Blood Supply

Question 1

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

Answer 1

Iliolumbar
Lateral sacral artery
Superior gluteal artery

(SUPerGILLS)

Question 2

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

Answer 2

Inferior gluteal artery
Internal pudendal artery
Middle rectal artery
Uterine artery
Vaginal artery
Obturator artery
Superior vesical artery (+obliterated umbilical artery)

SO (IV) U MR PIG

Question 3

What are the branches of the uterine artery?

Answer 3

Ureteral branches
Vaginal branches
Cervical branches
Arcuate branches
Branches to fundus
Terminates into two branches, which anastomose with similar branches from the ovarian artery
- Ovarian branch
- Tubal branch

Question 4

What is the origin of the ovarian artery?

What is the course of the ovarian artery?

Answer 4

Abdominal aorta. Just inferior to the renal artery.

Course: through the infundibulopelvic (IP) ligament in close proximity to the ureter along the lateral aspect of the psoas mnuscle.

Question 5

What is the origin of the uterine artery?

Answer 5

Anterior division of the internal iliac artery

Question 6

What is the venous drainage of the ovary?

Answer 6

Left ovarian vein drains into the left renal vain

Right ovarian vein drains into the IVC

Question 7

What is the venous drainage of the uterus?

Answer 7

Drains into the internal iliac vein via the venous plexus (of veins from uterus, vagina, cervix)

Question 8

What is the venous drainage of the vagina?

Answer 8

Drains into the internal iliac vein via the venous plexus (of veins from uterus, vagina, cervix)

Question 9

What is the blood supply of the vagina?

Answer 9

Various branches of the anterior division of the internal iliac artery

Vaginal
Uterine branches
Middle rectal
Internal pudendal

Question 10

Regarding the inferior epigastric artery:

• What is its origin?
• Where does it course?
• What does it perfuse?
• When placing lower abdominal lateral ports during laparoscopy, how would you avoid injuring the inferior epigastric vessels?

Answer 10

• Origin: external iliac artery.
• Course: Travels through transversalis fascia into space between rectus abdominis and posterior rectus sheath. Runs obliquely towards a more medial location as it approaches umbilicus.
• Supplies: rectus abdominis
• The inferior epigastric vessels must be visualised intra-abdominally running lateral to the medial umbilical ligament.

Question 11

Regarding the uterine artery:

• What is its origin?
• Where does it course?
• What does it perfuse?

Answer 11

• Origin: anterior division of the internal iliac artery.
• Course: anteromedially in base of broad ligament and superior cardinal ligament and gives rise to the vaginal branch then crosses ureter (1.5 cm lateral to cervix; water under bridge) to reach lateral aspect of cervix.
• Supplies: uterus, uterine ligaments, medial fallopian tubes and ovary and superior vagina.

Question 12

Regarding the vaginal artery:

• What is its origin?
• Where does it course?
• What does it perfuse?

Answer 12

• Origin: uterine artery; divides into vaginal br and inferior vesical br.
• Course: vaginal branch descends on vagina. Inferior vesical br passes to bladder.

Supplies:

• Vaginal br supplies lower vagina, vestibular bulb and adjcaent rectum.
• Inferior vesical br supplies top of bladder.

Question 13

Regarding the internal pudendal artery:

• What is its origin?
• Where does it course?
• What does it perfuse?

Answer 13

• Origin: anterior division of the internal iliac artery.
• Course: leaves pelvis via the greater sciatic foremen and enters the perineum via the lesser sciatic foremen, then passes via the pudendal canal into the urogenital triangle.

Supplies: main artery of the perineum

• Muscles and skin of anal and urogenital triangles
• Erectile bodies

Question 14

At what level does the aorta divide into the common iliac vessels?

Answer 14

L1