Arteries, Veins and Lymphatics of Pelvis and Gluteal Region Flashcards
Common iliac artery
o Splits between L5-S1
External iliac artery
o External iliac is the larger terminal branch
o Runs along medial border of psoas major m.
o Runs from intervertebral disc to inguinal ligament
o Deep to ligament between symphysis pubis and ASIS
External iliac artery is crossed by…
- Ureter
- Ovarian A/V
- Gential branch genitofemoral n
- Deep circumflex iliac v
- Ductus deferens
- Round ligament
Inferior epigastric artery
- Branch of external iliac
- Ascends superior/medial subperitoneal tissues - through transversalis fascia and between rectus abdominis and posterior rectus sheath
- Forms lateral umbilical fold
- Anastomoses w/ branches superior epigastric a. above umbilicus
Deep circumflex iliac artery
- Branch of external iliac
- Opposite origin inferior epigastric on medial side
- Lateral deep to inguinal ligament
- Ascends toward ASIS
Femoral artery in the pelvis
Branches in the pelvis
- Superficial external pudendal
- Deep external pudendal
- Profunda femoris
- Lateral femoral circumflex
- Medial femoral circumflex
Deep external pudendal
- Distal to superifical branch
- Medially across pectinues/adductor longus
- Anastomoses internal puedendal artery
Profunda femoris
- 2-5 cm distal to inguinal ligament
- Largest branch of femoral
- From lateral aspect femoral
- Spirals posteriorinferior then to medial
Lateral femoral circumflex
- Branch of profunda femoris (most often)
- Goes form rectus femoris & sartorius
- Ascending branch: superior and deep to fascia lata, enter fibrous capsule as retinacular branches and anastomoses with medial femoral circumflex, superior gluteal and deep circumflex iliac
Medial femoral circumflex
- MOST IMPORTANT ADULTS FOR NECK OF FEMUR
- 25% comes off femoral
- Disappear btwn pectineus & psoas
- Enter fibrous capsule as retinacular branches
- Acetabular branches: opposite acetabular notch, enters with acetabular branch of obturator, supplies fat in acetabular fossa & around round ligament to head of femur
- Anastamose with lateral femoral circumflex
Internal iliac artery
Supplies viscera, walls of pelvis
Obturator artery
- Branch of internal iliac artery
- Joins obturator nerve in the lateral wall of the pelvis, they then enter obturator canal together
- Foveolar branch – travels in ligament head of femur, supplies head femur
- NEED FOR KIDS! –during ossification
- Adults doesn’t matter
Internal iliac vein
Two veins drain into the internal iliac vein
- Superior gluteal vein
- Inferior gluteal vein
Superior gluteal vein
- Located above piriformis
- Goes through greater sciatic foramen
Inferior gluteal vein
- Anastomoses with medial femoral circumflex and 1st perforating
- Greater sciatic foramen is inferior to piriformis muscle
Lymphatics of pelvis and gluteal region
- Superficial inguinal nodes
- Deep inguinal nodes
- External iliac nodes
- Internal iliac nodes
Superficial inguinal nodes
- Form a lop-sided T
- Stem of T is parallel to the great saphenous vein
- Cross of T is parallel to the inguinal ligament
Lymph nodes parallel to great saphenous vein
o Known as Inferior group
o Foot, leg, thigh, perineum
o 4-6 nodes
Lymph nodes parallel to inguinal ligament
o Known as superior group
o Superifical, lateral protion gluteal region, anterior abdominal wall
o 5-7 nodes
o Pass primarily to external iliac nodes within false pelvis
o Some go deep inguinal lymph nodes
Deep inguinal nodes
o 1-3 nodes
o Within femoral sheath
o Medial to femoral vein
o Lowest/most constant node below termination of great saphenous vein in femoral vein
o Intermediate node: most variable, midway along length femoral canal
o Uppermost: near femoral ring, superior to femoral canal – cloquet or node of Rosenmuller
o Vessles from: femoral, deep femoral, perineum, superirfical inguinal nodes
o Efferent go to external iliac
External iliac nodes
o Above pelvic brim
o Afferent-from inguinal nodes
o Efferent- merge to common iliac
Internal iliac nodes
o Within pelvis
o Afferent- pelvic organs, deeper gluteal regions
o Coruse with superior/inferior gluteal bv
o Efferent- common iliac
