BRANCHES OF THE BRACHIAL ARTERY. 537 



The superior profunda arises from the inner arid back part of the brachial, just 

 below the lower border of the Teres major, and passes backward to the interval 

 between the outer and inner heads of the Triceps muscle, accompanied by the 

 musculo-spiral nerve ; it winds around the back part of the shaft of the humerus 

 in the spiral groove, between the outer head of the Triceps and the bone, to the 

 outer side of the humerus, where it reaches the external intermuscular septum and 

 divides into two terminal branches. One of these pierces the external intermus- 

 cular septum, and descends, in company with the musculo-spiral nerve, to the space 

 between the Brachialis anticus and Supinator longus, where it anastomoses with the 

 recurrent branch of the radial artery ; while the other, much the larger of the two, 

 descends along the back of the external intermuscular septum to the back of the 

 elbow-joint, where it anastomoses with the posterior interosseous recurrent, and across 

 the back of the humerus with the posterior ulnar recurrent, the anastomotica magna, 

 and inferior profunda (Fig. 306). The superior profunda supplies the Triceps muscle 

 and gives off a nutrient artery which enters the bone at the upper end of the musculo- 

 spiral groove. Near its commencement it sends off a branch which passes upward 

 between the external and long heads of the Triceps muscle to anastomose with the 

 posterior circumflex artery, and, while in the groove, a small branch which accom- 

 panies a branch of the musculo-spiral nerve through the substance of the Triceps 

 muscle and ends in the Anconeus below the outer condyle of the humerus. 



The nutrient artery of the shaft of the humerus arises from the brachial, about 

 the middle of the arm. Passing downward it enters the nutrient canal of that 

 bone near the insertion of the Coraco-brachialis muscle. 



The inferior profunda, of small size, arises from the brachial, a little below the 

 middle of the arm; piercing the internal intermuscular septum, it descends on the 

 surface of the inner head of the Triceps muscle to the space between the inner 

 condyle and olecranon, accompanied by the ulnar nerve, and terminates by anasto- 

 mosing with the posterior ulnar recurrent and anastomotica magna. It sometimes 

 supplies a branch to the front of the internal condyle, which anastomoses with the 

 anterior ulnar recurrent. 



The anastomotica magna arises from the brachial about two inches above the 

 elbow-joint. It passes transversely inward upon the Brachialis anticus, and, piercing 

 the internal intermuscular septum, winds round the back part of the humerus 

 between the Triceps and the bone, forming an arch above the olecranon fossa by its 

 junction with the posterior articular branch of the superior profunda. As this vessel 

 lies on the Brachialis anticus, branches ascend to join the inferior profunda, and 

 others descend in front of the inner condyle to anastomose with the anterior ulnar 

 recurrent. Behind the internal condyle an offset is given off which anastomoses 

 with the inferior profunda and posterior ulnar recurrent arteries and supplies the 

 Triceps. 



The muscular are three or four large branches, which are distributed to the 

 muscles in the course of the artery. They supply the Coraco-brachialis, Biceps, 

 and Brachialis anticus muscles. 



The Anastomosis around the Elbow-joint (Fig. 306). The vessels engaged in 

 this anastomosis may be conveniently divided into those situated in front and 

 behind the internal and external condyles. The branches anastomosing in front 

 of the internal condyle are the anastomotica magna, the anterior ulnar recurrent, 

 and the anterior terminal branch of the inferior profunda. Those behind the internal 

 condyle are the anastomotica magna, the posterior ulnar recurrent, and the 

 posterior terminal branch of the inferior profunda. The branches anastomosing in 

 front of the external condyle are the radial recurrent and the anterior terminal 

 branch of the superior profunda. Those behind the external condyle (perhaps 

 more properly described as being situated between the external condyle and the 

 olecranon) are the anastomotica magna, the interosseous recurrent, and the posterior 

 terminal branch of the superior profunda. There is also a large arch of anasto- 

 mosis above the olecranon, formed by the interosseous recurrent, joining with the 

 anastomotica magna and posterior ulnar recurrent (Fig. 306). 



