Henry Gray (18251861). Anatomy of the Human Body. 1918.
The superior gluteal artery (a. glutæa superior; gluteal artery) (Fig. 544) is the largest branch of the hypogastric, and appears to be the continuation of the posterior division of that vessel. It is a short artery which runs backward between the lumbosacral trunk and the first sacral nerve, and, passing out of the pelvis above the upper border of the Piriformis, immediately divides into a superficial and a deep branch. Within the pelvis it gives off a few branches to the Iliacus, Piriformis, and Obturator internus, and just previous to quitting that cavity, a nutrient artery which enters the ilium.
The superficial branch enters the deep surface of the Glutæus maximus, and divides into numerous branches, some of which supply the muscle and anastomose with the inferior gluteal, while others perforate its tendinous origin, and supply the integument covering the posterior surface of the sacrum, anastomosing with the posterior branches of the lateral sacral arteries.
The deep branch lies under the Glutæus medius and almost immediately subdivides into two. Of these, the superior division, continuing the original course of the vessel, passes along the upper border of the Glutæus minimus to the anterior superior spine of the ilium, anastomosing with the deep iliac circumflex artery and the ascending branch of the lateral femoral circumflex artery. The inferior division crosses the Glutæus minimus obliquely to the greater trochanter, distributing branches to the Glutæi and anastomoses with the lateral femoral circumflex artery. Some branches pierce the Glutæus minimus and supply the hip-joint.
5b. 2. The External Iliac Artery
(A. Iliaca Externa)
The external iliac artery(Fig. 539) is larger than the hypogastric, and passes obliquely downward and lateralward along the medial border of the Psoas major, from the bifurcation of the common iliac to a point beneath the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis, where it enters the thigh and becomes the femoral artery.
Relations.In front and medially, the artery is in relation with the peritoneum, subperitoneal areolar tissue, the termination of the ileum and frequently the vermiform process on the right side, and the sigmoid colon on the left, and a thin layer of fascia, derived from the iliac fascia, which surrounds the artery and vein. At its origin it is crossed by the ovarian vessels in the female, and occasionally by the ureter. The internal spermatic vessels lie for some distance upon it near its termination, and it is crossed in this situation by the external spermatic branch of the genitofemoral nerve and the deep iliac circumflex vein; the ductus deferens in the male, and the round ligament of the uterus in the female, curve down across its medial side. Behind, it is in relation with the medial border of the Psoas major, from which it is separated by the iliac fascia. At the upper part of its course, the external iliac vein lies partly behind it, but lower down lies entirely to its medial side. Laterally, it rests against the Psoas major, from which it is separated by the iliac fascia. Numerous lymphatic vessels and lymph glands lie on the front and on the medial side of the vessel.
Collateral Circulation.The principal anastomoses in carrying on the collateral circulation, after the application of a ligature to the external iliac, are: the iliolumbar with the iliac circumflex; the superior gluteal with the lateral femoral circumflex; the obturator with the medial femoral circumflex; the inferior gluteal with the first perforating and circumflex branches of the profunda artery; and the internal pudendal with the external pudendal. When the obturator arises from the inferior epigastric, it is supplied with blood by branches, from either the hypogastric, the lateral sacral, or the internal pudendal. The inferior epigastric receives its supply from the internal mammary and lower intercostal arteries, and from the hypogastric by the anastomoses of its branches with the obturator.1
Branches.Besides several small branches to the Psoas major and the neighboring lymph glands, the external iliac gives off two branches of considerable size:
Deep Iliac Circumflex.
Note 1. Sir Astley Cooper describes in Guys Hospital Reports, vol. i, the dissection of a limb eighteen years after successful ligature of the external iliac artery. [back]