Common, external and internal iliac arteries, their branches, areas of blood supply. What is iliac artery occlusion and why is it dangerous? External iliac artery

The iliac-lumbar artery (a. iliolumbalis) goes behind the psoas major back and laterally and gives off two branches:
- lumbar branch(r. lumbalis) goes to the large lumbar muscle and the square muscle of the lower back. A thin spinal branch (r. spinalis) departs from it, heading into the sacral canal;
- iliac branch(r. illiacus) supplies blood to the ilium and the muscle of the same name, anastomoses with the deep circumflex iliac artery (from the external iliac artery).
Lateral sacral arteries (aa. sacrales laterales), upper and lower, are sent to the bones and muscles of the sacral region. Their spinal branches (rr. spinales) go through the anterior sacral openings to the membranes of the spinal cord.
The superior gluteal artery (a. glutealis superior) exits the pelvis through the suprapiriform opening, where it is divided into two branches:
- superficial branch(r. superficialis) goes to the gluteal muscles and to the skin of the gluteal region;
- deep branch(r. profundus) splits into upper and lower branches (rr. superior et inferior), which supply blood to the gluteal muscles, mainly the middle and small, and adjacent pelvic muscles. The lower branch, in addition, is involved in the blood supply to the hip joint.

The superior gluteal artery anastomoses with branches of the lateral circumflex femoral artery (from the deep femoral artery).

The lower gluteal artery (a. glutealis inferior) is sent along with the internal pudendal artery and the sciatic nerve through the piriformis opening to the gluteus maximus muscle, gives a thin long artery accompanying the sciatic nerve(a. comitans nervi ischiadici).
Obturator artery (a. obturatoria), together with the nerve of the same name along the side wall of the small pelvis, is directed through the obturator canal to the thigh, where it is divided into anterior and posterior branches. The anterior branch (r. anterior) supplies blood to the external obturator and adductor muscles of the thigh, as well as the skin of the external genitalia. The posterior branch (r. posterior) also supplies the external obturator muscle and gives the acetabular branch (r. acetabularis) to the hip joint. The acetabular branch not only nourishes the walls of the acetabulum, but as part of the ligament of the femoral head reaches the femoral head. In the pelvic cavity, the obturator artery gives off a pubic branch (r. pubicus), which, in the medial semicircle of the deep ring of the femoral canal, anastomoses with the obturator branch from the inferior epigastric artery. With a developed anastomosis (in 30% of cases), it can be damaged during hernia repair (the so-called corona mortis).

Visceral (splanchnic) branches of the internal iliac artery

The umbilical artery (a. umbilicalis) functions throughout only the embryo; goes forward and up, rises along the back side of the anterior wall of the abdomen (under the peritoneum) to the navel. In an adult, it is stored as a medial umbilical ligament. From the initial part of the umbilical artery depart:
- superior vesical arteries(aa. vesicales superiores) give ureteral branches (rr. ureterici) to the lower ureter;
- vas deferens artery(a. ductus deferentis).
The lower vesical artery (a. vesicalis inferior) in men gives off branches to the seminal vesicles and the prostate gland, and in women to the vagina.
The uterine artery (a. uterina) descends into the pelvic cavity, crosses the ureter and between the sheets of the broad uterine ligament reaches the cervix. Gives away vaginal branches(rr. vaginales), pipe branch(r. tubarius) and ovarian branch(r. ovaricus), which in the mesentery of the ovary anastomoses with the branches of the ovarian artery (from the abdominal part of the aorta).
The middle rectal artery (a. rectalis media) goes to the lateral wall of the ampulla of the rectum, to the muscle that lifts the anus; gives off branches to the seminal vesicles and prostate in men and to the vagina in women. Anatomizes with branches of the superior and inferior rectal arteries.
The internal pudendal artery (a. pudenda interna) exits the pelvic cavity through the piriform opening, and then through the small sciatic foramen follows into the ischiorectal fossa, where it is adjacent to the inner surface of the obturator internus muscle. In the ischiorectal fossa gives inferior rectal artery(a. rectalis inferior), and then divided into perineal artery(a. perinealis) and glad of other vessels. For men it is urethral artery(a. urethralis), artery of the bulb of the penis(a. bulbi penis), deep and dorsal arteries of the penis(aa. profunda et dorsalis penis). Among women - urethral artery(a. urethralis), bulb artery of vestibule[vagina] (bulbi vestibuli), deep And dorsal clitoral artery(aa. profunda et dorsalis clitoridis).

