The brachial artery is the major blood vessel carrying oxygenated blood down the upper arm to the forearm and hand. It is important in medical practice, serving as the main site for manually measuring blood pressure. Palpating the brachial pulse provides a direct way to assess circulation and is the preferred pulse check location for infants during emergency assessments. Understanding its location and proper technique is necessary for accurately feeling the rhythmic beat of blood flow.
Understanding the Brachial Artery’s Path
The brachial artery is a continuation of the axillary artery, beginning just below the shoulder at the lower border of the teres major muscle. The vessel travels down the inner, or medial, side of the arm alongside the humerus bone. It is situated deep within the arm, lying close to the bone and running parallel to the median nerve.
The artery runs beneath the large biceps muscle for much of its length in the upper arm. As it descends, it moves closer to the surface on the front of the elbow. The brachial artery ends at the cubital fossa, the triangular depression at the front of the elbow crease.
At the cubital fossa, the artery typically splits into the radial and ulnar arteries, which supply blood to the forearm and hand. Its close relationship to the biceps tendon and the bony structure of the elbow makes it a predictable and accessible location for pulse checks.
Finding the Artery at the Elbow
The most common location to find the brachial pulse is in the cubital fossa, the area just above the elbow crease, used when taking blood pressure. The arm should be relaxed, extended, and positioned with the palm facing upward. This positioning allows the inner bend of the elbow to be fully exposed.
First, identify the biceps tendon, which feels like a firm, cord-like structure in the middle of the elbow crease. The brachial artery is situated just medial (toward the body’s midline) to this tendon. Using the pads of the index and middle fingers, place them about one to two inches above the crease of the elbow.
Apply gentle but firm pressure with the fingertips in the space immediately next to the biceps tendon. Since the artery is somewhat deep here, it may require slightly more pressure than feeling the wrist pulse. If no pulse is detected, carefully move the fingers up or down, or slightly more medially, until the distinct rhythmic throbbing is felt.
Locating the Artery in the Upper Arm
The brachial pulse can also be located higher up on the inner side of the upper arm. This mid-arm location is often used for emergency pulse checks, particularly in infants, or when the pulse is difficult to find at the elbow. The artery here is situated deeper, running along the groove between the biceps muscle on the front and the triceps muscle on the back.
To locate the pulse in the mid-humerus region, place the arm slightly away from the body to expose the inner arm. Use the index and middle fingers to palpate the soft tissue in the center of the medial side of the upper arm, roughly halfway between the shoulder and the elbow. The goal is to press into the muscular groove where the artery runs alongside the humerus bone.
Because the artery is protected by more muscle tissue in this area, increased pressure is necessary to compress the vessel against the bone. The technique requires pressing firmly and deeply into the muscle belly until the beat is confirmed. This higher location offers a reliable alternative for assessing circulation when the lower arm is inaccessible or in cases of severe shock.