The internal iliac artery provides blood. Iliac arteries: structure and functions

INTERNAL ILIAC ARTERY(arteria iliaca interna) - a branch of the bifurcation of the common iliac artery, heading into the small pelvis to the upper edge of the large sciatic foramen, where it is divided into terminal parietal and visceral branches.

parietal branches

ILIOLUMBAR ARTERY(arteria iliolumbalis) - passes under the psoas major muscle to the iliac fossa. Blood supply to the iliopsoas muscle, square muscle of the lower back, transverse abdominal muscle, ilium, spinal cord and its membranes.

LATERAL SACRAL ARTERIES(arteriae sacrales laterales) - descend along the pelvic openings of the sacrum, laterally from them. Blood supply: the sacrum, its ligaments, the contents of the sacral canal, the long muscles of the back, the muscles of the pelvis and perineum - piriform, coccygeal, raising the anus.

SUPERIOR BUTTOCIAL ARTERY(arteria glutea superior) - exits the pelvic cavity through the large sciatic foramen above the piriformis muscle. Blood supply to the gluteus medius and minimus, piriformis, tensor fascia lata, and hip joint.

LOWER BUTTOCIAL ARTERY(arteria glutea inferior) - exits the pelvic cavity through the large sciatic opening under the piriformis muscle. Blood supply to the gluteus maximus, piriformis, adductors major and minor, obturator externus and internus, quadratus femoris, twin muscles, semitendinosus and semimembranosus muscles, long head of the biceps femoris.

obturator artery(arteria obturatoria) - follows along the side wall of the pelvis and passes through the obturator canal. Blood supply to: iliopsoas, quadratus femoris, levator ani, obturator internus and externus, adductors, pectineus, gracilis, femoral head.

Visceral branches

UMBILICAL ARTERY ( arteria umbilicalis) - plays a role in the period of placental circulation, after birth it is obliterated (forming a medial umbilical fold), and the artery of the vas deferens and the upper vesical arteries depart from the remaining short trunk.

UTERINE ARTERY ( arteria uterina) - as part of the broad ligament of the uterus, it goes to its neck, where it divides into branches to the vagina and fallopian tube and ovary.

LOWER URINARY ARTERY(arteria vesicalis inferior) - supplies blood to the lower parts of the bladder, and in men, the prostate gland and seminal vesicle.

MIDDLE RECTINAL ARTERY(arteria rectalis media) - passes along the bottom of the pelvic cavity to the middle section of the rectum.

INTERNAL GENITAL ARTERY ( arteria pudenda interna) - together with the pudendal nerve passes in the subpiriform opening and through the small sciatic opening penetrates into the sciatic-rectal fossa. It supplies blood to the lower third of the rectum (inferior rectal artery), skin and all muscles of the perineum (perineal arteries), external genitalia (dorsal artery of the penis (clitoris).

HEMOMICROCIRCULATION

HEMOMICROCIRCULATION- a part of the vascular system that provides metabolic processes between blood and tissues and connects the arterial and venous channels. In homogeneous tissues, the hemomicrocirculatory bed is represented by structural and functional units - functional microvascular modules. The module includes arteriole, precapillary, capillary, postcapillary and venule.

ARTERIOLA (arteriola) - a blood vessel, which ends the branching of the arteries, bringing the vessel of the hemomicrocirculatory bed. Its wall is formed by three membranes (intima, media and adventitia), but the middle membrane contains only one layer of smooth muscle cells. The diameter of the arteriole is 15-30 microns. Several arterioles close arterio-arteriolar loops, from which 2 to 6 precapillaries depart.

PRECAPILLARY(precapillare) - precapillary arteriole, the final section of the branching of the arteriole, passing into the capillaries. A characteristic feature of the precapillary is the presence of circular moyocytes at its beginning, where a precapillary sphincter is formed, which is involved in the regulation of blood flow in the hemomicrocirculatory bed. The diameter of the precapillary is 8-20 µm.

CAPILLARY (capillare) - the final part of the branching of the arterial system, the thinnest vessel formed by a single layer of endothelial cells on the basement membrane. In the capillaries, exchange takes place between blood, tissues and the interstitial space. The capillary diameter is from 2 to 20 microns. In the hematopoietic, endocrine organs, liver, the size of the capillaries reaches 30-40 microns, and they are called sinusoidal.

POSTCAPILLARY(postcapillare) - postcapillary venule, small venules with a diameter of 8-30 microns, into which a network of capillaries passes.

