Iliac arteries: structure and function
The iliac arteries are one of the largest vessels in the body. They are paired vessels up to 7 cm in length and up to 13 mm in diameter. The beginning of the arteries is in the region of the 4th lumbar vertebra and is a continuation of the abdominal aorta( its bifurcation). Where the junction of the sacrum and iliac bones is located, these vessels are divided into the external and internal iliac arteries.
The iliac common artery
It should be lateral and down to the small pelvis. In the iliac sac joint region, the common iliac artery is divided into internal and external arteries of the same name, following on the thigh and in the small pelvis.
A. iliaca interna
The internal iliac artery( 2) feeds the pelvic organs and walls. It falls on the inside of the lumbar( large) muscle. In the upper part of the ischial large aperture from the vessel, the parietal and visceral arteries branch off.
Branches of parietal
- The lumbosacral branch( 3).It should be lateral and behind the lumbar large muscle, giving twigs to the iliac muscle and the same bone, as well as to the square and lumbar muscles. In addition, they supply blood and nerves to the spinal cord.
- Sacral lateral arteries( 4).They feed deep muscles of the back, sacrum, spinal cord( nerve roots and membranes), ligament of coccyx and sacrum, pear-shaped muscle, muscle that raises the anus.
- Artery locking( 6).Follows the front of the sides of the small pelvis. The branches of this vessel are: pubic, anterior, posterior arteries, nourishing the skin of the genital organs, blocking and leading muscles of the hip, hip joint, femur( its head), pubic symphysis, iliac, thin, comb, lumbosacral,blocking( external, internal) muscles and muscle, which raises the anus.
- Gluteal lower artery( 7).From the small pelvis emerges through the sub-arched aperture. Nourishes the skin in the gluteal region, hip joint, square, semimembranous, gluteal, pear-shaped, semitendinous, leading( big) muscles, twin( lower, upper), blocking( internal, external) muscles and double-headed femoral muscle( its long head).
- Gluteal superior artery( 5).It should be lateral and passes through the peri-tubular opening to the muscles and skin of the gluteal region in the form of deep and superficial branches. These vessels nourish small, medium gluteal muscles, hip joint, buttock skin.
- Artery umbilical( 13, 14).It lies on the back surface of the abdominal wall, rising to the navel. In the antenatal period, this vessel functions fully. After birth, the bulk of it empties and becomes an umbilical ligament. However, a small part of the vessel still functions and gives up the urinary upper arteries and the artery of the vas deferens, feeding the walls of the latter, as well as the bladder and the walls of the ureter.
- Uterine artery. Follows between the sheets of a wide uterine ligament to the uterus, crossing the ureter on the way and giving the tube, ovarian and vaginal branches. R. tubarius feeds the fallopian tubes, r.ovaricus through the thickness of the mesentery approaches the ovary and forms an anastomosis with branches of the ovarian artery. Rr. Vaginales follow down to the walls of the vagina( lateral).
- The rectum( middle) artery( 9).It should go to the rectum( the lateral wall of its ampulla), feeding the muscle, which raises the anus, the ureter, the lower and middle rectum departments, the women have the vagina, and the men have the prostate and the seminal vesicles.
- The sexual( internal) artery( 10) is the terminal branch from the ileum internal artery. A vessel comes out, accompanied by the gluteal lower artery through the tubular aperture, skirting the sciatic ist, again penetrates into the small pelvis( into the area of the rectum-ischiatic fossa) through the ischial( small) hole. In this fossa, the artery lays out the rectal lower artery( 11), and then branches into: the artery of the dorsal penis( clitoris), the perineal artery, the urethral artery, the deep clitoris( penis) artery, the vessel that feeds the penis bulb and the artery that feeds the onion bulb of the vagina. All of the above arteries feed the relevant organs( occlusal internal muscle, lower part of the rectum, genital organs, urethra, glands bulbourethral, vagina, muscles and skin of the perineum).
The external iliac artery begins at the iliac sac and is the continuation of the iliac common artery.
Follows the subordinate artery( marked by the arrow) down and forward along the inner surface of the lumbar muscle to the inguinal ligament, passing under which through the vascular lacuna, it turns into the artery of the thigh. The branches that give the iliac external artery, nourish the labia and pubis, the scrotum, the iliac muscle and the muscles of the abdomen.
Branches of the iliac external artery
- An epigastral lower artery( 1).It should be medial, and then up the straight muscle of the abdomen( its posterior part).The vessel gives several branches: the pubic artery, which nourishes the periosteum and pubic bone;the creamy artery( branching around the inguinal deep ring in men), feeding the shells of the testicles of the spermatic cord and muscle, which raises the testicle or the artery of the circular uterine ligament( in women), going to the skin on the genital organs.
- Deep artery that traverses the iliac bone( 2).It originates from under the inguinal ligament and saddles outward and upwards parallel to the crest of the ilium, forming an anastomosis with branches from the lumbosacral artery. The deep artery nourishes the abdominal wall( fore) and the muscles that make up it: iliac, transverse, tailoring, oblique, and also stretching the wide fascia on the thigh.
Occlusion of the iliac arteries
The reasons for the development of occlusion / stenosis of these arteries is the presence of aortoarteritis, thrombangiitis obliterans, musculoskeletal dysplasia and atherosclerosis.
The emergence of this pathology leads to tissue hypoxia and tissue metabolism disorders, and, as a result, to the development of metabolic acidosis and the accumulation of metabolic under-oxidized products. The properties of platelets vary, as a result of which the blood viscosity increases and multiple blood clots are formed.
There are several types of occlusion( according to the etiology):
- Aortic nonspecific.
- Mixed forms of atherosclerosis, aortitis and arteritis.
In accordance with the nature of damage to the iliac arteries, the following are distinguished:
- Chronic process.
- Acute thrombosis.
This pathology is characterized by several syndromes:
- Ischemia of the lower limbs( the appearance of chills, intermittent claudication, numbness, fatigue and paresthesias).
- Impotence( ischemia of the organs in the small pelvis, impaired blood supply to the spinal cord( its lower parts)).
Occlusion therapy is performed with both conservative and surgical methods.
Conservative treatment is aimed at optimizing blood clotting, eliminating pain and spasm of blood vessels. To do this, ganglion blockers, antispasmodics and so on are prescribed.
In the case of severe lameness, pain at rest, tissue necrosis, embolism, surgical operations are used. In this case, removal of the damaged part of the iliac artery, removal of plaques, sympathectomy or a combination of various techniques are performed.
Aneurysm of the iliac arteries
Initially, it is asymptomatic, and only after a significant increase begins to manifest clinically.
An aneurysm is a pouch-like protrusion of the vascular wall, as a result of which the elasticity of tissues is significantly reduced and replaced by connective tissue growths.
Aneurysm can cause: atherosclerosis of the iliac arteries, trauma, GB.
This pathology is dangerous by the development of a formidable complication - rupture of an aneurysm, which is accompanied by massive bleeding, lowering of blood pressure, heart rate and collapse.
In the case of a violation of the blood supply in the aneurysm area, thromboses of the vessels of the hip, shank and small pelvis may develop, which is accompanied by dysuria and intense pain.
This pathology is diagnosed by ultrasound, CT or MRI, angiography and duplex scanning.