376 The Internal Iliac Artery 



would receive blood from the inferior mesenteric; the uterine, from 

 the ovarian branch of the aorta ; the obturator, from the deep 

 epigastric and the internal circumflex ; the gluteal and the ilio-lumbar, 

 from the lumbar of the aorta, the circumflexa ilii, and the external 

 circumflex ; and the lateral sacral, from the sacra media. The empty 

 sciatic artery would probably bring blood from the cruciform anasto- 

 mosis, and the artery of the vas deferens (of the inferior vesical) 

 might possibly help by its anastomosis with the spermatic. 



Sympathetic nerves of the pelvis. The two knotted cords of 

 the sympathetic system are continued from the front of the last 

 lumbar vertebra upon the sacrum, internal to the foramina, till they meet 

 at last in front of the coccyx, in the ganglion impar. Each cord has 

 four or five ganglia which communicate with the sacral nerves ; several 

 branches pass on to the middle sacral artery, and others to the hypo- 

 gastric plexus a network placed between the two common iliac arteries 

 in front of the sacral promontory. From this plexus numberless 

 branches descend on each side to form the pelvic plexus, where com- 

 munications take place with the third and fourth sacral (spinal) nerves. 

 Filaments also pass with every branch of the internal iliac artery ; 

 thus, the pelvic viscera and the penis (but not the testes, p. 432) are 

 supplied. 



The sacra media comes off from the bifurcation of the aorta, and 

 descends between the two common iliac arteries over the last lumbar 

 vertebra, and down the sacrum ; it anastomoses with the lateral 

 sacrals of either side, and it ends in Luschka's gland. Ih its course 

 it gives twigs to the back of the rectum, which anastomose with other 

 haemorrhoidal branches. 



THE LYMPHATIC GLANDS OF THE ABDOMEN AND PELVIS 



are chiefly arranged along the abdominal aorta (lumbar glands] and the 

 trunks of the iliac arteries (pelvic glands\ those along the external iliac 

 being in association with the inguinal glands ; there are sacral glands 

 also, which quickly enlarge in cancer of the rectum. The pelvic 

 viscera are specially associated with the lymphatics which are grouped 

 along the internal iliac artery. The lumbar and pelvic lymphatic 

 vessels gradually reach the thoracic duct. 



With malignant disease of the testicle, the lumbar lymphatic 

 glands may be so much enlarged as to form a palpable abdominal 

 tumour, which may, by compressing the vena cava, cause oedema in 

 the lower extremities. 



THE ILIAC VEINS 



The external iliac vein is the continuation of the common femoral. 

 The name changes at Poupart's ligament, where the vein, occupying 

 the middle compartment of the crural sheath, lies to the inner side 