VENULA(venula) - the final section of the hemomicrocirculatory bed. The diameter of the venules is 30-100 microns. Separate myocytes and valves appear in the wall of venules.

ARTERIOL-VENULAR ANASTOMOSIS(anastomosis arteriovenularis) - a connection between an arteriole and a venule through which blood bypasses the capillary bed. The most important mechanism for regulating blood flow in the hemomicrocirculatory bed.

VIENNA

VIENNA ( vena) - a blood vessel that carries venous blood to the heart from organs and tissues. These blood vessels perform transport, draining, reflexogenic and depositing functions.

MORPHOLOGICAL FEATURES OF THE WALL OF THE VEINS - the intima of the veins forms valves in the form of pockets open in the direction of blood flow. The function of the valves is to prevent retrograde blood flow, since in most veins the blood moves against the gravity gradient. In the middle sheath of the veins, compared with the arteries, there are much fewer myocytes, and they are completely absent in the veins of the eye and venous sinuses of the dura mater. There are much fewer elastic fibers in the venous wall. Adventitia of the veins is associated with the connective tissue membranes of the surrounding organs, therefore, the lumen of the veins after the injury gapes, in the veins of the neck, where the pressure becomes negative when inhaled, this leads to the suction of air and the development of an air embolism. In the adventitia of the veins lying below the level of the heart there is a longitudinal layer of musculature.

FACTORS PROVIDING BLOOD MOVEMENT THROUGH THE VEINS - the propulsive effect of the heart (20% of the energy of the heart contraction goes to the movement of venous blood); suction action of the right atrium at the moment of diastole and chest at the moment of inspiration; contraction of the arteries and muscles lying next to the venous wall (massaging effect); contraction of the venous wall itself.

CAVO-CAVAL ANASTOMOUS ( anastomosis cavo-cavalis) - venous anastomosis between the tributaries of the superior and inferior vena cava. The most important in clinical and anatomical terms are the anastomoses between the superior and inferior epigastric veins, between the thoracic and inferior epigastric veins, between the unpaired and semi-unpaired and lumbar veins, and the venous plexuses of the spinal column.

PORTO-CAVAL ANASTOMOUS ( anastomosis porto-cavalis) - anastomosis between the tributaries of the hollow and portal veins. The most important in clinical and anatomical terms are anastomoses in the circumference of the navel between the paraumbilical, superior and inferior epigastric veins; in the wall of the rectum between the upper, middle and lower rectal veins; in the esophageal-gastric junction between the esophageal veins and the left gastric vein; between the veins of the kidney capsule and the tributaries of the splenic and superior mesenteric veins.

DEVELOPMENT OF THE VEINS

STAGES OF VEIN DEVELOPMENT- the first stage is the stage of formation of the primary capillary network. The second stage is the stage of mainstreaming of individual elements and the reduction of the rest. The beginning of the second stage occurs during the functioning of a simple tubular heart, which has a venous sinus. Initially, the mainization of four venous systems occurs: paired anterior cardinal veins; paired posterior cardinal veins (before flowing into the venous sinus, these veins merge to form common cardinal veins or Cuvier ducts); a system of two umbilical veins (carry arterial blood); two vitelline-mesenteric veins.

ANTERIOR CARDINAL VEINS ( venae cardinales anteriores) - embryonic venous highways (right and left), which divert blood from the part of the embryo that lies above the level of the heart bookmark.

posterior cardinal veins ( venae cardinales posteriores) - embryonic venous highways (right and left), which divert blood from the part of the embryo lying below the level of the anlage of the heart, mainly from the mesonephros.

umbilical vein ( vena umbilicalis) - exists only in the placental period of blood circulation, transfers arterial blood from the placenta to the circulatory system of the fetus. At the gates of the liver of the fetus is divided into two branches - one flows into the portal vein (portal sinus), the other - into the inferior vena cava (venous, duct of Arantia). Obliterated after birth.

vitelline-mesenteric veins ( venae omphalomesentericae) - they collect blood from the yolk sac and carry it through the umbilical ring to the venous system of the embryo.

