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# Brachial fascia

The brachial fascia is the sleeve of connective tissue around the upper arm; it holds the arm muscles in a front and a back compartment.

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## What it is

The sleeve of deep fascia around the upper arm muscles.

## What it does

Holds the arm muscles in their compartments.

## Key points

- Anterior compartment: biceps, [brachialis](https://durgical.com/en/anatomy/brachialis/), [coracobrachialis](https://durgical.com/en/anatomy/coracobrachialis/) and the [musculocutaneous nerve](https://durgical.com/en/anatomy/musculocutaneous-nerve/); posterior compartment: triceps and the [radial nerve](https://durgical.com/en/anatomy/radial-nerve/)
- The basilic vein and the [medial forearm skin nerve](https://durgical.com/en/anatomy/medial-antebrachial-cutaneous-nerve/) pierce it on the medial side, about halfway up the arm
- Arm compartment syndrome is much rarer than forearm compartment syndrome

## Key facts

**Where**
Deep fascia sleeve around the arm

**Function**
Encloses the arm muscles; with the septa forms the anterior and posterior compartments

## Relations

**Contents**
The two compartments; along the medial septum runs the bundle of the [brachial artery](https://durgical.com/en/anatomy/brachial-artery/), the [median nerve](https://durgical.com/en/anatomy/median-nerve/) and, in the upper arm, the [ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/)

**Superficial**
[Cephalic vein](https://durgical.com/en/anatomy/cephalic-vein/) on the lateral side, the lower [basilic vein](https://durgical.com/en/anatomy/basilic-vein/) on the medial side, and the [arm skin nerves](https://durgical.com/en/anatomy/other-cutaneous-nerves-of-the-arm-and-forearm/)

**Above**
Continuous with the deltoid and pectoral fasciae and the axillary fascia

**Below**
Continues into the [antebrachial fascia](https://durgical.com/en/anatomy/antebrachial-fascia/); the bicipital aponeurosis joins it at the elbow

## How to find it

It is not felt as such: it is the tough layer under the [skin](https://durgical.com/en/anatomy/skin/) and fat in any approach to the arm. The cephalic vein lies on it laterally; the basilic vein dives through it medially at about mid-arm.

## On imaging

A thin bright (hyperechoic) line around the arm muscles on ultrasound, and a thin dark line on MRI. Imaging does not diagnose compartment syndrome of the arm: examination and compartment pressure do. In necrotising fasciitis, soft-tissue gas on radiographs or CT is a warning sign and MRI shows fluid and thickening along the fascia; neither should delay surgery.

## Clinical notes

- Arm compartment syndrome (crush, prolonged lying on the arm, humeral fractures, bleeding) is released by opening both compartments
- For dialysis access, the basilic vein is freed from beneath the fascia and moved to a superficial position (basilic vein transposition)
- The basilic vein and the medial antebrachial cutaneous nerve go through the fascia together on the medial arm, so the nerve is at risk when the vein is harvested or transposed

## Test yourself

Think of the answer, then tap the question to see it.

## What are the contents of the two compartments enclosed by the brachial fascia?

Anterior: biceps, brachialis, coracobrachialis and the musculocutaneous nerve; posterior: triceps and the radial nerve.

## Which structures pierce the brachial fascia on the medial side of the arm?

The basilic vein and the medial forearm skin nerve, about halfway up the arm.

## How is arm compartment syndrome released?

By opening both the anterior and posterior compartments of the brachial fascia; it is much rarer than forearm compartment syndrome.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
fascia brachii TA2 2541

**Official Spanish (DeCS)**
Fascia del brazo

**English (TA2)**
Brachial fascia

## Related

- [Antebrachial fascia](https://durgical.com/en/anatomy/antebrachial-fascia/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Arm Muscles](https://www.ncbi.nlm.nih.gov/books/NBK554420/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/brachial-fascia/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/brachial-fascia/