Blood Vessels of the Pelvis Flashcards
Where does the abdominal aorta bifurcate and what vessels does it become?
- at the level of L4
- becomes the left and right common iliac arteries
Where do the common iliac arteries bifurcate and what vessels do they become?
- anterior to the sacroiliac joint
- external and internal iliac arteries
What are the branches of the external iliac artery?
- Deep circumflex iliac artery
- curves back along the iliac blade
- supplies the ilium and iliacus muscle - Inferior epigastric artery
- runs vertically upward behind the rectus abdominis
What does the external iliac artery become below the inguinal ligament?
femoral artery
What is the major source of blood to structures within the pelvis?
the internal iliac artery
What crosses the internal iliac artery anteriorly at the pelvic brim?
the ureter
What are the branches of the internal iliac artery?
- Posterior trunk
2. Anterior trunk
What are the branches of the posterior trunk of the internal iliac artery?
- Iliolumbar artery
- Iliac branch
- Lumbar branch - Lateral sacral artery
- Superior gluteal artery
What are the branches of the iliolumbar artery?
- iliac branch
- lumbar branch
What does the iliac branch of the iliolumbar artery supply?
iliacus muscle and ilium
What does the lumbar branch of the iliolumbar artery supply?
psoas major and quadratus lumborum
What does the lateral sacral artery anastomose with? What does it supply?
- branches enter the anterior sacral foramina and anastomose with the median sacral artery
- supplies the sacrum
Where does the superior gluteal artery pass?
- exits the pelvis through the greater sciatic foramen superior to the piriformis muscle
- usually passes between the lumbosacral trunk and 1st sacral nerve
What does the superior gluteal artery supply?
- gluteus medius
- gluteus minimus
- tensor fascia muscle
What are the branches of the anterior trunk of the internal iliac artery?
- inferior gluteal artery
- internal pudendal artery
- umbilical artery
- obturator artery
- inferior vesical artery
- middle rectal artery
- uterine artery
- vaginal artery
Describe the inferior gluteal artery.
- exits the pelvis through the greater sciatic foramen inferior to the piriformis muscle
- passes between the 1st and 2nd or 2nd and 3rd sacral nerves
- supplies the gluteus maximus
Describe the internal pudendal nerve.
- exits the pelvis through the greater sciatic foramen between the piriformis and coccygeus muscles
- it then enters the perineum through the lesser sciatic foramen
- it gives off important branches to the perineum
- supplies the external genitalia and underlying musculature
Describe the umbilical artery.
- its proximal (patent) portion gives off the superior vesical arteries, which supply the superior part of the bladder
- one of the superior vesical arteries usually gives rise to the artery of the ductus deferens
- the distal (obliterated) portion is obliterated and continues forward as the medial umbilical ligament
Describe the obturator artery.
- exits the pelvis through the obturator foramen
- supplies the muscles of the thigh
What does the inferior vesical artery supply?
- the inferior part of the bladder
- in the male: the prostate gland and seminal vesicles
What does the middle rectal artery supply?
- middle portion of the rectum
- male: prostate
- female: vagina
Describe the uterine artery.
- homologous to the artery of the ductus deferens in males
- arises from the internal iliac, or from a common trunk with the vaginal or middle rectal arteries
Describe the vaginal artery.
arises from a common trunk with the uterine or directly off the internal iliac artery
What other arteries supply structures in the pelvis?
- Gonadal (testicular or ovarian) artery
- Superior rectal artery
- Median sacral artery
Describe the gonadal (testicular or ovarian) artery.
- from the abdominal aorta
- supplies the testes or ovaries
Describe the superior rectal artery.
- from the inferior mesenteric artery
- supplies the rectum and anal canal
Describe the median sacral artery.
- an unpaired artery which arises from behind the bifurcation of the abdominal aorta
- runs down the middle of the sacrum
Describe the veins that drain the pelvis.
- the internal and external iliac veins unite to form the common iliac vein
- the left and right common iliac veins unite to form the inferior vena cava
- in general, tributaries of the internal iliac vein correspond to branches of the internal iliac artery
- most pelvic structures drain into the caval system
- only the rectum and anal canal have some portal drainage
