The pulse is a rhythmic sensation as blood moves through arteries with each heartbeat. It indicates heart function and blood flow throughout the body. While pulses can be detected at various points, the brachial pulse is located in the upper arm.
Understanding the Brachial Pulse
The brachial pulse is the pulsation felt from the brachial artery, a major blood vessel supplying the upper arm, elbow, forearm, and hand. This artery continues from the axillary artery, beginning just below the shoulder. It extends down the inner side of the upper arm, running along the front part of the bicep.
The brachial artery ends at the cubital fossa, the indentation at the front of the elbow. At this point, it divides into the radial and ulnar arteries, extending into the forearm. The brachial pulse is commonly palpated on the inner aspect of the upper arm, near the elbow crease. It is located between the biceps and triceps muscles, approximately 1 to 2 inches above the elbow crease.
The sensation of a pulse is not the blood itself flowing, but a shock wave traveling along arterial walls as the heart contracts and pushes blood into the circulatory system. This wave reflects pressure changes within the artery with each heartbeat. The brachial artery runs parallel to the median nerve, the main nerve for the forearm.
Clinical Assessment of the Brachial Pulse
The brachial pulse is assessed in clinical scenarios due to its accessibility and reliability. For infants, it is the preferred site for checking circulation during CPR and medical assessments. Other pulse points, such as the carotid pulse, can be more challenging to locate in the smaller anatomy of infants. A weak or absent brachial pulse in an infant, especially with signs of poor perfusion like pale skin, can indicate the need for immediate chest compressions.
The brachial pulse also plays a role in measuring blood pressure using a sphygmomanometer (blood pressure cuff). During this procedure, the cuff is placed around the upper arm, and the brachial artery is monitored to determine systolic and diastolic pressures. The cuff is inflated to temporarily stop blood flow. As it deflates, the first sounds heard through a stethoscope indicate systolic pressure, and the point where sounds disappear indicates diastolic pressure.
Assessing the brachial pulse can also help evaluate circulation to the lower arm and hand. A weak pulse might suggest issues like peripheral artery disease, reducing blood flow to the extremities.
Locating Your Own Brachial Pulse
To locate your own brachial pulse, position the arm slightly extended with the palm facing upward to expose the inner elbow. Place the pads of your index and middle fingers (avoiding the thumb, which has its own pulse) just above the elbow crease, on the inner side of the arm. Apply gentle pressure until a rhythmic pulsation is felt. This self-assessment offers a general understanding but should not replace professional medical evaluation.