434 ARTERIES. 



from the great sacro-sciatic foramen, and passes forwards near the base of the bladder, on the 

 upper part of the prostate gland, to the perineum, where it gives off those branches usually 

 derived from the pudic 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 super- 

 ficial perineal, the artery of the bulb being derived, with the other two branches, from the acces- 

 sory vessel. 



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. 



Branches. Within the pelvis, the internal pudic gives off several small branches, 

 which supply the muscles, sacral nerves, and viscera in this cavity. In the peri- 

 neum the following branches are given off. 



Inferior or external hemorrhoidal. Artery of the bulb. 



Superficial perineal. Artery of the corpus cavernosum. 



Transverse perineal. Dorsal artery of the penis. 



The external hemorrhoidal are two or three small arteries, which arise from 

 the internal 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 perineum. It arises from the internal pudic, in front of the preceding 

 branches, and piercing the lower border of the deep perineal fascia, runs across 

 the Transversus perinei, and through the triangular space between the Accelerator 

 urinas and Erector penis, both of which it supplies, and is finally distributed to 

 the skin of the scrotum and dartos. In its passage through the perineum 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 perinei 

 muscle. Piercing the lower border of the deep perineal fascia, it runs trans- 

 versely inwards along the cutaneous surface -of the Transversus perinei muscle, 

 which it supplies, as well as the structures between the anus and bulb of the 

 urethra. 



The artery of the bulb is a large but very short vessel, arising from the internal 

 pudic between the two layers of the deep perineal fascia, and passing nearly 

 transversely inwards, pierces the bulb of the urethra, in which it ramifies. It 

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

 with severe and alarming hemorrhage. This vessel is sometimes very small, 

 occasionally wanting, or even double. It sometimes arises from the internal pudic 

 earlier than usual, and crosses the perineum 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 for 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 pubes ; piercing the crus penis obliquely, it runs forwards in the 

 corpus cavernosum by the side of the septum pectiniforme, 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 dorsum of the penis, it lies immediately beneath the integument, parallel 

 with the dorsal vein and corresponding artery of the opposite side. It supplies 

 the integument and fibrous sheath of the corpus cavernosum. 



