Arteries, Veins and Lymphatics of Pelvis and Gluteal Region Flashcards Preview

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Flashcards in Arteries, Veins and Lymphatics of Pelvis and Gluteal Region Deck (22):

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

• 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