Internal Iliac Artery Scheme (Course, Branches, Mnemonic) | Anatomy — Transcript

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1. 0:00Alright so this video’s gonna be about  the Internal Iliac artery along with a
2. 0:04couple of tips on how to remember the  branches easier. I’m going to share
3. 0:08the way I used to remember these branches. So, as you know, the abdominal aorta will
4. 0:13continue downwards to the 4th Lumbar vertebrae  approximately, then then it’ll divide into
5. 0:18What is called the Common Iliac arteries.  They’ll continue to approximately the
6. 0:22Sacroiliac joint, and then Further divide into the External Iliac,
7. 0:27and the Internal Iliac arteries. Now, Let’s make a cross section and look at
8. 0:31them both from this perspective To visualize them easier.
9. 0:34Now from here we can finally focus on the Internal Iliac artery. The first thing to
10. 0:39understand is that the branching pattern of the  internal iliac is very variable. Meaning any
11. 0:45particular branching pattern of the internal iliac  arteries, whether in an anatomical altas or a
12. 0:49lecture, will probably have no bearing whatsoever  on the branching pattern in the next person you
13. 0:55encounter. Even the variation between the right  and the left side in a single person can be as
14. 1:00great as that among different people. So instead  of focusing on the branching sequence. Instead,
15. 1:07concentrate on matching the arteries to their  targets, which I’ll try to show you in this video,
16. 1:13it’ll be much much more easier to  remember the branches of this artery.
17. 1:17Now. The internal Iliac will travel along the  lateral wall of the leser pelvis, and then
18. 1:23Split into two divisions. There are typically  10 named branches of the internal iliac artery.
19. 1:29And if you know these 10, you’ll be  fine for almost any conceivable purpose.
20. 1:33There are a lot of ways to remember the branches  of the internal iliac, but a simple scheme for
21. 1:38remembering them is remembering the numbers 2 + 4 + 4:
22. 1:43That give you TWO to the back body wall FOUR leaving the pelvis entirely:
23. 1:48And FOUR to pelvic viscera: So let’s look at the two branches
24. 1:52going along the posterior body wall. The first one is an artery called
25. 1:57The iliolumbar A. It ascends and then eventually  divides into two branches: lumbar branch which
26. 2:05supplies muscles of the posterior wall of the  abdominal cavity, and the Iliac branch, which
27. 2:11passes along the iliac crest and supplies muscles  of the anterior wall of the abdominal cavity.
28. 2:17The Iliac branch will anastomose with the Deep  Iliac circumflex artery of the external iliac.
29. 2:24The other branch is the lateral  sacral artery. It descends along
30. 2:28the anterior surface of sacrum to supply  muscles of the pelvic girdle and the perineum.
31. 2:35They give off some spinal branches, which  goes through the anterior sacral foramina,
32. 2:41to enter the sacral canal and supply cauda equina; It keeps going downwards to supply the perineum.
33. 2:49So that was all the arteries Going towards the posterior body wall.
34. 2:53Now let’s do the 4 arteries leaving  the pelvic cavity completely.
35. 2:58The first one is the Obturator artery runs forward and downward
36. 3:04along the lateral wall of the lesser pelvis, then  goes through the obturator canal as you see here.
37. 3:10And then once it’s on the thigh, It divides into two branches – an
38. 3:14anterior branch and a posterior branch.  These terminal branches supply muscles of the
39. 3:20medial compartment of the thigh,  remember these are the Pectineus,
40. 3:25Gracilis and the adductor Longus/Brevis/Magnus.  It also supplies the obturator externus muscle.
41. 3:33Now the artery on its pathway  gives off two side branches:
42. 3:37One called the pubic branch, Which anastomose with the
43. 3:40pubic branch of the inferior epigastric  artery, and when they connect they get the name
44. 3:45Corona Mortis. The term ‘’Corona Mortis’’  translates as ‘’Crown of death’’,
45. 3:53indicating the importance of this structure  in orthopedic surgery. Accidental damage to
46. 3:59this structure can cause significant hemorraging  which may be difficult to then achieve hemostasis.
47. 4:05It must therefore be considered  cautiously during surgery.
48. 4:09So that’s the pubic branch.  The other branch is the
49. 4:12Acetabular branch. Let’s repeat some joint anatomy  a little bit so you understand this branch fully.
50. 4:18Here you see the acetubular fossa With the lunate surface up here
51. 4:23And the transverse acetubular ligament forming a  complete circle together with the lunate surface.
52. 4:28But you see this white arrow going under  the transverse acetubular ligmant? This is
53. 4:33Where the Acetubular branch of the obturator artery
54. 4:36will go through. It runs inside The ligament of the femoral head
55. 4:41to supply caput femoris. So that’s the obturator artery.
56. 4:47Next we need to add a muscle Called the piriform muscle,
57. 4:51because out of the next 3 arteries, one will  leave above the piriform muscle, and two below it.
58. 4:59So now the next artery is the Superior Gluteal  Artery, which leaves the pelvic cavity through
59. 5:05the space above the piriform muscle, the  suprapiriform foramen we call it, and then
60. 5:11Goes upwards as you see  here. This artery will supply
61. 5:15m. gluteus minimus, m. gluteus medius,
62. 5:18m. tensor fascia latae and  art. Coxae or the hip joint,
63. 5:24sometimes also called the acetubulofemoral joint.
64. 5:28So that’s this one Next since we have a superior gluteal artery,
65. 5:33we’ll also have the Infeiror gluteal artery.
