624 



THE ARTERIES. 



terminal branches, the dorsal artery of the penis and the artery of the 



cavernosum. 



Relations. In the first part of its course, within the pelvis, it lies in front of 



the Pyriforruis muscle and sacral plexus of nerves, and on the outer side of the 



rectum (on the left side). 

 As it crosses the spine 

 of the ischium it is cov- 



Ileo-lumbar 



Deep 

 epigastric 



Obturatoi 



Inf. hxmorrhoidal 



maximus. In the pelvis 

 it lies on the outer side 

 of the ischio-rectal fossa, 

 upon the surface of the 

 Obturator internus mus- 

 cle, contained in a fibi'ous 

 canal formed by the ob- 

 turator fascia and the 

 falciform process of the 

 great sacro-sciatic liga- 

 ment. It is accompa- 

 nied by the pudic veins 

 and the internal pudic 

 nerve, which lies inter- 

 nal to it on the ischial 

 spine. 



Peculiarities, The in- 



ternal pudic is sometimes 

 smaller than usual, or i'ails 

 to give off one or two of its 

 usual branches ; in such 

 cases the deficiency is sup- 

 plied by branches derived 

 from an additional vessel. 

 the accessor pudic, which 

 generally arises from the in- 

 ternal pudic artery before its 

 exit from the great sacro- 

 sciatic foramen. It passes 

 forward along the lower part 

 hypogastnc of th( ^ bladder and across 



nLpudic the side of the Prostate 

 gland to the root of the 

 penis, where it perforates 

 the triangular ligament and 

 gives off the branches usu- 

 ally derived from the pudic 



Gluteal 



Oblit. 



Dorsal artery 

 Artery of Corp. cav. 



Perinea! 

 FIG. 374.- The internal pudic artery and its branches in the male. (Gegenbaur.) artery. The deficiency most 



frequently met with is that 



in which the internal pudic ends as the artery of the bulb, the artery of the corpus cavernosum 

 and arteria dorsalis penis being derived from the accessory pudic. Or the pudic may terminate 

 as the superficial perineal, the artery of the bulb being derived, with the other two branches, 

 from the accessory vessel. 



Surgical Anatomy. The relation of the accessory pudic to the prostate gland and urethra 

 is of the greatest interest in a surgical point of view, as this vessel is in danger of being wounded 

 in the lateral operation of lithotomy. The student should also study the position of the internal 

 pudic artery and its branches, when running a normal course, with regard to the same operation. 

 The superficial and the transverse perineal arteries are, of necessity, divided in this operation, 

 but the haemorrhage from these vessels is seldom excessive ; should a ligature be required, it can 

 readily be applied on account of their superficial position. The artery of the bulb may be 

 divided if the incision be carried too far forward, and injury of this vessel maybe attended with 

 serious or even fatal consequences. The main trunk of the internal pudic artery may be wounded 

 if the incision be carried too far outward ; bat, being bound down by the strong obturator fascia 

 and under cover of the ram us of the ischiuin, the accident is not very likely to occur unless the 

 vessel runs an anomalous course. 



