THE ABDOMEN 66x 



rectus muscles. They anastomose with the lower two intercostal 

 arteries, the subcostal arter}', the abdominal branches of the 

 lumbar arteries, and the lateral or intermuscular epigastric (so 

 called ' ascending branch ') of the deep circumflex iliac arterj'. 



The cutaneous branches perforate the rectus and the anterior 

 wall of its sheath, to be distributed to the integument in which 

 they anastomose \\-ith branches of the superficial epigastric. 



The peritoneal branches pierce the posterior wall of the sheath 

 of the rectus, to be distributed to the adjacent parietal peritoneimi. 



The terminal or anastomotic brandies enter the rectus above 

 the level of the umbilicus and anastomose with the superior epi- 

 gastric of the internal mammary. 



For an abnormal or aberrant obturator artery, see p. 462, 



There are two venae comites with the deep epigastric artery, one 

 on either side. These ultimately join to form one vessel, which 

 terminates in the external iliac vein. 



The superior epigastric artery is one of the teitninal branches 

 of the internal mammary from the first part of the subcla\'ian. 

 It descends behind the seventh costal cartilage, passing between 

 the sternal and costal portions of the diaphragm, and enters 

 the sheath of the rectus, where it lies at first bet^veen the 

 muscle and the posterior wall of its sheath. It then enters the 

 muscle and anastomoses with the deep epigastric. Its branches 

 are as follows : melasternal, which crosses in front of the meta- 

 stemum and anastomoses with its feUow of the opposite side ; 

 phrenic, to the diaphragm ; muscular to the muscles of the abdo- 

 minal wall ; anterior cutaneous to the integument ; falciform or 

 hepatic (present only on the right side), which passes to the liver 

 in the falciform ligament and anastomoses with the hepatic artery ; 

 and peritoneal, which pierce the posterior wall of the sheath of the 

 rectus, to be distributed to the adjacent parietal peritoneum. 

 The vessel is accompanied by two venae comites, which terminate 

 in those of the internal mammarj' artery. 



The deep circumflex iliac artery arises from the outer side of the 

 external iliac nearly opposite the origin of the deep epigastric. It 

 passes outwards and upwards behind the outer half of Poupart's 

 ligament, where it is contained in a canal formed at the jimction 

 of the fascia transversalis and fascia iliaca. Having arrived at the 

 anterior superior iliac spine, it pierces the fascia transversalis, and 

 courses outwards and backwards along the iliac crest on its iimer 

 aspect. At its termination it anastomoses with the lumbar branch 

 • of the ilio-lumbar from the internal iliac. Over about the anterior 

 half of the iliac crest the artery lies beneath the transversalis 

 mtiscle, but about the centre of the crest it pierces that muscle, 

 and subsequently lies between it and the internal oblique. 



Branches. — In the first part of its course the vessel gives 

 branches to the ilio-psoas, sartorius, and tensor fasciae femoris, 

 in which latter muscle it anastomoses with the ascending branch 

 of the external circumflex from the arteria profunda femoris. 