The external iliac artery (a. iliaca externa) serves as a continuation of the common iliac artery. Through the vascular lacuna, it goes to the thigh, where it receives the name of the femoral artery. The following branches depart from the external iliac artery.

The lower epigastric artery (a. epigastrica inferior) rises along the back side of the anterior abdominal wall retroperitoneally to the rectus abdominis muscle. From the initial section of this artery departs pubic branch(r. pubicus) to the pubic bone and its periosteum. A thin obturator branch (r. obturatorius) is separated from the pubic branch, anastomosing with the pubic branch from the obturator artery, and the cremaster artery (a. cremasterica - in men). The cremasteric artery departs from the inferior epigastric artery at the deep inguinal ring, supplies blood to the membranes of the spermatic cord and testicle, as well as the muscle that lifts the testicle. In women, this artery is similar to the artery of the round ligament of the uterus (a. lig. teretis uteri), which, as part of this ligament, reaches the skin of the external genitalia.
The deep artery that surrounds the ilium (a. circumflexa iliaca profunda) goes along the iliac crest posteriorly, gives branches to the abdominal muscles and nearby pelvic muscles; anastomoses with branches of the iliac-lumbar artery.

The iliac arteries are one of the largest vessels in the body. They are paired vessels up to 7 cm long and up to 13 mm in diameter. The beginning of the arteries is located in the region of the 4th lumbar vertebra and is a continuation of the abdominal aorta (its bifurcation).

Where the articulation of the sacrum and iliac bones is located, these vessels are divided into external and internal iliac arteries.

Iliac common artery

It should be laterally and down to the small pelvis.

In the area of the iliac-sacral joint, the common iliac artery is divided into internal and external arteries of the same name, following to the thigh and small pelvis.

A. iliaca interna

The internal iliac artery (2) feeds the organs and walls of the pelvis. It descends along the inner side of the lumbar (large) muscle.

In the region of the upper part of the sciatic foramen magnum, the parietal and visceral arteries branch off from the vessel.

Parietal branches

Lumbar-iliac branch (3). It follows laterally and behind the lumbar large muscle, giving branches to the iliac muscle and the bone of the same name, as well as to the square and lumbar large muscles. In addition, they supply blood to the membranes and nerves of the spinal cord.
The sacral lateral arteries (4). They nourish the deep muscles of the back, the sacrum, the spinal cord (nerve roots and membranes), the ligaments of the coccyx and sacrum, the piriformis muscle, the muscle that raises the anus.
Obturator artery (6). It follows the front on the sides of the small pelvis. The branches of this vessel are: the pubic, anterior, posterior arteries that feed the skin of the genital organs, the obturator and adductor muscles of the thigh, the hip joint, the femur (its head), the pubic symphysis, the ilium, thin, comb, lumboiliac, square muscles, obturator (external, internal) muscles and a muscle that raises the anus.
Gluteal inferior artery (7). It leaves the pelvis through the piriform opening. Nourishes the skin in the gluteal region, hip joint, square, semimembranosus, gluteus maximus, piriformis, semitendinosus, adductor (large) muscles, twin (lower, upper), obturator (internal, external) muscles and the biceps femoris muscle (its long head).
Gluteal superior artery (5). It follows laterally and passes through the suprapiriform opening to the muscles and skin of the gluteal region in the form of deep and superficial branches. These vessels nourish the small, medium gluteal muscles, the hip joint, the skin of the buttocks.

Branches visceral

Umbilical artery (13, 14). It runs along the posterior surface of the abdominal wall, rising to the navel. In the antenatal period, this vessel functions fully. After birth, the main part of it starts to empty and becomes the umbilical ligament. However, a small part of the vessel still functions and gives off the upper bladder arteries and the artery of the vas deferens, which feed the walls of the latter, as well as the bladder and the walls of the ureter.
Uterine artery. It follows between the sheets of the broad uterine ligament to the uterus, crossing along the way with the ureter and giving off the tubal, ovarian and vaginal branches. R.tubarius nourishes 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).
Rectal (middle) artery (9). It follows the rectum (the lateral wall of its ampulla), nourishing the muscle that raises the anus, ureter, lower and middle rectal sections, in women - the vagina, and in men - the prostate and seminal vesicles.
Sexual (internal) artery (10) - the final branch from the iliac internal artery. The vessel leaves, accompanied by the gluteal inferior artery, through the subpiri-shaped opening, bending around the sciatic spine, again penetrates into the small pelvis (in the area of the recto-sciatic fossa) through the sciatic (small) foramen. In this fossa, the artery gives off the rectal inferior artery (11), and then branches into: the dorsal penis (clitoris) artery, the perineal, urethral artery, the deep clitoral (penis) artery, the vessel that feeds the bulb of the penis and the artery that feeds the bulb of the vestibule of the vagina. All of the above arteries feed the corresponding organs (the obturator internal muscle, the lower part of the rectum, the genital external organs, the urethra, the bulbourethral glands, the vagina, the muscles and skin of the perineum).