TRANSFORMATIONS IN THE SYSTEM OF THE ANTERIOR CARDINAL VEINS - each vein drains blood from the anlage of the brain and from the early-forming thyroid and thymus glands. Blood from the glands goes both to the right and to the left. When the heart is divided into two halves, the conditions for blood flow become easier for direction from left to right, and a vessel becomes mainstream from the system of veins of the thymus and thyroid glands, which is preserved in an adult in the form of the left brachiocephalic vein. Veins from the anlage of the left upper limb grow to the place where this vein begins. The veins of the right limb open at the same level. The final segments of the veins of the extremities are preserved as subclavian veins. Segments of the anterior cardinal veins above the subclavian veins are retained as the internal jugular veins, the external and anterior jugular veins appear later. The section of the right anterior cardinal vein between the subclavian vein and the confluence of the left brachiocephalic vein forms the right brachiocephalic vein. The remainder of the right anterior cardinal vein and the entire right common cardinal (right Cuvier) vein become the superior vena cava. When the heart descends, these veins take their proper position. The left anterior cardinal vein and almost all of the left common cardinal vein are reduced. The remaining small part of the left common cardinal vein is transformed into the coronary sinus of the heart.

TRANSFORMATIONS IN THE SYSTEM OF THE REAR CARDINAL VEINS - together with the reduction of the mesonephros, these veins are reduced, but they are replaced by two more pairs of veins. The first pair are the subcardinal veins. They lie ventromedial. The second pair are the supracardinal veins. They are located dorsolaterally. Quite quickly, four anastomoses are formed between these highways. 1) - iliac anastomosis - connects both posterior cardinal and both supracardinal veins 2) renal - connects all veins 3) is formed from a chain of veins connecting the middle of the renal anastomosis with the venous sinus, 4) thoracic - connects both supracardinal veins. Further, the processes of general reduction take place: both posterior cardinal veins are reduced, except for the segments below the iliac anastomosis - they become mainline and veins grow to them from the anlages of the lower extremities; both subcardinal veins are reduced above the renal anastomosis, and their sections below this anastomosis are preserved as gonadal veins; the right supracardinal vein above the renal anastomosis trunks into the azygous vein; the left supracardinal vein above the thoracic anastomosis becomes an accessory semi-unpaired vein; the remnant of the left supracardinal vein above the renal anastomosis and the thoracic anastomosis itself form the semi-azygous vein. The inferior vena cava is formed from several fragments: its subrenal part is formed from the right supracardinal vein, extending from the renal to iliac anastomosis; the renal part of the inferior vena cava is formed from the right part of the renal anastomosis. The remaining fragment of the right half of the renal anastomosis becomes the right renal vein; the adrenal and hepatic parts of the inferior vena cava are formed from the anastomosis connecting the renal anastomosis to the heart; the left half of the renal anastomosis becomes the left renal vein; the section of the left supracardinal vein between the renal and iliac anastomosis is reduced, and the iliac anastomosis itself is preserved as the common iliac veins.

TRANSFORMATIONS IN THE UMBILICAL VEINS SYSTEM - early lose pairing in the umbilical cord and initially carry blood directly to the heart. In this case, there is a connection with the mesenteric veins in the laying of the liver. Further, within the abdominal cavity, the right umbilical vein is reduced, and the left one loses its connection with the intrahepatic veins and divides into 2 trunks under the liver. One of them flows into the portal vein, and the other, called the venous (Aranic) duct, opens into the inferior vena cava.

TRANSFORMATIONS IN THE SYSTEM OF VYOLOCOLIC-MESENTERIC VEINS - vitelline-mesenteric veins in the early stages divert blood from the yolk sac and the wall of the primary intestine. Then the yolk sac is reduced and the veins carry blood only from the primary intestine, i.e. they become mesenteric veins. Before flowing into the heart, these veins are surrounded by the anlage of the liver. The prehepatic segments lose their pairing and become the portal vein and its tributaries. The intrahepatic part forms a system of veins, which includes interlobular, perilobular, capillaries of the hepatic lobules, central veins, and collecting veins. The suprahepatic segments become the hepatic veins (3-4), which, through complex transformations, merge into the inferior vena cava.

ANOMALIES OF VEINS - doubling of the hollow veins; absence of the inferior vena cava with compensatory development of the unpaired and semi-unpaired veins; confluence of the inferior vena cava into the coronary sinus of the heart.

VEIN CLASSIFICATION

Corresponding to the arteries:

Veins of the systemic circulation;

Veins of the pulmonary circulation.

For venous pools:

Veins of the system of the superior vena cava;

Veins of the system of the inferior vena cava;

Veins of the portal vein system;

Veins of the heart.

By region:

Trunk veins;

limb veins;

Veins of the head and neck.

