The more complicated division
is the anterior division.
And we can see the anterior division is
coming down in a more anterior direction.
so we can see it coming down here.
The anterior division will give rise to
couple of arteries first of all.
These being the umbilical and the obturator artery.
If we follow the obturator artery around here,
that is going to go and supply the
medial compartment of the thigh.
It supplies the medial compartment of the thigh and it
exits the pelvis by passing through the obturator canal.
That is an aperture in the obturator
fascia which fills the obturator
foramen. So we have got
the obturator foramen here.
We have a little deficit in this top
corner here and that allows obturator
artery to pass through. Also passing through
the obturator nerve and obturator vein.
And these going to supply the medial compartment
of the thigh, the adductor compartment.
We then have the umbilical
artery. The umbilical artery
is important as we were developing.
As this returned blood
back to the fetus, back to the
placenta. If you remember that
the fetus receive blood via the umbilical vein
via the umbilical cord from the placenta
which ran in the free edge
of the falciform ligament.
The blood then circulated
through the fetus then returns
to the placenta via these
two umbilical arteries.
And they then run up within
the anterior abdominal wall.
And you may remember when we looked at the anterior
abdominal wall there were some ridges
on the posterior surface of
the anterior abdominal wall.
If you look back you may remember
the medial umbilical ligament.
And that is where these umbilical
arteries were running.
Obviously when we are born, we loose
that connection with the placenta
and this umbilical artery becomes
obliterated, it becomes fibrosed
because blood no longer passes through it
However, all of it doesn't become fibrous.
And there is still a patent part,
the patent portion of the umbilical
artery that runs toward the bladder
where it gives rise to these
superior vesicle arteries.
The superior vesicle arteries, here
we can see the umbilical artery,
that will become obliterated.
But its giving rise to a 2, 3, 4
superior vesicle arteries. That run
towards the top superior surface
of the bladder. So
this is an important
artery, just be aware of the umbilical artery.
We have two umbilical arteries. One coming
here from the right and the other one on the left
internal iliac. And they're in the fetus responsible
for returning blood back to the placenta.
When we're born, they become fibrosed but it
doesn't all become fibrosed, not its enterity
and superior vesicle arteries continue
that pass to the bladder.
Alongside having superior
vesicle arteries we also have
inferior vesicle artery in the male
and that goes to supply the base of the
artery; base of the bladder, I make a pardon.
Inferior vesicle artery, its
prostatic branches that supply the
prostate. It'll also give rise to the artery to the ductus
deferens, that runs alongside the ductus deferens.
helping to supply it. In the female
this inferior vesicle artery
come be known as the vaginal artery
and it passes towards the vagina.
We can also see that we
have a uterine artery
and here in this diagram, you can see the uterine
artery that's passing towards the uterus in the female.
And this uterine artery may itself
gives rise to a vaginal branch
that helps to supply the vagina. We will look
at these in more detail when we look at the
blood supply to the female
Males don't, obviously, have uterine
arteries. They don't have a uterus.
We can then see that we have a few more arteries
which can be quite variable in position
or they may not actually occur.
For example, here we have got a middle rectal artery.
This is only present in about 60% of the population.
Not everyone has a middle rectal artery.
We have a superior rectal artery.
And we have an inferior rectal
artery which we will see later.
And these will form an anastomosis
that may be sufficient.
But about 60% of the population will
also find a middle rectal artery.
The final two really are the
bifurcating end of the internal
iliac artery where it terminates.
And importantly both of these
leave the pelvis by passing
inferior to piriformis
and pass out via the
greater sciatic foramen.
Now, this is a really complicated
but important part of this
pathway of this internal iliac artery.
These arteries leave the pelvis via the greater sciatic
foramen. We can see them here. This is the greater
sciatic foramen. Here we have got piriformis muscle.
And we see that superior gluteal left
through the greater sciatic foramen
superior to piriformis.
Internal pudendal and inferior gluteal
will also leave through the greater sciatic
foramen where they are going to leave
inferior to piriformis. So in the cadaver,
if you are struggling to
locate these arteries,
find piriformis, above would
tend to be the superior gluteal;
and below will be inferior
gluteal and internal pudendal.
Now the inferior gluteal will go to the gluteal
region and supply the muscles of the buttock, gluteus;
medius gluteus, minimus gluteus, maximus
go and supply that region.
Whereas internal pudendal will
go to supply the perineum.
And we will look at this in more detail when
we look at the perineum. But we have is
inferior gluteal passing out
to the gluteal region.
And internal pudendal actually hooking around this
structure here which is the ischial spine;
and connecting to the sacrum where we
have the sacrospinous ligament.
It will hook around this structure and
actually enter into the perineum
by passing through the lesser sciatic
foramen, this foramen here.
So we can see the internal pudendal artery
leaves the pelvis via the greater sciatic
foramen. It then enters the perineum
which is located underneath the pelvic floor
by passing through the lesser sciatic foramen.
We will look at that when we look
at the perineum in more detail