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Linea Terminalis

Linea Terminalis. Common Iliac Arteries. Internal Iliac Artery- Posterior Trunk. Internal Iliac Artery- Posterior Trunk. Internal Iliac Artery- Anterior Trunk. Glandula Prostatica (Prostata). The Female External Genitalia. L4. L5. S1. S2. S3. S4. Pelvic Vessels and Nerves. T12. L4.

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Linea Terminalis

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  1. Linea Terminalis

  2. Common Iliac Arteries

  3. Internal Iliac Artery- Posterior Trunk

  4. Internal Iliac Artery- Posterior Trunk

  5. Internal Iliac Artery- Anterior Trunk

  6. Glandula Prostatica (Prostata)

  7. The Female External Genitalia

  8. L4 L5 S1 S2 S3 S4 Pelvic Vessels and Nerves

  9. T12 L4 Common Iliac Arteries • Right and left common iliac arteries • Supply to pelvic cavity, its wall, and its organs. • Supply to lower limbs. • Bifurcates nearby sacroiliac joint. • External iliac artery • Internal iliac artery

  10. External Iliac Artery • Branches: • Inferior epigastric artery(anastomosis with superior epigastric artery. This is important in the case of the stenosis of the external iliac artery) • The pubic branch (anastomosis with the pubic branch of the obturatory artery, corona mortis) • Cremasteric branch • A branch to round ligament of uterus • Deep circumflex iliac artery (anastomosis with iliac branch of iliolumbal artery) • Femoral artery: External iliac artery is named as femoral artery inferior to inguinal ligament.

  11. External Iliac Artery

  12. External Iliac Artery • Branches: • Inferior epigastric artery(anastomosis with superior epigastric artery. This is important in the case of the stenosis of the external iliac artery) • The pubic branch (anastomosis with the pubic branch of the obturator artery, corona mortis) • Cremasteric branch • A branch to round ligament of uterus • Deep circumflex iliac artery (anastomosis with iliac branch of iliolumbar artery) • Femoral artery: External iliac artery is named as femoral artery inferior to inguinal ligament.

  13. External Iliac Artery • Branches: • Inferior epigastric artery(anastomosis with superior epigastric artery. This is important in the case of the stenosis of the external iliac artery) • The pubic branch (anastomosis with the pubic branch of the obturator artery, corona mortis) • Cremasteric branch • A branch to round ligament of uterus • Deep circumflex iliac artery (anastomosis with iliac branch of iliolumbar artery) • Femoral artery: External iliac artery is named as femoral artery inferior to inguinal ligament.

  14. External Iliac Artery • Branches: • Inferior epigastric artery(anastomosis with superior epigastric artery. This is important in the case of the stenosis of the external iliac artery)

  15. External Iliac Artery Corona mortis • Branches: • Inferior epigastric artery(anastomosis with superior epigastric artery. This is important in the case of the stenosis of the external iliac artery) • The pubic branch (anastomosis with the pubic branch of the obturator artery, coronamortis)

  16. Corona Mortis

  17. Internal Iliac Artery • Branches • Arises from the common iliac artery nearby sacroiliac joint. • Divided into an anterior trunkanda posterior trunk in the pelvic cavity. • Anterior trunk: divides into the visceral branches thatsupplies to the pelvic organs and carry blood to the external genitalia. • Posterior trunk:Divides into the parietal branches that supply to the pelvic wall and gluteal muscles.

  18. Internal Iliac Artery • Branches • Arises from the common iliac artery nearby sacroiliac joint. • Divided into an anterior trunkanda posterior trunk in the pelvic cavity. • Anterior trunk: divides into the visceral branches thatsupplies to the pelvic organs and carry blood to the external genitalia. • Posterior trunk: Divides into the parietal branches that supply to the pelvic wall and gluteal muscles.

  19. Internal Iliac Artery • Parietal branches: • Iliolumbar artery: anastomosis with deep circumflex iliac artery • Lateral sacral artery: supplies to the muscles on the pelvic wall and sacral plexus. And anastomosis with median sacral artery. • 3. Superior gluteal artery: leaves pelvic cavity passingthrough the suprapiriform foramen. • 4. Inferior gluteal artery: leaves pelvic cavity passingthrough the Infrapiriform foramen. • 5. Obturator artery: leaves pelvic cavity passingthrough the obturator foramen. • CORONA MORTIS

  20. Internal Iliac Artery • Parietal branches: • Iliolumbar artery: anastomosis with deep circumflex iliac artery • Lateral sacral artery: supplies to the muscles on the pelvic wall and sacral plexus. And anastomosis with median sacral artery. • 3. Superior gluteal artery: leaves pelvic cavity passingthrough the suprapiriform foramen. • 4. Inferior gluteal artery: leaves pelvic cavity passingthrough the Infrapiriform foramen. • 5. Obturator artery: leaves pelvic cavity passingthrough the obturator foramen. • CORONA MORTIS

  21. Internal Iliac Artery • Parietal branches: • Iliolumbar artery: anastomosis with deep circumflex iliac artery • Lateral sacral artery: supplies to the muscles on the pelvic wall and sacral plexus. And anastomosis with median sacral artery. • 3. Superior gluteal artery: leaves pelvic cavity passingthrough the suprapiriform foramen. • 4. Inferior gluteal artery: leaves pelvic cavity passingthrough the Infrapiriform foramen. • 5. Obturator artery: leaves pelvic cavity passingthrough the obturator foramen. • CORONA MORTIS

  22. Corona Mortis

  23. Internal Iliac Artery • Visceral branches • Umbilical artery: Its proximal part is obliterated and forms lateral umbilical ligament. • Superior vesical artery • Deferential artery: supplies to ductus • deferensandseminal vesicle • Inferior vesicle artery: Its branches spread to the lower part of the urinary bladder in addition to prostate, and seminal vesicle.

