Blood Vessels of the Pelvis

Question 1

Where does the abdominal aorta bifurcate and what vessels does it become?

Answer 1

• at the level of L4

- becomes the left and right common iliac arteries

Question 2

Where do the common iliac arteries bifurcate and what vessels do they become?

Answer 2

• anterior to the sacroiliac joint

- external and internal iliac arteries

Question 3

What are the branches of the external iliac artery?

Answer 3

1. Deep circumflex iliac artery
   - curves back along the iliac blade
   - supplies the ilium and iliacus muscle
2. Inferior epigastric artery
   - runs vertically upward behind the rectus abdominis

Question 4

What does the external iliac artery become below the inguinal ligament?

Answer 4

femoral artery

Question 5

What is the major source of blood to structures within the pelvis?

Answer 5

the internal iliac artery

Question 6

What crosses the internal iliac artery anteriorly at the pelvic brim?

Answer 6

the ureter

Question 7

What are the branches of the internal iliac artery?

Answer 7

1. Posterior trunk

2. Anterior trunk

Question 8

What are the branches of the posterior trunk of the internal iliac artery?

Answer 8

1. Iliolumbar artery
   - Iliac branch
   - Lumbar branch
2. Lateral sacral artery
3. Superior gluteal artery

Question 9

What are the branches of the iliolumbar artery?

Answer 9

• iliac branch

- lumbar branch

Question 10

What does the iliac branch of the iliolumbar artery supply?

Answer 10

iliacus muscle and ilium

Question 11

What does the lumbar branch of the iliolumbar artery supply?

Answer 11

psoas major and quadratus lumborum

Question 12

What does the lateral sacral artery anastomose with? What does it supply?

Answer 12

• branches enter the anterior sacral foramina and anastomose with the median sacral artery
• supplies the sacrum

Question 13

Where does the superior gluteal artery pass?

Answer 13

• exits the pelvis through the greater sciatic foramen superior to the piriformis muscle
• usually passes between the lumbosacral trunk and 1st sacral nerve

Question 14

What does the superior gluteal artery supply?

Answer 14

• gluteus medius
• gluteus minimus
• tensor fascia muscle

Question 15

What are the branches of the anterior trunk of the internal iliac artery?

Answer 15

1. inferior gluteal artery
2. internal pudendal artery
3. umbilical artery
4. obturator artery
5. inferior vesical artery
6. middle rectal artery
7. uterine artery
8. vaginal artery

Question 16

Describe the inferior gluteal artery.

Answer 16

• 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

Question 17

Describe the internal pudendal nerve.

Answer 17

• 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

Question 18

Describe the umbilical artery.

Answer 18

• 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

Question 19

Describe the obturator artery.

Answer 19

• exits the pelvis through the obturator foramen

- supplies the muscles of the thigh

Question 20

What does the inferior vesical artery supply?

Answer 20

• the inferior part of the bladder

- in the male: the prostate gland and seminal vesicles

Question 21

What does the middle rectal artery supply?

Answer 21

• middle portion of the rectum
• male: prostate
• female: vagina

Question 22

Describe the uterine artery.

Answer 22

• 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

Question 23

Describe the vaginal artery.

Answer 23

arises from a common trunk with the uterine or directly off the internal iliac artery

Question 24

What other arteries supply structures in the pelvis?

Answer 24

1. Gonadal (testicular or ovarian) artery
2. Superior rectal artery
3. Median sacral artery

Question 25

Describe the gonadal (testicular or ovarian) artery.

Answer 25

• from the abdominal aorta

- supplies the testes or ovaries

Question 26

Describe the superior rectal artery.

Answer 26

• from the inferior mesenteric artery

- supplies the rectum and anal canal

Question 27

Describe the median sacral artery.

Answer 27

• an unpaired artery which arises from behind the bifurcation of the abdominal aorta
• runs down the middle of the sacrum

Question 28

Describe the veins that drain the pelvis.

Answer 28

• 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