A.Iliaca externa

The external iliac artery originates at the iliosacral joint and is a continuation of the common iliac artery.

The iliac artery follows (marked with an arrow) downwards and anteriorly along the inner surface of the lumbar large muscle to the inguinal ligament, passing under which through the vascular lacuna, it turns into the artery of the thigh. The branches that give off the iliac external artery nourish the labia and pubis, the scrotum, the iliac muscle and the muscles of the abdomen.

Branches of the external iliac artery

Occlusion of the iliac arteries

The reasons for the development of occlusion / stenosis of these arteries are the presence of aortoarteritis, thromboangiitis obliterans, muscular fibrous dysplasia and atherosclerosis.

The occurrence of this pathology leads to tissue hypoxia and disorders of tissue metabolism, and, as a result, to the development of metabolic acidosis and the accumulation of metabolic underoxidized products. The properties of platelets change, as a result of which the viscosity of the blood increases and multiple blood clots form.

There are several types of occlusion (according to etiology):

Post-traumatic.
Post-embolic.
Iatrogenic.
Aortitis is nonspecific.
Mixed forms of atherosclerosis, aortitis and arteritis.

In accordance with the nature of damage to the iliac arteries, there are:

chronic process.
Stenosis.
Acute thrombosis.

This pathology is characterized by several syndromes:

Occlusion therapy is carried out by both conservative and surgical methods.

Conservative treatment is aimed at optimizing blood coagulation, eliminating pain and vasospasm. For 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, the damaged part of the iliac artery is removed, an operation to remove plaques, sympathectomy, or a combination of various techniques is carried out.

Aneurysms of the iliac arteries

Initially, it is asymptomatic, and only after a significant increase does it begin to manifest itself clinically.

An aneurysm is a sac-like protrusion of the vascular wall, as a result of which the elasticity of tissues is significantly reduced and replaced by connective tissue growths.

May become: atherosclerosis of the iliac arteries, trauma, GB.

This pathology is dangerous for the development of a formidable complication - aneurysm rupture, which is accompanied by massive bleeding, a decrease in blood pressure, heart rate and collapse.

In the event of impaired blood supply in the area of the aneurysm, thrombosis of the vessels of the thigh, lower leg and small pelvis may develop, which is accompanied by dysuria and intense pain.

This pathology is diagnosed using ultrasound, CT or MRI, angiography and duplex scanning.

Occlusion of the iliac arteries is a pathological change associated with a narrowing of the lumen of the vessels that supply blood to the lower extremities and pelvic organs. The result of this condition is a violation of blood flow. This is a very common occurrence, which is most susceptible to men over the age of 50 years.

This type of disorder has two causes that occur with the same frequency: obliterating atherosclerosis and obliterating endarteritis.

Speaking about the characteristics of the iliac artery itself, it should be mentioned that it is a large paired blood vessel (only the aorta is larger). The length of this vessel is 5-7 cm, width 11-13 mm. Arteries originate at the fork of the right and left aorta, in the area of the fourth lumbar vertebra.

The classification of the disease can be carried out according to the etiology or nature of the narrowing of the vessel: stenosis, chronic occlusion and thrombosis are distinguished. The lesion can affect any area along the entire length of the iliac artery.

Causes of the disease

obliterating atherosclerosis. A disease characterized by systemic vascular damage due to impaired lipid metabolism. At the same time, cholesterol is deposited on the walls of blood vessels, and atherosclerotic plaques are formed, as a result of which blood flow worsens.

