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Nerves and Veins in the Elbow and Forearm

The muscles and joints of the elbow and forearm need nervous supply and blood flow. The major nerves and veins start in your neck and run the length of your arms, often into your hands.

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Nerves

The following nerves branch from the brachial plexus in the neck and travel through the arm to supply the elbow and the forearm. Some of these nerves continue through the forearm to supply the wrist and hand.

  • Median nerve: This nerve starts from the brachial plexus and runs from the axilla down alongside the brachial artery. It descends into the cubital fossa. It gives off branches that serve the elbow joint and continues down the anterior part of the forearm and into the hand through the carpal tunnel.

  • Ulnar nerve: This nerve starts from the brachial plexus, passes through the arm medial to the brachial artery, continues posterior to the medial epicondyle of the humerus, and enters the forearm. It travels along the medial part of the forearm until it enters the hand at the wrist.

  • Radial nerve: This nerve starts from the brachial plexus and runs posterior to the brachial artery and anterior to the long head of the triceps. It curves around the shaft of the humerus and continues toward the cubital fossa. From there it branches into the deep and superficial branches and continues down the lateral part of the forearm to enter the hand.

  • Musculocutaneous nerve: This nerve runs from the brachial plexus through the anterior part of the arm and becomes the lateral cutaneous nerve of the forearm.

Blood supply

Arteries run from the shoulder down to the wrist with just a few branches given off near the elbow. Superficial and deep veins return blood toward the heart. Following is a brief overview:

  • Brachial artery: This artery stems from the axillary artery. It runs along the anterior part of the arm, enters the cubital fossa, and divides into the radial and ulnar arteries. It also has the following branches that form arterial anastomoses (joined arteries) that supply the elbow:

    • Deep artery of the arm (profunda brachii artery)

    • Superior ulnar collateral artery

    • Inferior ulnar collateral artery

  • Ulnar artery: This artery runs from the cubital fossa down the anterior and medial portion of the forearm until it enters the wrist.

  • Radial artery: This artery runs from the cubital fossa down the anterior and lateral portion of the forearm until it enters the wrist.

  • Cephalic and basilic veins: These veins provide superficial venous return.

  • Brachial, radial, and ulnar veins: These veins are deeper. They accompany the arteries of the same names.

You can easily palpate the olecranon and the epicondyles. The olecranon is the big bony bump that you feel (and probably see) on the back of the elbow. The epicondyles are the prominent bony bumps on either side of the elbow. The biceps and triceps brachii muscles give the fleshy part of the arm its shape.

The cubital fossa is a triangular depression on the anterior surface of the elbow. It’s bordered by the pronator teres and the brachioradialis muscles. The cubital fossa contains the radial and median nerves, the biceps brachii tendon, and deep veins, and it’s the spot where the brachial artery branches into the ulnar and radial artery. You can palpate this area by pressing your fingers into the skin over the anterior section of elbow. It’s easiest to do when the arm is relaxed and the elbow slightly bent. The median cubital vein, a common site for venipuncture, runs superficial to the brachial artery and lies just under the skin.

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