Internal iliac artery

Origin

  • It furnishes most of the blood supply to the pelvis.

  • Arises from the common iliac at the level of the inter vertebral disc between the fifth lumbar vertebrae  and the sacrum.

Surface marking

  • Upper point of trisection between the anterior superior iliac spine and pubic symphysis.

  • About 4cm long.

Relations

  • Crossed infront by the ureter

  • Separated from the sacro iliac joint behind by the internal iliac vein and lumbosacral trunk.

  • In upper part, external iliac vein and psoas major are lateral to it.

  • In the lower part the obturator nerve is lateral.

 
Distribution
  • The major branches, direct and indirect may be divided into parietal and visceral.
   

Parietal branches.

  
Artery
Branches
Distribution
  
 
Iliolumbar arterty



 Iliac branch
  • Nutrient branch to ilium
  • Iliacus muscle.
  
  Lumbar branch
  • psoas major,
  • Quadratus lumborum
  
 
Lateral sacral artery


 Spinal branches
  • Contents of the sacral canal
  
 
Obturator artery
 muscular branches
  • Obturator internus
  • Obturator externus
 
  nutrient branch to the ilium
  • Ilium
  
  pubic branch
  • Pubis
  
  acetabular branch
  • Fat in the acetabular fossa
  • Ligament of the head of the femur
  
 
Superior gluteal artery  
  • Gluteal muscles
 
 

Inferior gluteal artery		  
  • Gluteal muscles
 
 
Internal pudendal artery Inferior rectal artery
  • Rectum
  
  Posterior scrotal/ labial branches
  • Scrotumm
  • Labia majora
 
  Perineal artery
  • Perineum
  
  Artery of the bulb of the penis
  • Penis
  
  Urethral artery
  • Urethra
  
  Deep and dorsal arteries of the penis or clitoris.
  • Penis
  • Clitoris
  
 
Visceral Branches      
 

Umbilical arteries

 Superior vesical artery
  • Upper part of the bladder

  • Medial umbilical ligmanet

  • Lower part of the ureter.
  
  Artery of the ductus deferens-
  • Seminal vesicles
  • Back of bladder
  • Urethral branches to the ureter.
  
 
Inferior vesical artery

  
  • Lower parts of the bladder
  • Prostate,
  • Seminal vesicles,
  • Ductus deferens
  • Lower part of ureter.
  
 
Uterine artery  
  • Uterus,
  • Upper part of vagina,
  • Medial part of uterine tubes,
  • Round ligament of uterus
  • Ligament of the ovary
  
 
Vaginal artery Anterior and posterior azygous artery of the vagina
  • Front and back of the vagina
t		  
  Small branches
  • Bladder,
  • Rectum
  • Bulb of vestibule.
  
 
Middle rectal artery
  
  • Rectum
  • Prostate
  • Seminal vesicles
  • Ductus deferens
  
 
 
    Collateral circulation  

    The collateral circulation that develops after obstruction of an internal iliac artery results from anastomoses

    1) with branches of the opposite internal iliac,

    2) between parietal branches and branches of the femoral artery in the thigh, and

    3) between the superior and middle rectal arteries.

    The collateral circulation may be demonstrated by arteriography. The collateral channels also supply the lower part of the abdomen if the abdominal aorta is obstructed, and the lower limb if the femoral artery is obstructed.

    Three other arteries enter the pelvis

    a) Median sacral

    b) Inferior mesentric

    c) Ovarian artery