402 AETERIES OF THE UPPER LIMB. 



(a) The superior profunda arterv arises from the inner and back 

 part of the bracliial, just below the border of the teres major, 

 and inclines inwards and backwards, to reacli the interval between the 

 outer and inner heads of the triceps muscle. Accompanied by the 

 musculo-spiral nerve, it winds round the back of the humerus, in the 

 spiral groove, under cover of the triceps, and perforating the external 

 intermuscular septum, reaches the external and anterior aspect of the 

 bone. There the artery lies deeply in the interval between the 

 brachialis anticus and supinator longus muscles, considerably dimin- 

 ished in size by having given off several branches, and descends to the 

 elbow, where it anastomoses with the recurrent branch of the radial 

 artery. 



Branches. — The superior profunda giv3s off branches iii its first part to the 

 deltoid, coraco-brachialis. and triceps ; and many to the last-named muscle, whilst 

 it is between it and the bone. In this position it also gives one long branch, 

 which descends perpendicularly between the muscle and the bone to the back 

 part of the elbow-joint on the outer side, where it anastomoses with the inter- 

 osseous recurrent branch ; and another which anastomoses on the inner side 

 with the ulnar recurrent and the anastomotic or the inferior profunda. 



(b) The inferior profunda artery of small size, arises from the 

 brachial artery a little below the middle of tlie arm, and is directed to the 

 l)ack part of the inner condyle of the humerus. Descending in company 

 with the ulnar nerve, it pierces the intermuscular septum, then lies on 

 the inner surface of the triceps muscle, to which it gives branches, 

 and entering the interval between the olecranon and inner condyle, it 

 terminates by inosculating with the posterior recurrent branch of the 

 ulnar artery, and with the anastomotic branch of the brachial. 



(c) The nutrient artery of the shaft of the humerus is a small branch 

 given off by the brachial about tlie middle of the arm, or by one of its 

 collateral branches. It inclines downwards, enters the oblique canal in 

 the humerus near the insertion of the coraco-brachialis muscle, and is 

 distributed in the interior of the bone. 



{d) The anastomotic artery is a very constant branch of moderate 

 size. Arising from the brachial artery about two inches above the bend 

 of the arm, it is directed transversely inwards on the brachialis anticus 

 muscle, above the inner condyle of the humerus, and, after perforating 

 the intermuscular septum, turns outwards behind the humerus, between 

 the bone and the triceps muscle, and forms with the superior profunda 

 an arch across the humerus, immediately above the olecranon fossa 

 (arcus dorsalis humeri posticus, — Haller). In front of the humerus the 

 anastomotic artery furnishes a branch which ramifies in the pronator 

 teres, and anastomoses with the anterior ulnar recurrent branch. 

 Behind the inner condyle another offset joins with the posterior ulnar 

 recurrent, and behind the humerus several branches are given to the 

 joint and the muscle. 



Varieties. — From their comparative frequency, and siu-gical interest, the 

 peculiarities of the brachial artery, especially those which affect its tmnk, 

 deserve particular attention. 



Course. — The brachial artery sometimes lies in front of tlie median nerve, 

 instead of behind it. 



The brachial artery has been seen, though rarely, to descend, accompanied by 

 the median nerve, towards the inner condyle of the humeiiis. and regain its 

 usual position at the bend of the elbow by passing fora-ards underneath a fibrous 



