

THE HYPOGASTRIC ARTERY 



615 



the umbilical opening, the two arteries, now termed umbilical, enter the umbilical 

 cord, where they are coiled around the umbilical vein, and ultimately ramify in 

 the placenta. 



At birth, when the placental circulation ceases, the pelvic portion only of the 

 artery remains patent and constitute^ the hypogastric and the first part of the 

 superior vesical artery of the adult; the remainder of the vessel is converted into 

 a solid fibrous cord, the lateral umbilical ligament (obliterated hypogastric artery) 

 which extends from the pelvis to the umbilicus. 



Peculiarities as Regards Length. In two-thirds of a large number of cases, the length of the 

 hypogastric varied between 2.25 and 3.4 cm.; in the remaining third it was more frequently 

 longer than shorter, the maximum length being about 7 cm. the minimum about 1 cm. 



The lengths of the common iliac and hypogastric arteries bear an inverse proportion to each 

 other, the hypogastric artery being long when the common iliac is short, and vice versa. 



As Regards its Place of Division. The place of division of the hypogastric varies between 

 the upper margin of the sacrum and the upper border of the greater sciatic foramen. 



The right and left hypogastric arteries "in a series of cases often differed in length, but neither 

 seemed constantly to exceed the other. 



Collateral Circulation. The circulation after ligature of the hypogastric artery is carried on 

 by the anastomoses of the uterine and ovarian arteries; of the vesical arteries of the two sides; 

 of the hemorrhoidal branches of the hypogastric with those from the inferior mesenteric; of the 

 obturator artery, by means of its pubic branch, with the vessel of the opposite side, and with the 

 inferior epigastric and medial femoral circumflex; of the circumflex and perforating branches of 

 the profunda femoriswith the inferior gluteal; of the superior gluteal with the posterior branches 

 of the lateral sacral arteries; of the iliolumbar with the last lumbar; of the lateral sacral with the 

 middle sacral; and of the iliac circumflex with the iliolumbar and superior gluteal. 1 



Branches. The branches of the hypogastric artery are: 



From the Posterior Trunk. 

 Iliolumbar. 

 Lateral Sacral. 

 Superior Gluteal. 



From the Anterior Trunk. 

 Superior Vesical. 

 Middle Vesical. 

 Inferior Vesical. 

 Middle Hemorrhoidal. 

 Obturator. 

 Internal Pudendal. 

 Inferior Gluteal. 



VagilTai 



The superior vesical artery (a. xesicalis superior) supplies numerous branches 

 to the upper part of the bladder. From one of these a slender vessel, the artery 

 to the ductus deferens, takes origin and accompanies the duct in its course to the 

 testis, where it anastomoses with the internal spermatic artery. Other branches 

 supply the ureter. The first part of the superior vesical artery represents the 

 terminal section of the pervious portion of the fetal hypogastric artery. 



The middle vesical artery (a. vesicalis medialis), usually a branch of the superior, 

 is distributed to the fundus of the bladder and the vesiculse seminales. 



The inferior vesical artery (a. xesicalis inferior} frequently arises in common 

 with the middle hemorrhoidal, and is distributed to the fundus of the bladder, the 

 prostate, and the vesiculse seminales. The branches to the prostate communicate 

 with the corresponding vessels of the opposite side. 



The middle hemorrhoidal artery (a. hcemorrhoidalis media} usually arises with 

 the preceding vessel. It is distributed to the rectum, anastomosing with the 

 inferior vesical and with the superior and inferior hemorrhoidal arteries. It gives 

 offsets to the vesiculae seminales and prostate. 



The uterine artery (a. uterina} (Fig. 540) springs from the anterior division of 



1 For a description of a case in which Owen made a dissection ten years after ligature of the hypogastric artery, 

 see Med.-Chir. Trans., vol. xvi. 





