your brachial artery and compares it to the pressure in an artery near your ankle. This helps diagnose peripheral artery disease (PAD).
• Pulse point: Your provider may feel your pulse at your brachial artery, just above your elbow.
• Access point for procedures: Although it’s not common, surgeons can use the brachial artery as an access point for certain endovascular procedures. This means they insert a thin tube (catheter) into the artery and guide it to the area that needs repair.

Where is the brachial artery located?

Your brachial artery is in your upper arm, along the front part of your bicep and close to your skin’s surface. It starts near your armpit as a continuation of the axillary artery. It ends at the soft crease of your inner elbow. Along its course, the brachial artery runs close to the median nerve.

What are its branches?

Several arteries branch from the brachial artery along its course from just below your armpit to your inner elbow. Starting at the top, these include:

• Deep brachial artery (profunda brachii): This is the first branch. It runs next to the radial nerve.
• Superior ulnar collateral artery: This is the second branch of the brachial artery. In some people, it branches off the deep brachial artery instead.
• Inferior ulnar collateral artery: This is the third branch. It links up with the superior ulnar collateral artery and another artery around your elbow joint.
• Radial artery: Once your brachial artery reaches your inner elbow, it splits into two final (terminal) branches that supply blood to your forearm. The radial artery is one of these. It runs from your elbow crease to the base of your thumb.
• Ulnar artery: This is the other terminal branch. It runs from your elbow crease to the base of your pinky finger.

What’s the structure of the brachial artery?

Like all blood vessels, your brachial artery is shaped like a tube. Blood flows through its opening. Its walls are made of three layers:

• Inner layer (tunica intima): It’s made of endothelial cells that provide a smooth lining for blood to flow.
• Middle layer (tunica media): It’s made of smooth muscle cells that let your arteries expand and contract to move blood along.
• Outer layer (tunica adventitia): It’s made mostly of strong connective tissue that gives the artery its shape and structure.

What conditions and disorders affect the brachial artery?

Conditions that can affect your brachial artery include:

• Peripheral artery disease (PAD): This means plaque buildup limits blood flow in your arteries. Blood clots can also form on the plaque and stop blood flow. While PAD usually affects arteries in your legs, it can also affect those in your arms, like your brachial artery.
• Trauma: Traumatic injuries like broken bones or deep cuts can damage your brachial artery.
• Aneurysms: It’s rare for aneurysms (weak, bulging areas) to form in your brachial artery. But they’re a possible complication of an AV fistula. This is a connection between an artery and a vein that healthcare providers make for dialysis access.
• Pseudoaneurysms: These are also rare in your brachial artery. But they can result from an injury. Unlike a true aneurysm, this condition only affects one or two layers of the artery wall.

When should I call my healthcare provider?

Seek immediate medical attention if you have any of the following symptoms:

• Areas of your arm that are warm to the touch
• Discolored skin that looks pale, red or blue
• Painful ulcers on your hands or fingers
• Swelling in one arm

These can be signs of blood clots in your brachial artery or another artery in your arm. You need medical care right away.