  24. Internal Iliac Artery • Visceral branches • Middle rectal artery: supplies to the rectal ampulla. Sometimes, it may arise from the internal pudendal artery. • Internal pudendal artery: leaves pelvic cavity passingthrough the Infrapiriform foramen. But immediately turns inward and passes through the pudendal canal (Alcock’s canal) and extend over the external genitalia and perineum.

  25. Internal Iliac Artery • Visceral branches • Umbilical artery: Its proximal part is obliterated and forms lateral umbilical ligament. • Superior vesical artery • Deferential artery: supplies to ductus • deferensandseminal vesicle • Inferior vesicle artery: Its branches spread to the lower part of the urinary bladder in addition to prostate, and seminal vesicle.

  26. Internal Iliac Artery • Visceral branches • Middle rectal artery: supplies to the rectal ampulla. Sometimes, it may arise from the internal pudendal artery. • Internal pudendal artery: leaves pelvic cavity passingthrough the Infrapiriform foramen. But immediately turns inward and passes through the pudendal canal (Alcock’s canal) and extend over the external genitalia and perineum. • Inferior rectal artery • Perineal branches

  27. Internal Iliac Artery • Internal pudendalartey: • The branches given in the ischiorectal fossa: • Inferior rectal artery • Perineal rami • Posterior scrotal arteries • Posterior labial arteries

  28. Internal Iliac Artery • Internal pudendal artery continues as penile artery. • Branches: • Artery of bulb of penis (vestibule) • Urethral artery • Dorsal artery of penis (clitoris) • Deep artery of penis (clitoris) • Helicine arteries (Aa. Helicinae)

  29. A. İliaca İnterna • A. pudenda interna’nın devamı a. penis adını alır. • Bunun dalları ise: • A. bulbi penis (vestibuli) • A. Urethralis • A. dorsalis penis (clitoridis) • A. profunda penis (clitoridis) • Aa. helicinae

  30. Internal Iliac Artery • Visceral branches • Umbilical artery: Its proximal part is obliterated and forms lateral umbilical ligament. • Superior vesical artery • Uterine artery • Vaginal branch • Ovarian branch • Tubal branch • Inferior vesicle artery

  31. Internal Iliac Artery • Visceral branches • Umbilical artery: Its proximal part is obliterated and forms lateral umbilical ligament. • Superior vesical artery • Uterine artery • Vaginal branch • Ovarian branch • Tubal branch • Inferior vesicle artery

  32. Internal Iliac Artery • Visceral branches • Middle rectal artery: supplies to the rectal ampulla. Sometimes, it may arise from the internal pudendal artery. • Internal pudendal artery: leaves pelvic cavity passingthrough the Infrapiriform foramen. But immediately turns inward and passes through the pudendal canal (Alcock’s canal) and extend over the external genitalia and perineum. • Inferior rectal artery • Perineal branches

  33. A. İliaca İnterna • Visseral dalları • A. vesicalisinferior: mesanenin alt • kısmına, prostat ve vesiculaseminalis’e • dağılan dallar verir. • A. rectalismedia: ampullarecti’ye dağılır. • A. pudendainterna’dan da çıkabilir. • A. pudendainterna: A. gluteainferiorile • beraberforameninfrapriformeyoluyla • cavitaspelvis’i terk eder, fakat hemen içe • dönerek canalispudendalis’den (Alcock • kanalı) geçerek öne doğru uzanır.

  34. Internal Iliac Artery • Internal pudendalartey: • The branches given in the ischiorectal fossa: • Inferior rectal artery • Perineal rami • Posterior scrotal arteries • Posterior labial arteries

  35. Internal Iliac Artery

  36. Veins of pelvis Internal iliac veins • Parietal tributaries: accompany with arteries • Visceral tributaries →superior rectal vein→inferior mesenteric v. ① Rectal venous plexus →inferior rectal vein→internal iliac v. →anal vein→internal pudendal v. ② Vesical venous plexus →vesical v. ③ Uterine venous plexus →uterine v.

  37. External and Common Iliac Veins External iliac vein Accompany the artery Common iliac vein Formed by union of internal and external iliac veins in front of sacroiliac joint, end upon L4~L5 by uniting each other to form inferior vena cava

  38. The lymphatic Drainage of Pelvis Internal iliac lymph node • Surround internal iliac vessels. • Receive afferents from pelvic. viscera, perineum, buttock and back of thigh. External iliac lymph nodes • Lie along external iliac artery. • Receive afferents from lower limb and some parts of pelvic viscera. Common iliac lymph node • Lie along common iliac artery. • Receive afferents from all the above nodes. • Efferents pass to lumbar lymph node.

  39. Sacral Plexus Formation: Formed by anterior rami of L4 and L5 spinal nerves (the lumbrosacral trunk) and anterior rami of sacral and coccygeal nerves. Position:Lies in pelvic cavity, anterior to sacrum and piriformis.

  40. Pudendal Nerve

  41. Autonomic Plexuses of Pelvic Hypogastric plexus • Superior hypogastric plexus lies in front of L5 between common iliac ateries. • Inferior hypogastric plexus(pelvic plexus): lie on each side of rectum Sacral sympathetic trunk • Is continuous above with the abdominal part • Has 4 or 5 ganglion

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