Common Iliac Arteries
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Questions and Answers

At which vertebral level does the abdominal aorta bifurcate into the common iliac arteries?

  • L2
  • T12
  • L5
  • L4 (correct)

    • What is the primary function of the common iliac artery?

  • Supply the upper extremities
  • Supply the pelvis and lower extremities (correct)
  • Supply the brain
  • Supply the thorax

    • Which of the following statements about the inferior vena cava is incorrect?

  • It collects blood from the lower body.
  • It begins from the common iliac veins.
  • It has no tributaries. (correct)
  • It is located to the right of the abdominal aorta.

    • Which artery branches off the common iliac artery to supply the pelvic organs?

    <p>Internal iliac artery</p> Signup and view all the answers

    What structures are primarily supplied by the parietal branches of the internal iliac artery?

    <p>Pelvic wall and gluteal muscles</p> Signup and view all the answers

    Where does the common iliac artery divide into its branches?

    <p>At the sacroiliac joint</p> Signup and view all the answers

    Which segment of the lumbar plexus is primarily involved in innervating the lower extremities?

    <p>T12-L4</p> Signup and view all the answers

    Which of the following arteries does not emerge from the common iliac artery?

    <p>Femoral artery</p> Signup and view all the answers

    What condition results from compression of the lateral cutaneous nerve of the thigh?

    <p>Meralgia paresthetica</p> Signup and view all the answers

    Which of the following is NOT a symptom of femoral nerve injury?

    <p>Loss of sensation in the lateral thigh</p> Signup and view all the answers

    The femoral nerve provides somatosensory innervation to which area?

    <p>Anterior side of the thigh</p> Signup and view all the answers

    Which structures are primarily innervated by the muscular branches of the femoral nerve?

    <p>Iliopsoas and quadriceps femoris</p> Signup and view all the answers

    What is the consequence of pelvic fractures on the femoral nerve?

    <p>Loss of quadriceps function</p> Signup and view all the answers

    Which muscle is NOT innervated by the lumbar plexus?

    <p>Sartorius</p> Signup and view all the answers

    What is the main sensory function of the iliohypogastric nerve?

    <p>Innervation of the skin of the lateral abdomen</p> Signup and view all the answers

    Which nerve is responsible for the innervation of the anterior part of the scrotum in men?

    <p>Ilioinguinal nerve</p> Signup and view all the answers

    The lateral cutaneous branch of the iliohypogastric nerve is responsible for what type of innervation?

    <p>Sensory innervation of the skin of the lateral abdomen</p> Signup and view all the answers

    Which of the following accurately describes a function of the genitofemoral nerve?

    <p>Provides motor control for the cremaster muscle</p> Signup and view all the answers

    The anterior cutaneous branch of the iliohypogastric nerve innervates which area?

    <p>Skin around the superficial inguinal ring</p> Signup and view all the answers

    What regions receive sensory innervation from the lumbar plexus?

    <p>Lower abdomen</p> Signup and view all the answers

    Which muscle does NOT receive motor innervation exclusively from the lumbar plexus?

    <p>Rectus abdominis</p> Signup and view all the answers

    The femoral branch of the genitofemoral nerve is responsible for what type of innervation?

    <p>Sensory innervation to the medial aspect of the thigh</p> Signup and view all the answers

    Which nerve emerges laterally from the psoas major and runs above the iliac crest?

    <p>Iliohypogastric nerve</p> Signup and view all the answers

    What does the left testicular/ovarian vein drain into?

    <p>Left renal vein</p> Signup and view all the answers

    What is a common consequence of compression of the inferior vena cava during pregnancy?

    <p>Varicose veins in the lower limb</p> Signup and view all the answers

    Which artery supplies the gluteus maximus, medius, and minimus?

    <p>Superior gluteal artery</p> Signup and view all the answers

    Which lymphatic trunk is responsible for draining the lower extremities?

    <p>Lumbar trunk</p> Signup and view all the answers

    What is characteristic of the testicular vein in males?

    <p>It begins on the dorsal aspect of the testis and has valves.</p> Signup and view all the answers

    What is the main function of the umbilical artery during fetal development?

    <p>To carry deoxygenated blood from the fetus to the placenta</p> Signup and view all the answers

    Which of the following statements about the ovarian vein is true?

    <p>It begins in the ovary and usually has valves.</p> Signup and view all the answers

    Which artery is responsible for supplying the prostate and seminal glands in males?

    <p>Artery to ductus deferens</p> Signup and view all the answers

    What does the inferior vena cava connect to when it is compressed by tumors?

