II.IAC AUTKIUKS. 





may lie deficient or more developed, the obtu- 

 rator will be derived principally or altogether 

 the inti Tiial iliac or from the epigastric; 

 when both arc equally so it will present the 



double origin. 



2. The g/iitieul artery, denominated also 

 or i/iin; is the Largest branch of the 

 il iliac, and arises from, or is the conti- 

 nuation of the posterior division of that vessel ; 

 it rues downward, Backward, and outward, until 

 IH'N tln j >n|ierior part of the great sciatic 

 notch ; it then changes the direction of its 

 course, and making a turn passes dm ctlv out- 

 ward between the lumbo-sacral and the anterior 

 branch of the first sacral nerves, and c 

 from the pelvis through the upper part of the 

 notch above the pyriformis muscle, and accom- 

 panied by the superior glnteal nerve. A 

 as the artery has escaped from within the pelvis 

 lined its external aspect, it divides into 

 branches. The trunk of this artery, as it is the 

 -MI is it tlie shortest of the brandies of 

 (lie iliac; within the pelvis it corresponds ex- 

 teinally to the lumbo-sacral nerve, internally to 

 the rectum, and inferiorly to the first sacral 

 nerve and the pyriformis ; it gives small 

 brandies to the rectum, the pyriformis, and the 

 surrounding cellular structure ; at times it also 

 gives off the ilio-lumbar, the lateral sacral, or 

 the obturator. 



At its exit posteriorly from the pelvis it is 

 situate between the adjoining margins of the 

 pyriformis and the gluteus minimus, and it is 

 covered by the gluteus maximus. 



The branches into which it divides after its 

 are two, a superficial and deep one. 

 The first passes outward and upward between 

 the glutei maximus and medius, and divides 

 into numerous branches, which are distributed 

 to these muscles, particularly to the maximus; 

 many of them descend in its substance toward 

 its insertion, and there meet branches of the 

 circumflex (femoral) and sciatic arteries; others 

 pass through the muscle, become supeiliii.il, 

 and supply the integument and subcutaneous 

 fat; others again pass onward, traverse the 

 attachment of the glutens maximus to the sa- 

 crum, and are distributed to the muscles and 

 integuments of the posterior sacral region. 



The second, the deep branch, passes outward, 

 upward, and forward, between the glutei medius 

 and minimus muscles toward the superior 

 anterior spinous process of the ilium m an 

 arched course around the attachment of the 

 gluteus minimus. As it proceeds it gives off 

 numerous brandies upward from its convexity 

 and downward from its concavity ; the former 

 are distributed to the. glutens medius; the lat- 

 ter are chiefly two, of which one runs forward 

 and downward toward the anterior part of the 



great troclianter between the two n 

 branches to both, and finally throws itself into 

 the uluteus medius near the troehanter, and is 

 consumed in it : it communicates fre< 

 the external circumflex artery. The other runs 

 downward and Forward toward the hark of the 

 troclianter, lies for son . 



minimus, or over the interval between it and 

 the pynt'onnis. uives bnmclM to both n 

 vol.. n. 



and then gains the surface of the us mnomini 

 turn In III or bv p 



n it and the pyriformis, pursues its course 

 upon the bone, to which it uive.s an artery, above 

 the ilio-femoral articulation, to the capsule of 

 which it also gives branches, and appn>.' 

 the anterior inferior spinous process of the ilium 

 it terminates in supplying the gluten-, minimus, 

 and anastomosing with the external circumflex 

 artery. 



The deep division of the gluteal artery hav- 

 ing run round the line of attachment of the 

 gluteus minimus, and reached the superior 

 anterior spinous process, terminates in an anas- 

 tomosis with the circumflex iliac, the ilio-lumbar, 

 and the external circumflex arteries ; branches 

 also turn over the crest of the ilium, and so 

 communicate with the iholumlar. The deep 

 division, also, furnishes a nutritious artery to 

 the ilium, the canal for which is to be seen on 

 the dorsum of the bone. The branches of the 

 gluteal artery are numerous and large ; in order 

 to expose them the gluteus maximus having 

 been dissected clean may be detached from the 

 femur and raised toward the sacrum, when the 

 branches may be displayed running in every 

 direction as from an axis. 



The situation of the gluteal artery external to 

 the pelvis permits the trunk of the vessel to be 

 secured ; the gluteus maximus being the only 

 muscle by which it is covered, it may be exposed 

 by the division of that muscle; the situation of 

 the artery may be first determined " by draw ing 

 a line from the posterior spinous process of the 

 ilium to the midspace between the tuberosity of 

 the ischium and the great troehanter; if we divide 

 this line into three, we shall find the gluteal 

 artery emerging from the pelvis at the juncture 

 of its upper and middle thirds."* The ligature 

 of this artery in case of aneurism has been very 

 much superseded in favour of that of the inter- 

 nal or even of the primitive iliac, the latter of 

 which has been tied by Guthrie for aneurism 

 of the gluteal artery ; the propriety of this pro- 

 ceeding, however, may be questioned ; the 

 ligature of either the internal or the primitive 

 iliac must be regarded a more serious operation 

 than that of the gluteal, and the latter has 

 proved so efficacious in the many instances in 

 which it has been had recourse to, that, while 

 it is practicable, the other can be hardly justi- 

 fiable. 



3. The ischiatic artery arises from the ante- 

 rior division of the internal iliac, which, after 

 hani.o given off its internal branches, divides 

 into two, of which the posterior and larger is 

 hiatic; it is the second in size of the 

 branches of the iliac, being smaller than the 

 gluteal; but in the adult it appears, for the 

 mo.st )>art, in direction the continuation of the 

 original vessel; its course within the pelvis is 

 Ion,' : it descends, at the same time inclining 

 I, and forming a curve convex backward, 

 toward the inferior part of the great 

 notch, and escapes through it from the pelvis. 



ro-sciatic ligaments an 

 rior to the pyriformis muscle; it then descends 



Harrison. 



3 I 