PARTICULAR ANATOMY OF THE VEINS

The iliac artery is the largest paired blood vessel after the aorta, five to seven centimeters long and 11 to 13 mm in diameter. The arteries originate at the bifurcation of the aorta, at the level of the fourth lumbar vertebra. At the articulation of the iliac bones and the sacrum, they split into the external and internal iliac arteries.

The internal artery splits into branches - the middle rectal, iliac-lumbar, sacral, lateral, lower and upper gluteal, lower bladder, internal genital, obturator. They deliver blood to the organs and inner walls of the pelvic cavity.

The external artery, leaving the pelvic cavity, simultaneously gives its walls several branches and continues in the region of the lower extremities in the form of the femoral artery. Branches of the femoral artery (deep artery, inferior epigastric artery) deliver blood to the skin and muscles of the thighs and then branch into smaller arteries to supply the foot and lower leg.

In men, the iliac artery delivers blood to the testicular membranes, thigh muscles, bladder, and penis.

Aneurysm of the iliac artery

An aneurysm of the iliac artery is a saccular protrusion of the vessel wall. The wall of the artery gradually loses elasticity and is replaced by connective tissue. The causes of aneurysm formation can be hypertension, trauma, atherosclerosis.

An aneurysm of the iliac artery for a long time can proceed without any special symptoms. Pain at the location of the aneurysm occurs if it, reaching a large size, begins to compress the surrounding tissues.

An aneurysm rupture can cause gastrointestinal bleeding of unknown etiology, a drop in blood pressure, a decrease in heart rate, and collapse.

Violation of the blood supply in the area of the aneurysm can lead to thrombosis of the femoral artery, the arteries of the lower leg, and also the vessels of the pelvic organs. Blood flow disorders are accompanied by dysuric disorders, pain. Thrombus formation in the arteries of the lower leg sometimes leads to the development of paresis, intermittent claudication and the appearance of sensory disturbances.

An aneurysm of the iliac artery is diagnosed using ultrasound with duplex scanning, computed tomography, MRI, angiography.

Occlusion of the iliac arteries

Occlusion and stenosis of the iliac artery most often occur due to obliterating thromboangiitis, atherosclerosis of the arteries, fibromuscular dysplasia, aortoarteritis.

With stenosis of the iliac artery, tissue hypoxia develops, disrupting tissue metabolism. A decrease in oxygen tension in tissues leads to metabolic acidosis and the accumulation of underoxidized metabolic products. At the same time, the aggregation and adhesive properties of platelets increase, and the disaggregation properties decrease. The viscosity of the blood increases, and this inevitably leads to the formation of blood clots.

There are the following types of iliac artery occlusion (depending on the etiology): nonspecific aortitis, mixed form of arteritis, aortitis and atherosclerosis, iatrogenic, post-embolic, post-traumatic occlusions. Depending on the nature of the lesion, chronic occlusion, acute thrombosis, stenosis are distinguished.

Occlusion of the iliac arteries is accompanied by a number of syndromes. The syndrome of ischemia of the lower extremities manifests itself in the form of paresthesia, easy fatigue and intermittent claudication, numbness and chilliness of the lower extremities. Impotence syndrome manifests itself in ischemia of the pelvic organs and chronic circulatory failure of the lower parts of the spinal cord.

Conservative treatment of iliac artery occlusion is used to normalize blood coagulation processes, relieve pain, expand collaterals and relieve vascular spasms.

In the case of conservative therapy of affected vessels, the following drugs can be used:

means of ganglioblocking action (mydocalm, bupatol, vasculate);
pancreatic agents (dilminal, angiotrophin, andekalin);
antispasmodic drugs (no-shpa, papaverine).

Indications for surgical intervention are:

severe intermittent claudication or pain at rest;
necrotic changes in the tissues of the limb (urgent operation);
embolism of large and medium arteries (emergency operation).

Methods of surgical treatment of occlusion of the iliac arteries:

resection of the affected area of the artery and its replacement with a transplant;
endarterectomy - opening the lumen of the artery and removing plaques;
combination of shunting and resection with endarterectomy;
lumbar sympathectomy.

Currently, the method of X-ray endovascular dilatation is quite often used to restore arteries affected by stenosis. This method is successfully used as an addition to reconstructive operations for multiple vascular lesions.

The internal iliac artery (a. iliaca interna) steam room, 2-5 cm long, is located on the lateral wall of the pelvic cavity. At the upper edge of the large sciatic foramen, it is divided into parietal and visceral branches (Fig. 408).

