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.
The inferior or external hemorrhoidal arteries, [a. haemorrhoidalis inf.] two or three in number, incline inwards from the pudic artery, as it crosses above the tuber ischii. These small vessels run across the ischiorectal fossa, through the fat in that fossa, and are distributed to the sphincter and levator ani muscles, and to the parts about the anus.
The superficial perineal artery, [a. perinaea superficial,] is a long, slender, but regular vessel, which supplies the scrotum and upper part of the perinaeum. Given from the pudic artery in front of the preceding vessels, it turns upwards with the rami of the ischium and pubes. The perinaeal artery crosses the transverse muscle of the perinaeum, and runs forwards under cover of the superficial fascia and between the erector penis and accelerator urinae muscles, supplying both. In this course the artery gradually becomes superficial as it ascends, and is finally distributed to the skin of the scrotum and the dartos. It not infrequently gives off the following branch.
The transverse perineal artery, [a. transversa perinaea,] arises either from the pudic artery, or from the preceding branch, near the transversus perinaei muscle. This small vessel perforates the deep perinatal fascia near its base, and, as the name transverse perineal implies, lies across the perinaeum, and terminates in small branches which are distributed to the transverse muscle, and to the parts between the anus and the bulb of the urethra. It is a very small artery.
The artery of the bulb, [a. bulbosa], is, surgically considered, an important vessel. It is very short ; arising from the pudic between the layers of the triangular ligament, and, passing transversely inwards, this artery reaches the bulb a little in front of its end. Having entered the bulb, it ramifies in the erectile tissue. It gives a branch to Cowper's gland.
Peculiarities of the artery of the bulb. — From the connection of this vessel with the operation of lithotomy, its various conditions require a special notice. It is sometimes small, sometimes wanting on one side, and occasionally, it is double.
But a more important deviation from the common condition of the artery of the bulb, is one sometimes met with, in which the vessel, arising earlier than usual, crosses the perinaeum further back than in the ordinary arrangement, and reaches the bulb from behind. In such a case there would be considerable risk of dividing the artery in performing the lateral operation for stone.
On the contrary, when this small vessel arises from an accessory pudic artery, it lies higher or more forward than usual, and out of danger in case of operation. The artery of the corpus cavernosum, ([a. cavernosa s.] profunda penis,) one of the terminal branches of the internal pudic, runs a short distance between the crus penis and the bone, and then, continuing forwards, penetrates the crus, and ramifies in the corpus cavernosum.
The-dorsal artery of the penis, [a. dorsalis penis,] runs between the crus and the pubic symphysis, and, having pierced the suspensory ligament, continues along the dorsum of the penis immediately beneath the skin, and parallel with the dorsal vein, as well as with the corresponding artery of the opposite side. It supplies the integument of the penis, and the fibrous sheath of the corpus cavernosum, anastomosing with its deep arteries. Near the corona glandis, each dorsal artery divides into branches, which supply the glans and the prepuce.
The dorsal artery of the penis has been observed to arise from the deep femoral artery, and to pass obliquely upwards and inwards to reach the root of the penis. Tiedemann gives a drawing of this variety.
The pudic artery in the female
In the female this vessel is much smaller than in the male. Its course is similar, and it supplies the following branches :
The superficial perineal branch is distributed to the labia pudendi ; the artery of the bulb supplies the mass of erectile tissue above and at the sides of the entrance of the vagina, named the bulb of the vagina ; whilst the two terminal branches, analogous to the artery of the corpus cavernosum and to the dorsal artery of the penisrare distributed to the clitoris, and are named its profunda and dorsal arteries.
The arteries of the clitoris were found in one case to be derived from the accessory pudic artery, which took its origin from the epigastric artery.
