Description

This video covers the External Iliac Artery (A. Iliaca Externa), its course, branches, and its clinical significance, particularly in surgical applications.

Course of the External Iliac Artery:

• Originates from the common iliac artery.
• Passes through the vascular space (Lacuna Vasorum) beneath the inguinal ligament.
• Continues as the femoral artery (A. Femoris) after passing into the thigh.

Side Branches of the External Iliac Artery:

1. Deep Circumflex Iliac Artery (Arteria Circumflexa Iliaca Profunda):

• Runs along the iliac crest.
• Supplies muscles of the anterior abdominal wall.

2. Inferior Epigastric Artery (Arteria Epigastrica Inferior):

• Ascends inside the lateral umbilical fold (Plicae Umbilicalis Lateralis).
• Supplies the rectus abdominis and overlying skin.
• Gives off several branches:
  • Pubic Branch: Communicates with the pubic branch of the obturator artery, forming an important anastomotic connection known as Corona Mortis (Crown of Death). This anastomosis is significant in surgery because unexpected bleeding from this vessel can be life-threatening.
  • Cremasteric Artery (Arteria Cremasterica): Supplies the cremaster muscle in males and is an important vascular component of the spermatic cord.
  • Artery of the Round Ligament (Arteria Ligamentum Teres Uteri): Analogous to the cremasteric artery, but in females, it supplies the round ligament of the uterus.

Clinical Significance:

• Corona Mortis: Surgeons must be cautious when performing procedures near the pubic branch, as damage to this anastomosis can lead to severe hemorrhage.
• Inferior Epigastric Artery: Can be a source of collateral circulation in cases of iliac artery occlusion.
• Hernia Surgery: The inferior epigastric artery is a key landmark when distinguishing direct from indirect inguinal hernias.

Sources Used:

• Memorix Anatomy (2nd Edition) – Hudák Radovan, Kachlík David, Volný Ondřej.
• Complete Anatomy by 3D4Medical.
• Biorender.
• University Notes and Lectures.

