BRAXCHE8 OF THE INTERNAL ILIAC. 625 



Branches. The branches of the internal pudic artery are 



Muscular. Transverse Perineal. 



Inferior Haemorrhoidal. Artery of the Bulb. 



Superficial Perineal. Artery of "the Corpus Cavernosum. 



Dorsal Artery of the Penis. 



The muscular branches consist of two sets one given off in the pelvis, the 

 other as the vessel crosses the ischial spine. The former are several small offsets 

 which supply the Levator ani, the Obturator internus, the Pyriformis, and the 

 Coccygeus muscles. The branches given off outside the pelvis are distributed to 

 the adjacent part of the Gluteus maximus and External rotator muscles. They 

 anastomose with branches of the sciatic artery. 



The inferior haemorrhoidal are two or three small arteries which arise from the in- 

 ternal pudic as it passes above the tuberosity of the ischium. Crossing the ischio- 

 rectal fossa, they are distributed to the muscles and integument of the anal region. 



The superficial perineal artery supplies the scrotum and muscles and integu- 

 ment of the perinaeum. It arises from the internal pudic in front of the preceding 

 branches, and turns upward, crossing either over or under the Transversus perinaei 

 muscle, and runs forward, parallel to the pubic arch, in the interspace between the 

 Accelerator urinae and Erector penis muscles, both of which it supplies, and is 

 finally distributed to the skin and dartos of the scrotum. In its passage through 

 the perinteum it lies beneath the superficial perineal fascia. 



The transverse perineal is a small branch which arises either from the internal 

 pudic or from the superficial perineal artery as it crosses the Transversus perinaei 

 muscle. It runs transversely inward along the cutaneous surface of the Trans- 

 versus perinaei muscle, which it supplies, as well as the structures between the anus 

 and bulb of the urethra, and anastomoses with the one of the opposite side. 



The artery of the bulb is a large but very short vessel which arises from the 

 internal pubic between the two layers of the deep perineal fascia, and, passing 

 nearly transversely inward, pierces the bulb of the urethra, in which it ramifies. 

 It gives off a small branch which descends to supply Cowper's gland. 



Surgical Anatomy. This artery is of considerable importance in a surgical point of view, 

 as it is in danger of being wounded in the lateral operation of lithotomy an accident usually 

 attended in the adult with alarming haemorrhage. The vessel is sometimes very small, occasion- 

 ally wanting, or even double. It sometimes arises from the internal pudic earlier than usual, and 

 s the perinasum to reach the back part of the bulb. In such a case the vessel could hardly 

 fail to be wounded in the performance of the lateral operation of lithotomy. If, on the contrary, 

 it should arise from an accessory pudic, it lies more forward than usual and is out of danger in 

 the operation. 



The artery of the corpus cavernosum, one of the terminal branches of the inter- 

 nal pudic, arises from that vessel while it is situated between the crus penis and 

 the ramus of the os pubis ; piercing the crus penis obliquely, it runs forward in the 

 centre of the corpus cavernosum, to which its branches are distributed. 



The dorsal artery of the penis ascends between the crus and pubic symphysis, 

 and. piercing the suspensory ligament, runs forward on the dorsum of the penis to 

 the glans. where it divides into two branches which supply the glans and prepuce. 

 On the dorsurn of the penis it lies immediately beneath the integument, parallel 

 with the dorsal vein and the corresponding artery of the opposite side with the 

 nerve external. It supplies the integument and fibrous sheath of the corpus caver- 

 nosum, sending branches through the sheath to anastomose with the preceding 

 vessel. 



The Internal Pudic Artery in the Female is smaller than in the male. Its 

 origin and course are similar, and there is considerable analogy in the distribution 

 of its branches. The superficial artery supplies the labia pudendi ; the artery of 

 the bulb supplies the bulbi vestibuli and the erectile tissue of the vagina ; the 

 artery of the corpus cavernosum supplies the cavernous body of the clitoris ; and 

 the arteria dorsalis clitoridis supplies the dorsum of that organ, and terminates in 

 the glans and in the membranous fold corresponding to the prepuce of the male. 



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