The next sign is the occurrence of impotence. The patient is diagnosed with pelvic ischemia and chronic lack of blood circulation in the lower spinal cord. Neglect of treatment can lead to abdominal ischemia syndrome, in which the pulse in the affected area is not detected.

The lack of timely treatment leads to a lack of nutrients and oxygen, as a result of which the “starving” organs completely cease to function.

Medical therapy

Treatment of any type of occlusion should take place in a hospital setting. Nevertheless, conservative therapy can also be carried out, but only at the initial stage, or if the patient refuses surgery.

The main task of drug treatment is to eliminate pain, relieve spasm and normalize the process of blood circulation. Among the prescribed drugs, there is Bupatol, Vasculat, Dilminal, etc. In case of blockage of the artery by a thrombus, an anticoagulant may be prescribed.

In the absence of results of conservative treatment, they resort to surgical intervention, sometimes emergency. Emergency surgery is required in the case of intermittent claudication, when it becomes impossible for the patient to overcome a distance of two hundred meters without severe pain in the legs.

Indications are also pain in the right or left leg at complete rest, ulcerative formations and necrosis, as well as embolism of large vessels equivalent to occlusion of the iliac artery.

In modern medicine, there are a number of methods of surgical treatment. For example, the affected area may be completely removed and a graft placed in its place. The second option involves opening the vessel with the subsequent removal of a thrombus, embolus or atherosclerotic plaques. Also, aorto-femoral bypass and femoro-popliteal bypass on the right or left leg can be used.

In some cases, physicians are forced to combine several methods, for example, removal of a section of the vessel and subsequent shunting. The most severe cases in which gangrene develops require amputation of the limb.

The iliac-lumbar artery (a. iliolumbalis) goes behind the psoas major back and laterally and gives off two branches:
- lumbar branch(r. lumbalis) goes to the large lumbar muscle and the square muscle of the lower back. A thin spinal branch (r. spinalis) departs from it, heading into the sacral canal;
- iliac branch(r. illiacus) supplies blood to the ilium and the muscle of the same name, anastomoses with the deep circumflex iliac artery (from the external iliac artery).
Lateral sacral arteries (aa. sacrales laterales), upper and lower, are sent to the bones and muscles of the sacral region. Their spinal branches (rr. spinales) go through the anterior sacral openings to the membranes of the spinal cord.
The superior gluteal artery (a. glutealis superior) exits the pelvis through the suprapiriform opening, where it is divided into two branches:
- superficial branch(r. superficialis) goes to the gluteal muscles and to the skin of the gluteal region;
- deep branch(r. profundus) splits into upper and lower branches (rr. superior et inferior), which supply blood to the gluteal muscles, mainly the middle and small, and adjacent pelvic muscles. The lower branch, in addition, is involved in the blood supply to the hip joint.

The superior gluteal artery anastomoses with branches of the lateral circumflex femoral artery (from the deep femoral artery).

The lower gluteal artery (a. glutealis inferior) is sent along with the internal pudendal artery and the sciatic nerve through the piriformis opening to the gluteus maximus muscle, gives a thin long artery accompanying the sciatic nerve(a. comitans nervi ischiadici).
Obturator artery (a. obturatoria), together with the nerve of the same name along the side wall of the small pelvis, is directed through the obturator canal to the thigh, where it is divided into anterior and posterior branches. The anterior branch (r. anterior) supplies blood to the external obturator and adductor muscles of the thigh, as well as the skin of the external genitalia. The posterior branch (r. posterior) also supplies the external obturator muscle and gives the acetabular branch (r. acetabularis) to the hip joint. The acetabular branch not only nourishes the walls of the acetabulum, but as part of the ligament of the femoral head reaches the femoral head. In the pelvic cavity, the obturator artery gives off a pubic branch (r. pubicus), which, in the medial semicircle of the deep ring of the femoral canal, anastomoses with the obturator branch from the inferior epigastric artery. With a developed anastomosis (in 30% of cases), it can be damaged during hernia repair (the so-called corona mortis).

