The external iliac artery admits of being tied in a surgical operation at any part except near its upper and lower end ; the near neighbourhood of the upper end being excepted on account of the circulation through the internal iliac, and the lower end on account of the common position of the branches (epigastric and circumflex iliac). Occasional deductions from this statement occur in consequence of a branch or branches taking origin near or at the middle of the artery; and as the operator may see such a branch he will avoid placing a ligature very near it.
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Before escaping from the pelvis, the pudic artery occasionally gives small and irregular branches to the muscles and to the sacral nerves : and, besides its two terminal branches, it furnishes several named branches in the perineum.
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The vessel which supplies the lower extremity forms a continuous trunk from the point of division of the common iliac artery down to the lower border of the popliteus muscle, where it divides into the anterior and posterior tibial arteries ; but though thus continued as a single trunk different parts of the vessel have received different names, taken from the anatomical regions through which they pass. Whilst within the pelvis, it is named iliac; in the upper two-thirds of the thigh, femoral ; and thence to its termination, popliteal. These divisions, however, are artificial, and are intended merely to facilitate reference to the vessel in different situations.
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The pudic or internal pudic artery (pudica interna; pudica communis,— Winslow ; pudenda (simpliciter),— Haller), a branch of considerable size (smaller in the female than in the male), is distributed to the external generative organs. The following description of this artery has reference to its arrangement in the male;— its distribution in the female will be noticed separately.
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The anastomosis which exists between the obturator artery (when that vessel is derived from the internal iliac) and the epigastric, by means of those small branches of each which ramify behind the pubes, serves to afford some explanation of one of the most striking instances of variety of origin met with in the arterial system, viz., the transfer of the origin of the obturator from the internal iliac to the epigastric artery.
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The obturator artery [a.obturatoria], when derived from the internal iliac, usually arises from the anterior division of that vessel, but not infrequently from its posterior division. The artery is directed forwards through the pelvis to reach the groove on the under surface of the horizontal portion of the pubes, at the upper part of the thyroid foramen. Beneath this bone it passes out of the pelvis, and immediately divides into its terminal branches. In its course through the pelvis the artery is placed between the pelvic fascia and the peritoneum, a little below the obturator nerve. Beneath the pubes it lies with the nerve in an oblique canal, formed partly by the groove in the bone, and partly by fibrous tissue.
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