THE EXTERNAL ILIAC ARTERY 



683 



Branches. The branches of this vessel are: The cremasteric (a. spermatica 

 externa in the male, a. ligamenti teretis uteri in the female}, which accompanies the 

 spermatic cord, and supplies the Crema^er muscle and other coverings of the 

 spermatic cord, anastomosing with the spermatic artery in the male, and which 

 accompanies the round ligament in the female; a pubic branch (ramus pubicus), 

 which runs along Poupart's ligament, and then descends behind the os pubis 

 to the inner side of the femoral ring, and anastomoses with offshoots from the 

 obturator artery ; muscular branches, some of which are distributed to the Abdominal 

 muscles and peritoneum, anastomosing with the lumbar and circumflex iliac 

 arteries; cutaneous branches, which perforate the tendon of the External oblique, 

 and supply the integument, anastomosing with branches of the superficial epi- 

 gastric. 



Fir,. 478. Femoral sheath laid open to show its three compartments. Iliac portion of fascia lata removed. 



Peculiarities. The origin of the deep epigastric may take place from any part of the external 

 iliac between Poupart's ligament and two inches and a half above it, or it may arise below this 

 ligament, from the common femoral or from the deep femoral. It frequently arises from the 

 external iliac by a common trunk with the obturator. Sometimes the epigastric arises from 

 the obturator, the latter vessel being furnished by the internal iliac, or the epigastric may be 

 formed by two branches, one derived from the external iliac, the other from the internal iliac. 



Applied Anatomy. The deep epigastric artery follows a line drawn from the middle of 

 Pounart's ligament toward the umbilicus; but shortly after this line crosses the linea semilunaris 

 the direction changes, and the course of the vessel is directly upward in the line of junction of 

 the inner third with the outer two-thirds of the Rectus muscle. It has important surgical rela- 

 tions, in addition to the fact that it is one of the principal means, through its anastomosis with 

 the internal mammary, in establishing the collateral circulation after ligation of either the com- 

 mon or external iliac arteries. It lies close to the internal abdominal ring, and is therefore 

 internal to an oblique inguinal hernia, but external to a direct inguinal hernia, as the hernia 