Visceral (splanchnic) branches of the internal iliac artery

The umbilical artery (a. umbilicalis) functions throughout only the embryo; goes forward and up, rises along the back side of the anterior wall of the abdomen (under the peritoneum) to the navel. In an adult, it is stored as a medial umbilical ligament. From the initial part of the umbilical artery depart:
- superior vesical arteries(aa. vesicales superiores) give ureteral branches (rr. ureterici) to the lower ureter;
- vas deferens artery(a. ductus deferentis).
The lower vesical artery (a. vesicalis inferior) in men gives off branches to the seminal vesicles and the prostate gland, and in women to the vagina.
The uterine artery (a. uterina) descends into the pelvic cavity, crosses the ureter and between the sheets of the broad uterine ligament reaches the cervix. Gives away vaginal branches(rr. vaginales), pipe branch(r. tubarius) and ovarian branch(r. ovaricus), which in the mesentery of the ovary anastomoses with the branches of the ovarian artery (from the abdominal part of the aorta).
The middle rectal artery (a. rectalis media) goes to the lateral wall of the ampulla of the rectum, to the muscle that lifts the anus; gives off branches to the seminal vesicles and prostate in men and to the vagina in women. Anatomizes with branches of the superior and inferior rectal arteries.
The internal pudendal artery (a. pudenda interna) exits the pelvic cavity through the piriform opening, and then through the small sciatic foramen follows into the ischiorectal fossa, where it is adjacent to the inner surface of the obturator internus muscle. In the ischiorectal fossa gives inferior rectal artery(a. rectalis inferior), and then divided into perineal artery(a. perinealis) and glad of other vessels. For men it is urethral artery(a. urethralis), artery of the bulb of the penis(a. bulbi penis), deep and dorsal arteries of the penis(aa. profunda et dorsalis penis). Among women - urethral artery(a. urethralis), bulb artery of vestibule[vagina] (bulbi vestibuli), deep And dorsal clitoral artery(aa. profunda et dorsalis clitoridis).

The lower epigastric artery (a. epigastrica inferior) rises along the back side of the anterior abdominal wall retroperitoneally to the rectus abdominis muscle. From the initial section of this artery departs pubic branch(r. pubicus) to the pubic bone and its periosteum. A thin obturator branch (r. obturatorius) is separated from the pubic branch, anastomosing with the pubic branch from the obturator artery, and the cremaster artery (a. cremasterica - in men). The cremasteric artery departs from the inferior epigastric artery at the deep inguinal ring, supplies blood to the membranes of the spermatic cord and testicle, as well as the muscle that lifts the testicle. In women, this artery is similar to the artery of the round ligament of the uterus (a. lig. teretis uteri), which, as part of this ligament, reaches the skin of the external genitalia.
The deep artery that surrounds the ilium (a. circumflexa iliaca profunda) goes along the iliac crest posteriorly, gives branches to the abdominal muscles and nearby pelvic muscles; anastomoses with branches of the iliac-lumbar artery.

common iliac artery, a . iliaca communis (diameter 11 - 12.5 mm) (Fig. 62), follows the direction of the small pelvis and at the level of the sacroiliac joint is divided into internal and external iliac arteries.

internal iliac artery,A. Shasainterna, blood supply to the walls and organs of the pelvis. It descends along the medial edge of the psoas major muscle down into the cavity of the small pelvis and, at the upper edge of the large sciatic foramen, is divided into the posterior and anterior branches (trunks), which supply the walls and organs of the small pelvis with blood. The branches of the internal, iliac artery are the iliac-lumbar, middle rectal, lateral sacral, superior and inferior gluteal, umbilical, inferior vesical, uterine, internal pudendal and obturator arteries.

1. Iliac-lumbar artery,a. iliolumbalis, goes behind the psoas major back and laterally and gives off two branches: 1) the lumbar branch, G.lumbalis, to the psoas major and quadratus lumborum; a thin spinal branch, d.spinalis, heading into the sacral canal; 2) iliac branch, G.ilidcus, which supplies the iliac bone and the muscle of the same name and anastomoses with the deep circumflex iliac artery (from the external iliac artery).

2 lateral sacral arteries,aa.sacrales taterales, top and bottom, sent to the bones and muscles of the sacral region. Their spinal branches,rr. spinales, go through the anterior sacral foramen to the membranes of the spinal cord.

3superior gluteal artery,a. glutedlis superior, exits the pelvis through the suprapiriform opening, where it divides into superficial branch,superficial, to the gluteal muscles and skin, and deep branch,profundus. The latter, in turn, breaks down into upper and lower branchesrr. superior et inferior, which supply blood to the gluteal muscles, mainly the middle and small, and adjacent pelvic muscles. The lower branch, in addition, is involved in the blood supply to the hip joint. The superior gluteal artery anastomoses with branches of the lateral circumflex femoral artery (from the deep femoral artery).

