- The umbilical artery is the intrapelvic portion of the fetal umbilical artery. It retains its lumen for a short distance from the internal iliac and gives off the superior vesical artery. Distally it forms a fibrous cord running beside the bladder to the umbilicus as the lateral umbilical ligament or the obliterated hypogastric artery.
The obturator artery courses along the lateral wall of the pelvis to the obturator canal. Superior to the artery is the obturator nerve, and the vein is inferior. There is a pubic branch communicating with the pelvic surface of the pubic bone and anastomosing with a similar branch from the inferior epigastric artery. This anastomosis may replace the more common course of the obturator artery originating from the internal iliac and is called the abnormal obturator artery.
The uterine artery runs forward to the base of the broad ligament, where it crosses the ureter anteriorly and ascends along the lateral border of the uterus. It forms an anastomosis with the ovarian and vaginal arteries.
The vaginal artery corresponds to the inferior vesical artery in the male; it supplies the vagina, the uterus, and the inferior portion of the bladder.
The middle rectal artery arises from a common trunk with the vaginal artery. It communicates with the superior and inferior rectal arteries.
The internal pudendal artery leaves the pelvis through the greater sciatic foramen and reenters at the lesser sciatic foramen, where it goes forward to the pudendal canal.
The inferior gluteal artery also leaves the pelvis through the greater sciatic foramen and passes to the gluteal region. It is located posterior to the internal pudendal artery.
The iliolumbar artery passes posteriorly and laterally between the fourth and fifth lumbar nerves, passing behind the psoas major muscle and proximal portion of the obturator nerve. Its vein terminates in the common iliac vein.
The lateral sacral artery has a superior and an inferior branch that may have separate or common origins. The superior branch enters the vertebral canal between the upper two anterior sacral foramina, and the inferior branch is directed to the lower two foramina and the coccyx.
The superior gluteal artery runs posteriorly between the fourth and fifth lumbar nerves or between the lumbosacral trunk and the first sacral nerve. It travels through the greater sciatic foramen to the gluteal region.
Collateral circulation between the branches of the internal iliac artery and the systemic circulation is clinically significant. The lumbar branch of the iliolumbar artery communicates with the lumbar arteries of the systemic circulation. The lateral sacral artery communicates with the median sacral artery. The middle rectal artery communicates with the inferior and superior rectal arteries.