    <p>Superior vena cava</p> Signup and view all the answers

    Which artery contributes to the blood supply of the vagina in females?

    <p>Inferior vesical artery</p> Signup and view all the answers

    What is the primary function of lymphatic capillaries?

    <p>Drain excess fluid from tissues</p> Signup and view all the answers

    Which branch of the internal iliac artery supplies the iliopsoas and quadratus lumborum muscles?

    <p>Iliolumbar artery</p> Signup and view all the answers

    Which artery primarily supplies the skin over the sacrum?

    <p>Inferior gluteal artery</p> Signup and view all the answers

    What type of vein does the right testicular vein open into?

    <p>Inferior vena cava</p> Signup and view all the answers

    Which trunk drains lymphatic fluid from half of the head and neck?

    <p>Jugular trunk</p> Signup and view all the answers

    What is one of the branches that arise from the umbilical artery?

    <p>Superior vesical arteries</p> Signup and view all the answers

    What can result from blockage of the inferior vena cava due to malignant tumors?

    <p>Dilatation of the thoraco-abdominal vein</p> Signup and view all the answers

    Which artery supplies the cauda equina and adjacent back muscles?

    <p>Iliolumbar artery</p> Signup and view all the answers

    Which internal iliac artery branch supplies blood to the sacroiliac joint?

    <p>Obturator artery</p> Signup and view all the answers

    Which artery supplies blood to the fundus of the urinary bladder?

    <p>Inferior vesical artery</p> Signup and view all the answers

    Which statement correctly describes the right lymphatic duct?

    <p>It drains lymph from the right half of the head and neck.</p> Signup and view all the answers

    What is the primary function of the thoracic duct?

    <p>To drain lymph from both lower extremities and the left half of the body.</p> Signup and view all the answers

    Where is the cisterna chyli located?

    <p>At the beginning of the thoracic duct.</p> Signup and view all the answers

    Which of the following describes the lymphatic drainage from the left half of the heart?

    <p>It drains into the thoracic duct.</p> Signup and view all the answers

    What represents a key difference between the right lymphatic duct and the thoracic duct?

    <p>The right lymphatic duct is responsible for the drainage of the right upper body.</p> Signup and view all the answers

    At what vertebral level does the abdominal aorta begin its descent in front of the vertebral column?

    <p>T12</p> Signup and view all the answers

    Which statement accurately describes the common iliac artery?

    <p>It bifurcates into the internal and external iliac arteries.</p> Signup and view all the answers

    Which artery supplies the pelvic wall and the organs within the pelvis?

    <p>Internal iliac artery</p> Signup and view all the answers

    What is the main course of the common iliac artery after its bifurcation?

    <p>It passes medially to the psoas major.</p> Signup and view all the answers

    Which branch of the common iliac artery is responsible for supplying the lower extremities?

    <p>External iliac artery</p> Signup and view all the answers

    Where does the inferior vena cava begin?

    <p>At the level of L4 from the common iliac veins</p> Signup and view all the answers

    Which of the following arteries does NOT arise from the internal iliac artery?

    <p>Femoral artery</p> Signup and view all the answers

    What structure does the thoracic duct primarily drain?

    <p>Upper body and lower extremities</p> Signup and view all the answers

    What does the left testicular/ovarian vein drain into?

    <p>Left renal vein</p> Signup and view all the answers

    Which of the following complications is commonly caused by compression of the inferior vena cava during pregnancy?

    <p>Edema of the ankle and feet</p> Signup and view all the answers

    What characteristic is true for both the testicular and ovarian veins?

    <p>Both possess valves</p> Signup and view all the answers

    Which lymphatic trunk is responsible for draining the lower extremities?

    <p>Lumbar trunk</p> Signup and view all the answers

    What clinical presentation can result from the blockage of the inferior vena cava by malignant retroperitoneal tumors?

    <p>Caval-caval shunt dilatation</p> Signup and view all the answers

    How do lymphatic vessels differ from lymphatic capillaries?

    <p>Lymphatic vessels have a more complex valve system</p> Signup and view all the answers

    Which part of the lymphatic system is unpaired and drains unpaired abdominal organs?

    <p>Intestinal trunk</p> Signup and view all the answers

    What is a common characteristic of both the right testicular and right ovarian veins?

    <p>They both open into the inferior vena cava</p> Signup and view all the answers

    During which trimester is the compression of the inferior vena cava by the uterus most likely to occur?

    <p>Third trimester</p> Signup and view all the answers

    Which branch of the uterine artery specifically supplies the vaginal fornices?

