Henry Gray (18251861). Anatomy of the Human Body. 1918.
The inferior epigastric artery (a. epigastrica inferior; deep epigastric artery) (Fig. 547)arises from the external iliac, immediately above the inguinal ligament. It curves forward in the subperitoneal tissue, and then ascends obliquely along the medial margin of the abdominal inguinal ring; continuing its course upward, it pierces the transversalis fascia, and, passing in front of the linea semicircularis, ascends between the Rectus abdominis and the posterior lamella of its sheath. It finally divides into numerous branches, which anastomose, above the umbilicus, with the superior epigastric branch of the internal mammary and with the lower intercostal arteries (Fig. 522). As the inferior epigastric artery passes obliquely upward from its origin it lies along the lower and medial margins of the abdominal inguinal ring, and behind the commencement of the spermatic cord. The ductus deferens, as it leaves the spermatic cord in the male, and the round ligament of the uterus in the female, winds around the lateral and posterior aspects of the artery.
Branches.The branches of the vessel are: the external spermatic artery (cremasteric artery), which accompanies the spermatic cord, and supplies the Cremaster and other coverings of the cord, anastomosing with the internal spermatic artery (in the female it is very small and accompanies the round ligament); a pubic branch which runs along the inguinal ligament, and then descends along the medial margin of the femoral ring to the back of the pubis, and there anastomoses with the pubic branch of the obturator artery; muscular branches, some of which are distributed to the abdominal muscles and peritoneum, anastomosing with the iliac circumflex and lumbar arteries; branches which perforate the tendon of the Obliquus externus, and supply the integument, anastomosing with branches of the superficial epigastric.
Peculiarities.The origin of the inferior epigastric may take place from any part of the external iliac between the inguinal ligament and a point 6 cm. above it; or it may arise below this ligament, from the femoral. It frequently springs from the external iliac, by a common trunk with the obturator. Sometimes it arises from the obturator, the latter vessel being furnished by the hypogastric, or it may be formed of two branches, one derived from the external iliac, the other from the hypogastric.
The deep iliac circumflex artery (a. circumflexa ilium profunda) arises from the lateral aspect of the external iliac nearly opposite the inferior epigastric artery. It ascends obliquely lateralward behind the inguinal ligament, contained in a fibrous sheath formed by the junction of the transversalis fascia and iliac fascia, to the anterior superior iliac spine, where it anastomoses with the ascending branch of the lateral femoral circumflex artery. It then pierces the transversalis fascia and passes along the inner lip of the crest of the ilium to about its middle, where it perforates the Transversus, and runs backward between that muscle and the Obliquus internus, to anastomose with the iliolumbar and superior gluteal arteries. Opposite the anterior superior spine of the ilium it gives off a large branch, which ascends between the Obliquus internus and Transversus muscles, supplying them, and anastomosing with the lumbar and inferior epigastric arteries.
6. The Arteries of the Lower Extremity
The artery which supplies the greater part of the lower extremity is the direct continuation of the external iliac. It runs as a single trunk from the inguinal ligament to the lower border of the Popliteus, where it divides into two branches, the anterior and posterior tibial. The upper part of the main trunk is named the femoral, the lower part the popliteal.
a. The Femoral Artery
The femoral artery (Figs. 549,550) begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis, and