Parietal branches of the internal iliac artery: 1. The iliac-lumbar artery (a. iliolumbalis) branches off from the initial part of the internal iliac artery or from the superior gluteal, passes behind n. obturatorius, a. iliaca communis, at the medial edge of m. psoas major is divided into lumbar and iliac branches. The first vascularizes the lumbar muscles, spine and spinal cord, the second - the ilium and iliac muscle.

2. The lateral sacral artery (a. sacralis lateralis) (sometimes 2-3 arteries) branches off from the posterior surface of the internal iliac artery near the third anterior sacral opening, then, descending along the pelvic surface of the sacrum, gives branches to the membranes of the spinal cord and pelvic muscles.

3. Superior gluteal artery (a. glutea superior) - the largest branch of the internal iliac artery, penetrates from the pelvic cavity into the gluteal region through for. suprapiriforme.

On the posterior surface of the pelvis, it is divided into a superficial branch for blood supply to the gluteus maximus and medius muscles and a deep branch for the gluteus minimus and medius, the capsule of the hip joint. Anastomoses with the lower gluteal, obturator and branches of the deep femoral artery.

4. The lower gluteal artery (a. glutea inferior) goes to the back of the pelvis through for. infrapiriforme together with the internal pudendal artery and sciatic nerve. It supplies blood to the gluteus maximus and quadratus femoris, the sciatic nerve and the skin of the gluteal region. All parietal branches of the internal iliac artery anastomose with each other.

5. The obturator artery (a. obturatoria) is separated from the initial part of the internal iliac artery or from the superior gluteal artery and through the obturator canal goes to the medial part of the thigh between m. pectineus and m. obturatorius internus. Before the obturator artery enters the canal, it is located on the medial side of the femoral fossa. On the thigh, the artery is divided into three branches: internal - for blood supply to the internal obturator muscle, anterior - for blood supply to the external obturator muscle and skin of the genital organs, posterior - for blood supply to the ischium and head of the femur. Before entering the obturator canal, the pubic branch (r. pubicus) is separated from the obturator artery, which at the symphysis is connected to branch a. epigastric inferior. The obturator artery anastomoses with the inferior gluteal and inferior epigastric arteries.

Visceral branches of the internal iliac artery: 1. The umbilical artery (a. umbilicalis) is located under the parietal peritoneum on the sides of the bladder. In fetuses, it then enters the umbilical cord through the umbilical opening and reaches the placenta. After birth, part of the artery from the side of the navel is obliterated. From its initial section to the top of the bladder departs the superior vesical artery (a. vesicalis superior), which supplies blood not only to the bladder, but also to the ureter.

2. The lower vesical artery (a. vesicalis inferior) goes down and forward, enters the wall of the bottom of the bladder. It also vascularizes the prostate gland, seminal vesicles, and in women, the vagina.

3. The artery of the vas deferens (a. ductus defferentis) sometimes departs from the umbilical or superior or inferior cystic arteries. In the course of the vas deferens, it reaches the testis. Anastomoses with the internal spermatic artery.

4. The uterine artery (a. uterina) is located under the parietal peritoneum on the inner surface of the small pelvis and penetrates into the base of the wide uterine ligament. At the cervix, it gives a branch to the upper part of the vagina, rises up and, on the lateral surface of the cervix and body of the uterus, gives corkscrew-shaped branches into the thickness of the uterus. At the angle of the uterus, the terminal branch accompanies the fallopian tube and ends at the hilum of the ovary, where it anastomoses with the ovarian artery. The uterine artery crosses the ureter twice: once - on the side wall of the pelvis near the iliac sacral joint, and again - in the broad ligament of the uterus near the uterine neck.

5. The middle rectal artery (a. rectalis media) goes forward along the pelvic floor and reaches the middle part of the rectum. Supplies blood to the rectum, m. levator ani and external sphincter of the rectum, seminal vesicles and prostate gland, in women - the vagina and urethra. Anastomoses with the superior and inferior rectal arteries.

a) perineal artery (a. rerinealis), which supplies blood to the muscles of the perineum, scrotum or labia majora;

b) the artery of the penis (a. penis) at the site of fusion of the right and left mm. transversi perinei superficialises penetrates under the symphysis and divides into the dorsal and deep arteries. The deep artery supplies blood to the cavernous bodies. In women, the deep artery is called a. clitoridis. The dorsal artery is located under the skin of the penis, supplies blood to the scrotum, skin and glans penis;

c) the arteries of the urethra supply blood to the urethra;

d) the vestibulo-bulbous artery supplies blood to the vagina and spongy tissue of the bulb of the vestibule of the vagina.