    <p>Vaginal branches</p> Signup and view all the answers

    What is the primary function of the internal pudendal artery?

    <p>Supplies blood to the perineal structures</p> Signup and view all the answers

    Which artery ascends along the posterior surface of the anterior abdominal wall?

    <p>Inferior epigastric artery</p> Signup and view all the answers

    Which artery combines with the ovarian artery to form the ovarian arcade?

    <p>Ovarian branch</p> Signup and view all the answers

    What part of the male anatomy does the urethral artery primarily supply?

    <p>Corpus spongiosum penis</p> Signup and view all the answers

    What does the deep artery of the penis/clitoris supply?

    <p>Corpora cavernosa of penis/clitoris</p> Signup and view all the answers

    Which artery runs to the pubic symphysis?

    <p>Pubic branch of the inferior epigastric artery</p> Signup and view all the answers

    Which artery supplies the bulb of the penis and vestibule of the vagina?

    <p>Artery of the bulb of penis/vestibule</p> Signup and view all the answers

    What part of the external iliac artery supplies part of the wall of the greater pelvis?

    <p>Deep circumflex iliac artery</p> Signup and view all the answers

    Which artery primarily supplies the anterior and lateral muscles of the abdominal wall?

    <p>Inferior epigastric artery</p> Signup and view all the answers

    What is the primary function of the iliac veins?

    <p>Drain deoxygenated blood from the pelvis</p> Signup and view all the answers

    Which structure does NOT drain into the inferior vena cava?

    <p>Subclavian veins</p> Signup and view all the answers

    At which vertebral level do the common iliac veins combine to form the inferior vena cava?

    <p>L4-L5</p> Signup and view all the answers

    Which of the following is a parietal tributary of the inferior vena cava?

    <p>Ascending lumbar vein</p> Signup and view all the answers

    What is true about the inferior vena cava?

    <p>It arises from the junction of the common iliac veins</p> Signup and view all the answers

    Which structure drains the inferior part of the diaphragm?

    <p>Inferior phrenic veins</p> Signup and view all the answers

    Where do the renal veins drain into?

    <p>Inferior vena cava</p> Signup and view all the answers

    Which of the following veins drains the right suprarenal gland?

    <p>Right suprarenal vein</p> Signup and view all the answers

    What is a key characteristic of the inferior vena cava?

    <p>It possesses no valves</p> Signup and view all the answers

    What connection does the ascending lumbar vein create?

    <p>Between the common iliac vein and the azygos vein</p> Signup and view all the answers

    Study Notes

    Abdominal Aorta

    • Begins at the level of the aortic hiatus (T12) as the continuation of the thoracic aorta
    • Descends in front of the vertebral column, on the left of the inferior vena cava (IVC)
    • Bifurcates into the common iliac arteries at the level of the 4th lumbar vertebra
    • Has parietal and visceral branches

    Common Iliac Artery

    • Paired continuation of the abdominal aorta from its bifurcation at the level of L4
    • Passes on the medial surface of the psoas major
    • Divides into the external and internal iliac arteries at the level of the sacroiliac joint
    • Supplies the pelvis and lower extremities

    Internal Iliac Artery (Parietal Branches)

    • Medial branch of the common iliac artery
    • Descends behind the peritoneum to the lesser pelvis
    • Supplies the pelvic wall, gluteal muscles, and medial side of the thigh
    • Mnemonic: I Love Odorous Sweet Ice-cream

    Specific Parietal Branches

    • Iliolumbar artery: Supplies the iliopsoas, quadratus lumborum, ilium, and vertebral column including the cauda equina
    • Lateral sacral arteries: Two branches (each then bifurcate) supply the sacrum, cauda equina, and adjacent muscles of the back
    • Obturator artery: Supplies the muscles of the medial femoral group, sacroiliac joint
    • Superior gluteal artery: Supplies the gluteus maximus, medius, and minimus
    • Inferior gluteal artery: Supplies the gluteus maximus, tensor fasciae latae, as well as some skin over the sacrum

    Internal Iliac Artery (Visceral Branches)

    • Supplies the perineum and the organs within the lesser pelvis except for the rectal ampulla and part of the ovary and uterine tube
    • Mnemonic: (U)nder (V)ery (M)uch (I)ntense (R)ain, (D)og, (I)ce (P)oured

