BRACHIUM

Dr Misbah Ghous
DPT, MSNMPT
Intro..
 Extend from shoulder joint to elbow joint
 The bone of the Brachium (arm) is humerus.
 The medium and lateral intramuscular septa divides
the arm into anterior and posterior compartment.
 The anterior compartment is flexor and
posterior is extensor.
 The arm is also called brachium so most of the
structures are named accordingly like brachialis,
corachobrachialis, brachial artery.
Front of the Brachium
 The shaft of the humerus is felt only indistinctly
because it is surrounded by muscles. The humerus
is covered ant by brachialis and bicep and
posteriorly by the tricep.
 Medial epicondyle prominent bony projection on
medial side of the Elbow. best seen and felt in
midflexed elbow.
 Lateral epicondyle is less prominent than medial at
lateral side.
 In the lower one forth of the arm the lat and medial
supracondylar ridges are better felt.
 The deltoid form the rounded counter of the shoulder
and its apex is attached to deltoid tuberosity located at
the middle of the anterolateral surface of the humerus.
 Corachobrachialis form an inconspicuous rounded
ridge in the upper part of the medial side of the arm.
Pulsation of the brachial artery is often seen or felt
behind it.
 The bicep overlapped above by pectoralis major
and deltoid, below these muscle the bicep form a
conspicuous elevation on the front of the arm. On
flexing the elbow the muscles become more
prominent.
 The tendon of the bicep is feel in front of the
elbow. Brachial artery lies medial to the tendon.
 Brachial artery can be felt in front of the elbow just
medial to the tendon of bicep, brachial pulsation
are used in recording the blood pressure.
 The superficial cubital vein can be made more
prominent by applying tight pressure round the
arm and then contracting the fore arm muscles by
clenching and unclenching the fist few time.
 Cephalic vein run upward along the lat border of
bicep.
 Basilic vein can be seen along the lower half of
medial border of bicep.
 The cephalic and Basilic vein are connected in
front of the elbow by median cubital vein.
Muscles of anterior compartment of the arm

 Bicep brachii
 Corachobrachialis

 Brachialis

Brachial artery is the supply of these muscles while

nerve supply of these muscles is the
musculocutaneous nerve.
coracobrachialis
brachialis
Structure passing through the compartment

 Musculocutaneous, median and ulnar nerves

 Brachial artery and Basilic vein
 Radian nerve is present in the lower part of the
compartment
In the clinic

 Rupture of biceps tendon

 It is relatively unusual for muscles and their tendons to
rupture in the upper limb; however, the tendon that most
commonly ruptures is the tendon of the long head of the
biceps brachii muscle. In isolation, this has relatively
little effect on the upper limb, but it does produce a
characteristic deformity-on flexing the elbow, there is an
extremely prominent bulge of the muscle belly as its
unrestrained fibers contract-the 'Popeye' sign.
Rupture of long head of bicep
Arterial Anastomosis around the
Shoulder Joint

 The extreme mobility of the shoulder joint may

result in kinking of the axillary artery and a
temporary occlusion of its lumen. To compensate
for this, an important arterial anastomosis exists
between the branches of the subclavian artery and
the axillary artery.
Branches from the Subclavian Artery

 The suprascapular artery, which is distributed to

the supraspinous and infraspinous fossae of the
scapula
 ■■ The superficial cervical artery, which gives
off a deep branch that runs down the medial border
of the scapula
Branches from the Axillary
Artery
 The subscapular artery and its circumflex
scapular
 branch supply the subscapular and infraspinous
fossae of the scapula, respectively.
 ■■ The anterior circumflex humeral artery
 ■■ The posterior circumflex humeral artery
The Scapular–Humeral Mechanism

 The scapula and upper limb are suspended from the

clavicle by the strong coracoclavicular ligament
assisted by the tone of muscles.
 When the scapula rotates on the chest wall so that
the position of the glenoid fossa is altered, the axis
of rotation may be considered to pass through the
coracoclavicular ligament.
 Abduction of the arm involves rotation of the scapula
 as well as movement at the shoulder joint.
 For every 3° of abduction of the arm, a 2° abduction
occurs in the shoulder joint and a 1° abduction occurs
by rotation of the scapula.
 At about 120° of abduction of the arm, the greater
tuberosity of the humerus comes into contact with the
lateral edge of the acromion. Further elevation of the
arm above the head is accomplished by rotating the
scapula.