PELVIC VASCULATURE

Question 1

-abdominal aorta bifurcates at vertebral level L-4 into 2 common iliac arteries (one for each lower limb)

Answer 1

Aorta

Question 2

• a small branch from the dorsal aortic surface just proximal to the bifurcation
• small branches pass to the rectum

Answer 2

Median Sacral Artery

Question 3

• sends branches to psoas major and iliacus muscles

- bifurcates into the internal and external iliac arteries at vertebral level L-5

Answer 3

Common Iliac Artery

Question 4

• larger branch of the common iliac artery
• follows the psoas major muscle (also sends a branch to this muscle and to the iliacus muscle) and enters the thigh deep to the midpoint of the inguinal ligament where it becomes the femoral artery in the thigh

Answer 4

External Iliac Artery

Question 5

• arises laterally just prior to the inguinal ligament and passes superolaterally
  along the deep side of the ligament to reach the anterior superior iliac spine
• anastomoses with the iliolumbar and superior gluteal arteries (branches
  of internal iliac artery)

Answer 5

Deep Circumflex Iliac Artery

Question 6

• arises anteriorly just prior to the inguinal ligament and medial to the deep circumflex iliac artery
• passes superiorly along the abdominal wall and anastomoses with the superior epigastric artery

This anastomosis can provide collateral circulation between the subclavian artery and the external iliac artery.

Answer 6

Inferior Epigastric Artery

Question 7

• the medial and smaller branch of the common iliac artery
• divides into anterior and posterior trunks at the greater sciatic foramen
• supplies the psoas major and iliacus muscles

Answer 7

Internal Iliac Artery

Question 8

• passes toward the ischial spine

- usually appears to be the direct continuation of the internal iliac artery

Answer 8

Anterior Trunk of the Internal Iliac Artery

Question 9

• most lateral branch of the anterior trunk
• exits the pelvis via the obturator canal with the obturator nerve
• may be a branch from the internal iliac artery or sometimes (40%) a branch of the external iliac artery at the pelvic brim

Answer 9

Obturator Artery

Question 10

• the larger terminal branch

- supplies medial compartment thigh and obturator externus muscles

Answer 10

Anterior Branch of Obturator Artery

Question 11

• the other terminal branch
• supplies medial compartment thigh muscles, and posterior
  compartment thigh muscles proximally at the ischial tuberosity
• provides branches to the hip joint
• anastomoses with the anterior branch and the inferior gluteal artery

Answer 11

Posterior Branch of Obturator Artery

Question 12

• terminal division of the anterior trunk
• exits pelvis via greater sciatic foramen, usually intermediate to the ventral rami of S-1 & S-2 or the ventral rami of S-2 & S-3
• before its exit, supplies piriformis muscle
• after its exit, supplies gluteal region muscles and the sciatic nerve
• anastomoses near hip joint with superior gluteal, obturator, internal pudendal and medial femoral circumflex arteries

Answer 12

Inferior Gluteal Artery

Question 13

• terminal branch of the anterior trunk
• exits the pelvis via the greater sciatic foramen and re-enters the pelvis via the lesser sciatic foramen
• supplies the sacral plexus, obturator internus muscle, piriformis muscle and external genitalia

Answer 13

Internal Pudendal Artery

Question 14

• arises anterior to the sacroiliac joint and passes superolaterally in the
  pelvis
• anastomoses near iliac crest with the superior gluteal, the deep circumflex iliac and the lateral femoral circumflex arteries

Answer 14

Iliolumbar Artery

Question 15

• terminal branch of the posterior trunk, arises within the true pelvis
• supplies the sacral ala

Answer 15

Lateral Sacral Artery

Question 16

• largest branch from either trunk, usually
• appears as the direct continuation of the posterior trunk, usually
• exits pelvis via greater sciatic foramen, usually intermediate to the lumbosacral trunk and the S-1 ventral ramus
• before its exit, supplies the piriformis and obturator internus muscles
• after its exit, supplies the 3 gluteal muscles (named gluteal)
• anastomoses at hip joint with deep circumflex iliac, medial and lateral femoral circumflex, and inferior gluteal arteries

Answer 16

Superior Gluteal Artery