The brachial artery is the major blood vessel located on the upper arm. It is a continuation of the axillary artery, and it begins from the lower margin of the teres major and continues down the arm. The brachial artery at first lies medial to the humerus until it reaches the cubital fossa at the elbow; it can be palpated throughout its entire length. The brachial artery terminates by dividing into the radial and ulnar artery which runs down the forearm.
The brachial artery has several branches along its course. These supply blood to the muscles of the upper arm, such as the bicep and tricep, while contributing to the anastomotic networks of the elbow and the shoulder.
Palpation of the brachial artery is a part of a physical examination in which the artery is felt to determine its location and pulse activity in the area. The pulse in this area is called the brachial pulse.
Palpate the Brachial Artery
Seat the patient comfortably with legs uncrossed and palms facing up, the arm resting at the level of the fourth inter-costal space and not tensed.
Place the pads of your index and middle fingers halfway between the shoulder and elbow, in the middle of the inner arm, between the bicep and tricep muscles. Start the palpation of the brachial artery just below the bend of the elbow.
Apply slight pressure with your fingers and palpate the brachial artery just below the bend of the elbow. If you place your fingers in the center of the armpit and slide them half the distance to the inner side of the elbow, they should be in the correct position.
Tips & Warnings
- Along with the use of a stethoscope and sphygmomanometer, the brachial artery is often used to measure blood pressure.
- It can be tricky to find and palpate the brachial artery, especially when the individual has large muscles. Press your index and middle fingers down, maneuvering them around the muscles by pressing the artery against the bone.
- Palpation is not the same as palpitation. Palpitation is the awareness of the heartbeat.
- Be careful when applying pressure to the brachial artery. If you apply too much pressure, you might stop the flow of blood which may cause an inaccurate pulse reading.
- Do not use your thumb to palpate the brachial artery, especially if you are checking for the pulse since the thumb has its own pulse too and might be mistaken for the pulse of the patient. This will lead to inaccuracy.
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