Now let's move onto the individual
branches in the male and the
female that may be specific.
Here in this diagram we can see
we have the bladder. We can see we have the seminal
vesicles. We can have the vas deference.
If we look at the vas deference, we will see running
along here. We can see running alongside it,
we have the artery to the vas deference. So this is specifically
found in the male where we have the vas deference
We can see we have the superior
vesicle arteries supplying
the superior aspect of the bladder.
And we can also see that we have
inferior vesicle arteries that are coming down
and supplying the base of the bladder and also
giving prostatic branches to supply the prostate.
So this is what we find in the male. Here in
this diagram we can also see we have got the
superior rectal arteries, running
down on the lateral surface
either side on the lateral
surfaces of the rectum.
We can also see in this example we have the
middle rectal artery and that's giving rise
just before the internal iliac dives out of
the pelvis via the lesser sciatic foramen.
I have included the testes here just
to show the blood supply to the testes.
But all I really wanted to mention is
that we have the testicular artery.
Remember the testicular artery
comes from the aorta.
It doesn't come from the
internal iliac artery.
So we have got the testicular artery
which is going to supply the testes.
But look we can see here we still
have the artery to the vas deference.
Running on the vas deference that's then going to go to towards
the epididymis. So we can see there is the potential here
for some kind of collateral
circulation between the two
systems; branches from the internal iliac
and branches from the abdominal aorta.
So that's a general overview of the branches
in the internal iliac within the male.
If we look at the female, then
I have mentioned few of these
arteries before. Again we have the idea that
we have got the ovary here, we've got the ovary here.
And we can see that we have the ovarian artery.
Remember the ovarian artery is coming up from the
aorta. Its not coming from
the internal iliac artery.
And then we look at the specific branches
that supply the uterus and the vagina
from the internal iliac. Remember
we have the uterine artery
here its the uterine artery is
supplying the body of the uterus.
It will run within the broad ligament and form a
collateral circulation, an anatomosis with the
ovarian arteries. So again there is potential
for links between the internal iliac
and the aorta. We can see that coming
from the uterine artery we have
the vaginal branches. And these
are supporting the vaginal artery
So here we can see the vaginal artery.
This direct branch coming from the
internal iliac and in the male
it is inferior vesicle.
In the female it's the vaginal artery and
that specifically going to supply the
vagina. So here we can
see the various branches
in the female. The branches coming from the internal
iliac, uterine artery, its vaginal branches
and the vaginal artery. And also branches coming
from the aorta where we have the
It?s really important to remember
that this uterine artery
is positioned above the ureter.
So if a lady was to have a hysterectomy,
then when the uterus was removed
then you would clamp
off the uterine artery
If you didn't and then you removed the uterus
you would have bleeding out in the pelvis.
So the relationship is that
you have got the uterine artery
uterine artery and coming down you have
the ureter that flows underneath this
blood vessels. That's really important when you need
to remove the uterus that you clamp the uterine artery
and you can deal with it, you can ligate it,
and you leave the ureter intact.
How you can tell the difference between
the ureter and uterine artery?
Well, uterine artery will
have this pulsatile
contraction as the blood is passing
through the uterine artery.
And if you are the surgeon you can just tap the ureter
and that will stimulate a way of the peristalsis
that will go in both directions. The direction
back up the kidney and a direction down to the
ureter. So remember that the water
within the ureter flows under the bridge.
The bridge being the uterine artery.
And that's an important consideration when
looking at the blood supply to the female.