    Specific Visceral Branches

    • Umbilical artery: Main fetal artery carrying deoxygenated blood from fetus to the placenta (after delivery obliterates → lateral umbilical ligament)
      • Superior vesical arteries: Arise from the umbilical artery and supply the superior part of the urinary bladder, part of the ureter and the urethra
    • Inferior vesical artery: Supplies the fundus of the urinary bladder
      • In female, it participates in the blood supply of the vagina
      • In male supplies the prostate and seminal glands
    • Middle rectal artery: Supplies the levator ani
      • In female, participates in the blood supply of the vagina
      • In male supply the prostate and seminal glands
    • Artery to ductus deferens: In male, supplies the ductus deferens, prostate, seminal glands, and part of the ureter
    • Uterine artery: In female, supplies the uterus, vagina, and part of the ovary

    Inferior Vena Cava

    • Begins at the level of the L4 vertebra
    • Receives blood from the lower limbs, pelvis, and abdominal organs
    • Empties into the right atrium of the heart

    Visceral Tributaries

    • Right suprarenal vein: Drains the right suprarenal gland
    • Left suprarenal vein: Drains the left suprarenal gland
    • Right testicular/ovarian vein: Opens into the inferior vena cava
    • Left testicular/ovarian vein: Opens into the left renal vein
    • Right renal vein: Drains the right kidney
    • Left renal vein: Drains the left kidney
    • Right common iliac vein: Receives blood from the right lower limb and pelvic organs
    • Left common iliac vein: Receives blood from the left lower limb and pelvic organs

    Compression of the Inferior Vena Cava

    • Commonly compressed by an enlarged uterus during the last trimester of pregnancy
    • Results in edema of the ankle and feet, and varicose veins in the lower limb
    • Compression and blockage by retroperitoneal tumors can lead to:
      • Dilatation of the anastomotic channel between IVC and superior vena cava (caval–caval shunt)
      • Prominent subcutaneous vein called thoraco-abdominal vein

    Lymphatic Drainage

    • Lymphatic capillaries: The smallest lymphatic vessels
    • Lymphatic vessels: Collect lymph from the capillaries
    • Lymphatic trunks: Larger lymphatic vessels that drain lymph into the venous system
      • Paired: Jugular, subclavian, bronchomediastinal, lumbar
      • Unpaired: Intestinal

    Lumbar Plexus (T12-L4)

    • Motor innervation - Lower abdominal muscles, pelvic muscles, muscles of the anterior and medial compartments of the thigh
    • Sensory innervation - Lower abdomen, Lateral gluteal region, External genitalia, Thigh, Medial aspect of the leg (via the saphenous nerve)

    Lumbar Plexus Branches

    • Iliohypogastric nerve: T12-L1 - Motor branches for internal oblique and transversus abdominis, somatosensory innervation of the skin of the lateral abdomen, innervates skin around the superficial inguinal ring
      • Muscular branches
      • Lateral cutaneous branch
      • Anterior cutaneous branch
    • Ilioinguinal nerve: L1 - Travels through the inguinal canal, innervates skin of the anterior part of the scrotum (in men) and skin on the anterior part of the labia majora (in women)
    • Genitofemoral nerve: L2-L3 - Innervates the cremaster, dartos fascia and a small area on the medial side of the thigh (men), skin of the medial side of the thigh
      • Genital branch
      • Femoral branch
    • Lateral cutaneous nerve of thigh / lateral femoral cutaneous nerve: L2-L3 - Somatosensory innervation for the lateral thigh
    • Femoral nerve: L2-L4 - Innervates the iliopsoas, quadriceps femoris, sartorius and pectineus, somatosensory innervation for the anterior side of the thigh, somatosensory innervation of the skin of the medial part of the leg
      • Muscular branches
      • Anterior cutaneous branches
      • Saphenous nerve
        • Infrapatellar branch
        • Medial cutaneous nerve of leg/medial crural cutaneous nerve

    Clinical Correlation

    • Meralgia paresthetica: Compression of the lateral cutaneous nerve of the thigh in the muscular space - acute pain, loss of sensation on the lateral thigh above the knee
    • Femoral nerve injury: Trauma, pelvic fractures, hip dislocations, surgeries, inguinal lymphatic nodes induration, femoral artery aneurysms - impaired function of the quadriceps femoris, difficulty walking without support and walking upstairs, inability to raise lower limb when lying supine, unstable standing and squatting, genu recurvatum (back knee)

    Abdominal Aorta

    • Begins at the level of the aortic hiatus (T12) and continues from the thoracic aorta
    • Descends in front of the vertebral column, on the left of the inferior vena cava (IVC)
    • Bifurcates into the common iliac arteries at the level of the 4th lumbar vertebra
    • Has parietal and visceral branches