Transcript

Introduction
0:00
alright so this video is going to be
0:02
about the common iliac and the external
0:04
iliac artery
0:05
and then the next video will be about
0:06
the internal iliac artery along with
0:08
some tips on how to remember it easier
0:10
so as you know the abdominal aorta will
0:13
continue downwards to approximate the
0:15
fourth lumbar vertebrae
0:17
and then it will divide into what is
0:18
called the common iliac arteries
0:21
they will continue to approximate the
0:23
sacroiliac joint as you see here
0:25
and then further divide into the
0:27
external iliac
0:28
and the internal iliac arteries now
0:31
let’s make a cross-section
0:32
and look at them both from this
0:33
perspective to you know visualize them
0:35
easier
Course
0:36
now from here we can finally focus on
0:38
the external iliacare
0:40
but first let’s look at some important
0:41
structures to go through
0:43
you’re probably already familiar with
0:44
these ligaments but the inguinal
0:46
ligament
0:47
together with the iliopectinal arch the
0:49
pectinal ligament and the lacunar
0:51
ligament
0:52
will form two important canals now what
0:55
were these two canals called
0:58
muscular and the vascular space or in
1:00
latin lacunae
1:02
and lacunae good job if you remember
1:03
these ones
1:05
the external iliac artery will run along
1:07
the terminal line of the pelvic bone as
1:09
you see here
1:10
and then eventually go through the
1:12
vascular space
1:14
where it will now become the femoral
1:15
artery which is going to be the main
1:17
blood supply to the lower extremities
1:19
let’s now go through the side branches
1:21
there’s really only going to be two side
1:23
branches of the external iliac artery
1:25
the first one is a deep circumflex
Deep Circumflex Artery
1:27
artery
1:28
this one arises from the distal end of
1:30
the external iliac as you see here
1:32
from its origin it travels along the
1:35
inguinal ligaments
1:36
and the iliac crest to supply the
1:38
abdominal muscles of the anterior
1:40
muscles of the pelvic girdle
1:41
like the ipswa’s major and the minor for
1:44
example
Inferior Epigastric Artery
1:45
the other branch of the external iliac
1:47
is the inferior epigastric artery
1:50
which supplies the anterior wall of the
1:52
abdominal cavity
1:53
and as it ascends it forms a fold so
1:56
let’s look at how that works so here’s
1:59
basically the anterior abdominal wall
2:01
with the
2:01
rectus abdominis muscle here the urinary
2:04
bladder here
2:05
the prostate and the navel and then here
2:07
on the side you’ll
2:08
see a fold called the lateral umbilical
2:10
fold or plitsa umbilicalis lateralis in
2:13
latin
2:14
and the reason why i’m showing you this
2:16
is because the inferior epigastric
2:18
artery
2:19
will travel within this layer and then
2:21
eventually communicate with the superior
2:23
epigastric artery
2:25
so it travels inside the this layer the
2:29
lateral umbilical folds
2:30
and then eventually communicate with the
2:33
superior epigastric artery
2:35
so remember the subclavian artery gives
2:38
off
2:38
a large side branch called the internal
2:40
thoracic artery
2:41
which descends along the thoracic wall
2:44
and then
2:45
at around the seventh rib it divides
2:47
into the
2:48
musculophenic and the superior
2:50
epigastric artery
2:52
so here we see the inferior epigastric
2:54
ascending along the anterior abdominal
2:56
wall
2:57
to anastomose with the superior
2:59
epigastric artery
3:01
now the inferior epigastric has two side
3:04
branches
3:05
one of them is common in both male and
3:07
female and this one is the pubic branch
3:10
now the pubic branch will run along the
3:13
internal surface of the pubic bone
3:15
and connect with another pubic branch of
3:17
the internal iliac artery so let’s look
3:20
a little bit into that
3:21
here we see the external and the
3:23
internal iliac arteries
3:24
the external iliac give off the inferior
3:27
epigastric
3:28
while the internal iliac give off the up
3:30
to outer artery
3:32
both of them has a side branch called
3:34
the pubic branch
3:36
and when they connect they get the name
3:38
corona multis
3:39
and the term corona mortis translates as
3:42
the crown of
3:43
death which indicates the importance of
3:45
these structures in
3:46
orthopedic surgery especially because
3:49
accidental damage this structure can
3:51
cause significant hemorrhaging which
3:53
may be difficult to then achieve
3:55
hemostasis
3:56
and it must therefore be considered
3:58
cautiously during surgery
4:00
so that’s that one now the other branch
4:04
is on found only in males and this one
4:06
is the chromosteric artery
4:08
it travels along the inguinal canal to
4:10
supply a muscle called the
4:12
chromosteric muscle found around the
4:14
testis now if you’re a male
4:16
you’re probably very aware of the
4:17
function of this muscle the clear muscle
4:19
muscles function
4:20
is to raise and lower the testes in
4:23
order to regulate the scrotal
4:24
temperature for
4:26
optimal spermatogenesis and the survival
4:29
of the resultant spermatozoa
4:32
the other artery is found only in female
4:35
and that is the artery of the round
4:36
ligament of the uterus
4:38
or the artery ligamentum teres utili
4:41
supplying a ligament called the round
4:43
ligaments of the uterus
4:45
it’s a large ligament highlighted right
4:47
here and the function of this
4:49
the function of the round ligament is to
4:51
maintain the
4:52
anterior reflection of the uterus it’s a
4:55
position where the fundus
4:56
of the uterus is turned forward at the
4:59
junction of the cervix
5:00
and the vagina as you see here and when
5:03
the uterus grows during
5:04
pregnancy the round ligament can stretch
5:07
and and cause
5:08
pain but essentially this ligament is
5:11
important to keep the natural position
5:13
of the uterus
5:14
so that’s all i had for the external
5:17
iliac artery
5:18
um as long as you remember these two
5:20
side branches you’re more or less got a
5:22
grasp of the external iliac
5:24
next let’s do the internal iliac artery