4umbilical artery,a. umbilicdlis (functions throughout the entire length only in the embryo), goes forward and upward, rises along the back surface of the anterior wall of the abdomen (under the peritoneum) to the navel. In an adult, it is stored as a medial umbilical ligament. From the initial part of the artery depart superior vesical arteries, aa.vesicates supe priors, who give ureteral branches,rr. ureterici, to the lower ureter, and vas deferens artery,a. ductus deferentis.

5inferior vesical artery,a. vesicalis inferior, in men it gives off branches to the seminal vesicles and the prostate gland, and in women to the vagina.

6uterine artery,a. uterina, descends into the pelvic cavity, crosses the ureter and between the leaves of the broad uterine ligament reaches the cervix. Gives away vaginal branches,rr. vagindles, tubal and ovarian branches,tubarius etG.ovaricus. ovarian branch in the mesentery of the ovary anastomoses with the branches of the ovarian artery (from the abdominal aorta).

7middle rectal artery,a. rectalis media, goes to the lateral wall of the ampulla of the rectum, to the muscle that lifts the anus, gives off branches to the seminal vesicles and the prostate gland in men and to the vagina in women. Anastomoses with branches of the superior and inferior rectal arteries.

8internal pudendal artery,a. pudenda interna, exits the pelvic cavity through the subpiri-shaped opening, and then through the small sciatic opening follows into the ischiorectal fossa, where it is adjacent to the inner surface of the obturator internus muscle. In the ischiorectal fossa gives inferior rectal artery,a. rectalis inferior, and then divided by perineal artery,a. perinealis, and a number of other vessels: in men it is urethral artery,a. urethralis, artery of the bulb of the penis,a. bulbi penis, deep and dorsal arteries of the penis,aa. profunda et dorsdlis pe nis; women also urethral artery,a. urethralis, artery of the bulb of the vestibule (vagina),aa. bulbi vestibuli (va ginae), deep and dorsal arteries of the clitoris,aa. profunda et dorsalis clitoridis.

9obturator artery,a. obturatoria, along with the nerve of the same name along the side wall of the small pelvis is sent through the obturator canal to the thigh, where it is divided into anterior branch,anterior, blood supply to the external obturator and adductor muscles of the thigh, as well as the skin of the external genitalia, and posterior branch,posterior, which also supplies blood to the obturator externus muscle and gives acetabular branch,acetabularis, to the hip joint. The acetabular branch not only nourishes the walls of the acetabulum, but as part of the ligament of the femoral head reaches the femoral head. In the pelvic cavity, the obturator artery gives pubic branch, g. ri-bicus, which, at the medial semicircle of the annulus of the femoral canal, anastomoses with the obturator branch from the inferior epigastric artery. With a developed anastomosis (at 30 % cases) a. obturatdrius thickened and can be damaged by hernia repair (so-called corona Mortis).

10. inferior gluteal artery,a. glutealis inferior, goes along with the internal pudendal artery and the sciatic nerve through the piriformis opening to the gluteus maximus muscle, gives off a thin long artery that accompanies the sciatic nervea. comitans nervous ischiadici.

external iliac artery,a. iliaca externa, serves as a continuation of the common iliac artery. Through the vascular lacuna, it goes to the thigh, where it receives the name of the femoral artery. The following branches depart from the external iliac artery:

1. inferior epigastric artery, a. epigastrica inferior, rises along the posterior surface of the anterior abdominal wall retroperitoneally to the rectus abdominis muscle; departs from its initial department pubic branch, Mr.pubicus, to the pubic bone and its periosteum, from which, in turn, a thin obturator branch, g.obturatdrius, anastomosing with a pubic branch from the obturator artery (see above), and cremaster artery,a. cremasterica (in men). The cremasteric artery departs from the inferior epigastric artery at the deep inguinal ring, supplies blood to the membranes of the spermatic cord and testicle, as well as the muscle that lifts the testicle. In women, this artery is similar artery of the round ligament of the uterus,a. lig. teretis uteri, which, as part of this ligament, reaches the skin of the external genitalia. 2. Deep circumflex artery of the iliuma. cir cumflexa iliaca profunda, goes along the iliac crest posteriorly, gives off branches to the abdominal muscles and nearby pelvic muscles, anastomoses with the branches of the iliac-lumbar artery.