    Common Iliac Artery

    • Paired continuation of the abdominal aorta from its bifurcation at the level of L4
    • Passes on the medial surface of the psoas major
    • Divides into the external and internal iliac arteries at the level of the sacroiliac joint
    • Supplies the pelvis and lower extremities

    Internal Iliac Artery (Parietal Branches)

    • Medial branch of the common iliac artery
    • Descends behind the peritoneum to the lesser pelvis, passing in front of the sacroiliac joint
    • Supplies the pelvic wall, gluteal muscles, and medial side of the thigh
    • Branches include: iliolumbar artery, lateral sacral arteries, uterine artery

    Internal Iliac Artery (Visceral Branches)

    • Supplies the pelvic organs
    • Branches include: internal pudendal artery

    Internal Pudendal Artery

    • Arterial trunk supplying blood to all perineal structures inferior to the pelvic diaphragm
    • Branches include: inferior rectal artery, perineal artery, dorsal artery of penis/clitoris, deep artery of penis/clitoris, urethral artery, artery of bulb of penis/vestibule

    External Iliac Artery

    • Lateral branch of the common iliac artery
    • Supplies majority of the lower extremity, anterior and lateral muscles of the abdominal wall, and part of the scrotum in males
    • After leaving the vascular space, it continues as the femoral artery
    • Two branches arise just medial to the inguinal ligament: inferior epigastric artery, deep circumflex iliac artery

    Inferior Epigastric Artery

    • Ascends along the posterior surface of the anterior abdominal wall inside the lateral umbilical fold
    • Anastomoses with the superior epigastric artery within the rectus abdominis
    • Branches include: pubic branch, cremasteric artery, artery of round ligament of uterus

    Iliac Veins

    • Drain deoxygenated blood from the pelvis and return it to the heart
    • Major vessels include: external iliac vein, internal iliac vein, common iliac vein
    • Left and right common iliac veins combine at L4-L5 to become the inferior vena cava

    Inferior Vena Cava

    • Largest vein in the human body
    • Collects blood from the inferior half of the body (below the diaphragm)
    • Arises from the junction of the right and left common iliac veins at the level of L4–L5
    • Runs on the right of the abdominal aorta, courses dorsally to the liver, and passes through the diaphragm
    • Has both parietal and visceral tributaries

    Inferior Vena Cava - Parietal Tributaries

    • Include: lumbar veins, inferior phrenic veins, external vertebral venous plexuses

    Inferior Vena Cava - Visceral Tributaries

    • Include: hepatic veins, right suprarenal vein, renal veins, testicular/ovarian vein

    Compression of the Inferior Vena Cava

    • Commonly compressed by an enlarged uterus during the last trimester of pregnancy
    • Results: edema of the ankle and feet, varicose veins in the lower limb
    • Compression by malignant retroperitoneal tumors can lead to dilatation of the anastomotic channel between IVC and superior vena cava (caval–caval shunt)

    Lymphatic Vessels

    • Drainage system that collects excess fluid and waste products from the body
    • Major components: lymphatic capillaries, lymphatic vessels, lymphatic trunks, lymphatic ducts

    Lymphatic Trunks

    • Paired: jugular trunk, subclavian trunk, bronchomediastinal trunk, lumbar trunk
    • Unpaired: intestinal trunk

    Lymphatic Ducts

    • Right lymphatic duct: originates from the right jugular, right subclavian, and right bronchomediastinal trunks, collects lymph from the right half of the head and neck, right upper extremity and right half of the thoracic cavity
    • Thoracic duct: originates from the lumbar trunks, collects lymph from both lower extremities, pelvis, abdominal cavity, left half of the thoracic cavity, left upper extremity and left half of the head and neck.

    Cisterna Chyli

    • Widened area at the beginning of the thoracic duct at the level of T11–L1
    • Receives lymph from the lumbar trunks and intestinal trunk

    Lymphatic Drainage of Posterior Abdominal Wall

    • Lymph vessels draining the posterior abdominal wall and most of the abdominopelvic organs (except part of the liver) terminate in the cisterna chyli and thoracic duct
    • Deep lymph nodes are not palpable

    Lumbar Plexus

    • Formed from the anterior branches of spinal nerves L1–L4 and a contributing branch from T12
    • Located within the psoas major, lateral to the lumbar vertebrae
    • Nerves include: iliohypogastric nerve, ilioinguinal nerve, genitofemoral nerve, lateral cutaneous nerve of thigh, femoral nerve, obturator nerve

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