Iliac vessels

31 Iliac vessels



31.1 Anatomy


The aorta divides into the median sacral artery and the two common iliac arteries, to the left side of L4 and L5 intervertebral disc.



31.1.1 Median sacral artery


The median sacral artery is posterior to the iliac vessels and descends over the sacral promontory. It is difficult to palpate, and it is not of great interest to us.



31.1.2 Common iliac artery



Course


From the L4 and L5 intervertebral discs, the common iliac arteries diverge as they descend to divide at the sacroiliac joints. These arteries are about 5–6 cm in length (Fig. 31.1).


image

Fig. 31.1 Common iliac arteries.



Noteworthy relationships


The ureter crosses the common iliac arteries like an X. These small tubes are covered with peritoneum and run along the medial border of the psoas.


The common iliac arteries diverge at an angle of 65° in men, and 75° in women, whose pelvis is wider.



Terminals


The common iliac arteries divide into the internal and external iliac arteries.



31.1.3 Internal iliac artery



Course


Formerly called the hypogastric artery, the internal iliac artery (Fig. 31.2) separates from the common iliac artery at the sacroiliac junction and descends posteriorly towards the greater sciatic foramen.


image

Fig. 31.2 Internal iliac artery.



Pelvic collaterals


At the greater sciatic foramen the internal iliac artery gives off about ten branches. We have selected the most important among them. They can be divided into two groups:



• parietal branches for the walls of the lesser pelvis


• visceral branches for the pelvic organs.



Parietal branches


Parietal branches are divided in accordance with their function.



• The iliolumbar artery often sends a small spinal branch to penetrate the intervertebral foramen, between the fifth lumbar and first sacral vertebrae.


• The lateral sacral artery supplies branches to the cauda equina and smaller vessels that penetrate the vertebral canal.


• The obturator artery passes out of the pelvis through the obturator canal. Of special note is the acetabular branch, which enters the hip joint at the acetabular notch and sends a branch along the ligament of the femoral head.


• The inferior gluteal artery runs in the buttock between the piriformis and adjacent muscles. Together with the comitans artery of the sciatic nerve, the inferior gluteal branch supplies the vascularization of the sciatic nerve.

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Nov 7, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Iliac vessels

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