66. 5:37It leaves the pelvic cavity through  the space below the piriform muscle and
67. 5:42Then goes towards the lower part of the  hip joint as you see here, so supply all of
68. 5:46These muscles you see here. And these are the Internal Obturator muscle,
69. 5:51Gemellus, Quadratus femoris
70. 5:54As well as the gluteus maximus and the  levator ani muscles. So that’s it for the
71. 6:00Inferior gluteal artery. The last artery That leaves the pelvis completely
72. 6:06is the Internal Pudendal Artery. This  artery will also leave the pelvis
73. 6:11in the space below the piriform muscle  as you see here. And if we follow the
74. 6:16Artery looking from this perspective You’ll
75. 6:19See the that the artery winds around spina  ischiadica and then continues into the
76. 6:26Space between the Perineal muscles and  the muscle of the pelvic diaphragm, to the
77. 6:33Continue towards the anterior side As you see here where it terminates.
78. 6:37In males, it terminates as the two arteries  Deep and Dorsal arteries of the Penis, while
79. 6:44In females, it terminates as the Deep and Dorsal  arteries of the clitoris. So that’s the course of
80. 6:52the internal pudendal artery, let’s now Look from the posterior view
81. 6:57To cover the side branches  of the internal pudendal.
82. 7:01The first one is the inferior rectal artery,  which supplies the lower third of the rectum,
83. 7:07There’s the perineal artery which  supplies the muscles of the perineum
84. 7:11and gives branches to the external genitals: And these branches are the posterior scrotal
85. 7:18artery supplying the posterior  surface of the scrotum in males,
86. 7:22Or the Posterior Labial Artery which  supplies the posterior parts of the
87. 7:26Labia Majora in females. Another branch  of the internal pudendal artery is the,
88. 7:30Urethral branch supplying  the urethra, then there’s the
89. 7:34Artery of the bulb of the penis which supplies  the bulbus penis in Male, or the Artery of the
90. 7:41bulb of the vestibule for the bulbus vestibuli.  So that’s all for the internal pudendal
91. 7:48Now we’ve covered the two arteries towards the back body wall, and the
92. 7:534 arteries leaving the pelvis completely. Next let’s do the 4 arteries supplying structures
93. 7:58within the pelvis supplying the pelvic viscera.
94. 8:02So let’s add the urinary bladder and  continue with the first artery, which
95. 8:05Is the Umbilical artery. The umbilical artery is  actually an artery found during the fetal life,
96. 8:13but then regresses after birth.  And a portion obliterates to
97. 8:17become the medial umbilical ligament. As you see here on the anterior abdominal wall,
98. 8:22the peritoneum forms this fold.  What remains of this artery
99. 8:28Are the Superior Vesical Artery, which
100. 8:31ascends along the urinary bladder to supply  the body and the apex of the urinary bladder.
101. 8:38Another artery that remains Is the artery of the ductus deferens which
102. 8:42goes together with the ductus deferens, supplies  it and the vesicula seminalis. Then on it’s way,
103. 8:50the artery gives branches small uretheral  branches to supply the lower third of the ureter;
104. 8:58So that’s this artery The next artery is the inferior
105. 9:01vesical artery in male which supplies the Fundus of the urinary bladder,
106. 9:06the prostate and the seminal vescicle. Then in females, this artery is called
107. 9:12the vaginal artery, which supplies  the anterior wall of the vagina.
108. 9:16I made this scheme showing the different arteries.  So here you see the internal pudendal artery going
109. 9:23down to supply the clitoris through the  deep/dorsal arteries of the clitoris,
110. 9:28as well as a side branch of the  internal pudendal as mentioned earlier,
111. 9:32the posterior labial artery which supplies  the posterior part of the labia majora.
112. 9:37So let’s continue with this scheme, because the  next artery is called Uterine artery which is..
113. 9:43you know.. only in females. And we’ll add the urether
114. 9:48and the cardinal ligaments as a landmark, because The uterine artery runs upwards and passes the
115. 9:54cardinal ligament of the uterus to cervix  before it ascends along the lateral side
116. 10:00of the uterus as you see here, where it divides into two branches: tubal branch
117. 10:06which supplies tuba uterina and mesosalpinx; and  the ovarian branch which supplies the ovaries.
118. 10:13There are many variations to this as  mentioned earlier, but mainly both of
119. 10:18these branches anastomose with the ovarian artery of the abdominal aorta. Another thing
120. 10:24with the uterine artery is that it also supplies the anterior and posterior walls of the uterus.
121. 10:31Ocasionally you may find the uterine artery also  giving off urethral branches for the lower third
122. 10:37of the urether, and the vaginal artery for  the vagina. So that’s the uterine artery.
123. 10:43Now the last artery is an artery for the rectum,
124. 10:46called the middle rectal artery. Which goes behind the vaginal canal. Now let’s
125. 10:52do the full blood supply of the  rectum so you get the whole idea.
126. 10:56The internal iliac artery descends, And give off the internal pudendal artery,
127. 11:02which then branch off giving the Inferior rectal artery.
128. 11:06Now tell me, where does the  superior rectal artery come from?
129. 11:11It comes from the inferior mesenteric  artery, good job if you remembered this one.
130. 11:18Then there’s the middle rectal artery, which  comes directly from the internal iliac artery.
131. 11:26So that’s all I had for the internal iliac artery.
132. 11:30I really hope this video helped you understand  the internal iliac artery. Until next time.