Henry Gray (18251861). Anatomy of the Human Body. 1918.
the umbilical opening, the two arteries, now termed umbilical, enter the umbilical cord, where they are coiled around the umbilical vein, and ultimately ramify in the placenta.
At birth, when the placental circulation ceases, the pelvic portion only of the artery remains patent and constitutes the hypogastric and the first part of the superior vesical artery of the adult; the remainder of the vessel is converted into a solid fibrous cord, the lateral umbilical ligament (obliterated hypogastric artery) which extends from the pelvis to the umbilicus.
Peculiarities as Regards Length.In two-thirds of a large number of cases, the length of the hypogastric varied between 2.25 and 3.4 cm.; in the remaining third it was more frequently longer than shorter, the maximum length being about 7 cm. the minimum about 1 cm.
The lengths of the common iliac and hypogastric arteries bear an inverse proportion to each other, the hypogastric artery being long when the common iliac is short, and vice versa.
As Regards its Place of Division.The place of division of the hypogastric varies between the upper margin of the sacrum and the upper border of the greater sciatic foramen.
The right and left hypogastric arteries in a series of cases often differed in length, but neither seemed constantly to exceed the other.
Collateral Circulation.The circulation after ligature of the hypogastric artery is carried on by the anastomoses of the uterine and ovarian arteries; of the vesical arteries of the two sides; of the hemorrhoidal branches of the hypogastric with those from the inferior mesenteric; of the obturator artery, by means of its pubic branch, with the vessel of the opposite side, and with the inferior epigastric and medial femoral circumflex; of the circumflex and perforating branches of the profunda femoris with the inferior gluteal; of the superior gluteal with the posterior branches of the lateral sacral arteries; of the iliolumbar with the last lumbar; of the lateral sacral with the middle sacral; and of the iliac circumflex with the iliolumbar and superior gluteal.1
Branches.The branches of the hypogastric artery are:
From the Anterior Trunk.
From the Posterior Trunk.
In the Female.
The superior vesical artery (a. vesicalis superior) supplies numerous branches to the upper part of the bladder. From one of these a slender vessel, the artery to the ductus deferens, takes origin and accompanies the duct in its course to the testis, where it anastomoses with the internal spermatic artery. Other branches supply the ureter. The first part of the superior vesical artery represents the terminal section of the pervious portion of the fetal hypogastric artery.
The middle vesical artery (a. vesicalis medialis), usually a branch of the superior, is distributed to the fundus of the bladder and the vesiculæ seminales.
The inferior vesical artery (a. vesicalis inferior) frequently arises in common with the middle hemorrhoidal, and is distributed to the fundus of the bladder, the prostate, and the vesiculæ seminales. The branches to the prostate communicate with the corresponding vessels of the opposite side.
The middle hemorrhoidal artery (a. hæmorrhoidalis media) usually arises with the preceding vessel. It is distributed to the rectum, anastomosing with the inferior vesical and with the superior and inferior hemorrhoidal arteries. It gives offsets to the vesiculæ seminales and prostate.
The uterine artery (a. uterina) (Fig. 540) springs from the anterior division of
Note 1. For a description of a case in which Owen made a dissection ten years after ligature of the hypogastric artery, see Med.-Chir. Trans., vol. xvi. [back]