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Iliac arteries: want to learn more about it?

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Iliac arteries

The blood supply to the body arises from the aorta, the main outflow of the left ventricle of the heart. The abdominal aorta gives rise to two common iliac arteries at its termination, which then further divided into the external and internal iliac arteries. These two arteries supply the abdomen, pelvis and lower limb.

In this article, we will discuss the anatomy and clinical relevance of the common iliac artery. We will also conclude with a summary and some review questions to test the reader’s understanding of the article content.

Key facts about the iliac arteries
Common iliac artery

Source: abdominal aorta

Branches: internal iliac artery, external iliac artery

External iliac artery

Branches: inferior epigastric, deep circumflex iliac and femoral arteries

Supply area: part of the abdominal wall and the lower limb.

Internal iliac artery

Branches: obturator, inferior gluteal, umbilical, uterine, vaginal, inferior vesical, middle rectal and internal pudendal arteries (anterior trunk); iliolumbar, lateral sacral and superior gluteal arteries (posterior trunk)

Supply area: sphincters, reproductive organs and pelvic viscera

Recommended video: Arteries of abdomen and pelvis
Main arteries supplying the structures of the abdomen and pelvis.

Common iliac artery

The abdominal aorta divides at the level of the L4 vertebral body, and forms the two common iliac arteries. The common iliac arteries run laterally, and divide into the external and internal iliac arteries anterior to the sacroiliac joints.

Iliac ateries (diagram)

The internal iliac descends into the pelvis to supply the sphincters, reproductive organs and pelvic viscera. The external iliac will continue to run inferiorly, and pass deep to the inguinal ligament. At this point the artery is renamed as the femoral artery, which goes on to supply the lower limb.

As the common iliac artery descends, it runs along the medial border of the psoas major muscle. They have peritoneum in front, and is crossed near their bifurcation by the ureter and spermatic nerves and vessels. The arteries are accompanied by the common iliac veins along their course which lie posterior. The right common iliac is slightly longer than left, the average length of common iliac arteries is 2.5 inches.

External iliac artery

The external iliac artery arises from the division of the common iliac artery, anterior to the sacroiliac joints. The external iliac artery then continues to pass under the inguinal ligament and is renamed the femoral artery once it emerges. It runs medial to the femoral nerve and lateral to the common iliac vein.

Iliac vessels in a cadaver

External iliac artery supplies the part of the abdominal wall and the lower limb. It has three major branches: inferior epigastric, deep circumflex iliac and femoral arteries

Learn more about the external iliac artery and its branches with our article and video tutorial.

Internal iliac artery

The internal iliac artery arises from the division of the common iliac artery. The vessel runs posterior to the ureter in its upper section, posterior to the internal iliac vein along its entire course, posterior to the lumbosacral trunk as it passes the sacral foramina. It is separated from the psoas major muscle by the internal iliac vein.

How to remember all the definitions, courses of the vessels and their branches? Kenhub can provide you with your personalized human anatomy study plan to help you learn anatomy effectively and cut your studying time in half!

Internal iliac artery bifurcates into the anterior and posterior trunks. The anterior trunk has eight branches that supply the pelvis and perineum. They are the obturator, inferior gluteal, umbilical, uterine, vaginal, inferior vesical, middle rectal and internal pudendal arteries. The branches of the posterior trunk are the iliolumbar, lateral sacral and superior gluteal arteries.

Learn the internal iliac artery anatomy with our article, videos and quizzes.

Clinical points

Common Iliac artery aneurysms- Aneurysms of the common iliac artery do occasionally occur. 10-20% of abdominal aortic aneurysms is associated with aneurysm of the common iliac artery. They are usually asymptomatic, but may present with hydronephrosis (due to ureteric blockage), neurological symptoms (sciatic nerve compression). If they rupture then symptoms include shock, and abdominal pain.

Surgical relevance- The ureters run underneath the uterine arteries (hence the saying, ‘water under the bridge’). It can be damaged in operation to the uterus such as hysterectomy.

Severe haemorrhage in the lower limb can be reduced by ligation of the internal iliac artery while surgical repair takes place. The pelvis also has significant collateral circulation which is able to ensure an adequate blood supply even in the event of vascular compromise.

EVAR (endovascular aneurysm repair)- This is a procedure for the repair of abdominal aortic aneurysm, it involves the insertion of a trouser leg graft into the femoral artery, and the graft will expand and close any leakage in the abdominal aorta. This minimally invasive approach reduces post-procedure morbidity, but leads to higher rates of some complications e.g. aortoenteric fistula.

Iliac arteries: want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

Sign up for your free Kenhub account today and join over 1,203,894 successful anatomy students.

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

Show references

References:

  • Frank H.Netter MD: Atlas of Human Anatomy, 5th Edition, Elsevier Saunders.
  • Chummy S.Sinnatamby: Last’s Anatomy Regional and Applied, 12th Edition, Churchill Livingstone Elsevier.
  • Richard L. Drake, A. Wayne Vogl, Adam. W.M. Mitchell: Gray’s Anatomy for Students, 2nd Edition, Churchill Livingstone Elsevier. 
  • Shetty A. MD and Bashir O. MD et al: Common iliac artery. Radiopaedia.org (accessed 10/03/16)
  • Henry Gray: The Common Iliac Arteries. Anatomy of the Human Body. (accessed 10/03/16)
  • Ronald A. Bergman, PhD, Adel K. Afifi, MD, MS Ryosuke Miyauchi, MD: Common Iliac Artery. Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Pelvis (accessed 10/03/16) 
  • Krishna Kandarpa: Peripheral Vascular Interventions. (accessed 10/03/16)

Author, review and layout:

  • Shahab Shahid
  • Uruj Zehra
  • Catarina Chaves

Illustrators:   

  • Iliac arteries (diagram) - Paul Kim
  • Iliac vessels in a cadaver - Prof. Carlos Suárez-Quian
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

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