284 



DISSECTION OF THE ABDOMEN. 



Inferior 

 or deep 

 epigastric 

 artery : 



relations 

 in wall of 

 abdomen. 



Branches : 



pubic joins 

 obturator ; 



cremas- 

 teric; 



muscular ; 



cutaneous. 



Epigastric 

 veins. 



Circumflex 

 iliac artery 



offsets, 

 muscular, 



the abdomen beneath the cartilage of the seventh rib. Descend-] 

 ing in the sheath of the rectus, it soon enters the substance of 

 the muscle, and anastomoses in it with the epigastric artery. 

 Branches are given to the neighbouring muscles and the overlying 

 integument. 



The DEEP EPIGASTRIC ARTERY (fig. 106, , p. 287) arises from the 

 external iliac about a quarter of an inch above Poupart's ligament ; 

 it ascends in the sheath of the rectus, and above the umbilicus 

 divides into branches which enter that muscle, and anastomose with 

 the superior epigastric. 



As the artery courses to the rectus it passes beneath the spermatic 

 cord (or round ligament of the uterus), and on the inner side of the 

 internal abdominal ring ; and it is directed obliquely inwards across 

 the lower part of the abdomen, so as to form the outer boundary of 

 a triangular space along the edge of the rectus. It lies at first 

 beneath the transversalis fascia ; but it soon perforates that mem- 

 brane, and enters the sheath of the rectus over the semilunar fold 

 of Douglas. 



The branches of the artery are numerous, but small in 

 size : 



a. The pubic branch is a small artery, which runs transversely 

 behind Poupart's ligament to the back of the pubis, where it anasto- 

 moses with the similar branch of the opposite side, and with an 

 offset from the obturator artery (fig. 107, /, p. 294). The size of the 

 anastomosis with the obturator artery varies very much, but it is 

 often so large that the obturator artery is derived wholly or in part 

 from the deep epigastric through the enlargement of its pubic 

 branch, giving rise to the commonest form of an abnormal obturator 

 artery. 



b. A cremasteric branch is furnished to the muscular covering of 

 the cord. 



c. Muscular branches are given from the outer side of the artery 

 to the abdominal wall, and anastomose with the intercostal and 

 lumbar arteries ; others enter the rectus. 



d. Cutaneous offsets pierce the muscle, and ramify in the integu- 

 ments with the anterior cutaneous nerves. 



Two epigastric veins lie with the artery ; they join finally into 

 one, which opens into the external iliac vein. 



The DEEP CIRCUMFLEX ILIAC ARTERY arises from the outer j side of 

 the external iliac, opposite, or a little below the deep epigastric. It 

 runs at first over the iliacus, close behind Poupart's ligament, in a 

 fibrous sheath at the junction of the iliac and transversalis fasciae, 

 and then along the inner margin of the iliac crest to about the middle, 

 where it ends by anastomosing with the iliac branch of the ilio- 

 lumbar artery. 



Branches. Near the front of the iliac crest a branch (fig. 106, 

 6, p. 287) ascends between the internal oblique and transversalis 

 muscles, supplying them, and anastomosing with the epigastric and 

 lumbar arteries. 