The structure of the iliac artery includes an external and internal canal. They nourish the organs of the pelvic region, muscles and skin of the thigh, provide blood supply to the lower leg and foot, and affect the activity function of the lower extremities.

Anatomy and function of the common iliac artery system

The common iliac artery originates from the fourth lumbar vertebra at the point where the aorta bifurcates. It is considered one of the largest: a paired vessel 5–7 centimeters long and 11–13 mm in diameter.

In the area of articulation of the sacrum and bones, it is divided into two parts: internal and external.

internal iliac artery

Delivers blood to all organs and walls of the pelvis. It diverges into the following branches:

middle rectal;
ilio-lumbar;
sacral;
lateral;
obturator;
lower and upper gluteal;
internal sexual;
lower bladder;
uterine.

In addition to these parts, the branches of the internal iliac artery are divided, in turn, into parietal and visceral.

External iliac artery

It leaves the pelvic cavity and then diverges along the walls, stretches to the lower extremities and into the femoral canal. It branches into the lower and deep epigastric parts, which supply blood to the skin of the thigh and muscles. It divides into smaller arteries that feed the legs and feet.

The external iliac artery consists of channels that saturate the abdomen, genitals, and pelvic muscles.

The epigastric lower branch continues along the rectus abdominis. It passes into the inguinal, pubic, which nourish the membranes of the testicles or uterus.

The deep artery goes around the bone. It starts from the inguinal ligament and follows in parallel, provides blood supply to the abdomen and muscles:

transverse;
tailor;
oblique;
straining.

parietal branches

The lumbar-iliac canal runs behind the large muscle of the lumbar region, stretches to the muscle of the same name and bone. It supplies blood to the membranes and nerve endings of the spinal cord.

The sacral lateral arteries feed:

spinal cord;
back muscles;
sacrum;
coccyx;
piriformis muscle;
muscle that lifts the anus.

The obturator canal stretches along the sides and in front of the small pelvis, its branches: pubic, anterior and posterior. These vessels provide blood to:

hip joint;
femur;
adductor, obturator muscles;
genital skin;
pubic symphysis.

The gluteal inferior artery stretches through the opening from the small pelvis, supplies blood to the skin in this area, nourishes:

biceps femoris;
hip joint;
adductor, semitendinosus, obturator, piriformis muscle.

Gluteus superior extends through the suprapiriform opening to the skin and muscles of the buttocks, is divided into superficial and deep branches that nourish the hip joint, skin and muscles of the buttocks.

Visceral branches

The umbilical vessel passes behind the surface of the abdominal wall, stretches to the navel. The main part after birth is not active, it is a ligament. Small functions - feeds the bladder, ureter, vas deferens.

The uterine artery follows the uterus, crosses with the ureter, supplies the tubal, vaginal, ovarian branches. Saturates the fallopian tubes, ovaries, vagina.

The rectal artery runs directly to the rectum, is responsible for the blood supply:

lower and middle sections of the rectum;
anus;
ureter;
prostate;
vagina;
seminal vesicles.

The genital branch of the iliac artery is located in the buttocks. Passes through the pear-shaped opening into the small pelvis. Nourishes the genital external organs, perineum, urethra.

Pathology of the artery

The vessel is especially vulnerable to the development of pathologies that pose a serious threat to human life. In case of violation of the patency of the channel, it is noted:

pale skin;
fragility of nails;
amyotrophy;
foot ulcers;
gangrene of fingers;
impaired motor function of the limbs.

The most common diseases are atherosclerosis and aneurysm.

With atherosclerosis, cholesterol plaques appear on the walls of the vessel. They cause narrowing of the lumen and prevent the passage of blood. The disease must be treated so that there are no complications.

Perhaps the development of occlusion - a complete blockage of the vessel, in which fatty deposits grow, sticking of epithelial cells and blood occurs. Cholesterol plaques provoke stenosis - vasoconstriction. As a result, hypoxia and metabolic disorders occur. Due to oxygen starvation, acidosis develops - the accumulation of metabolic products. The viscosity of the blood increases, blood clots form.

Occlusion can develop against the background of:

thromboangiitis obliterans;
embolism;
fibromuscular dysplasia;
aortoarteritis.

With this pathology develops:

syndrome of ischemia of the lower extremities, in which fatigue, numbness, chilliness of the legs, lameness occur;
impotence syndrome - occurs due to a violation of the blood supply to the lower back in the pelvic area.

Aneurysm is a fairly rare disease that develops against the background of atherosclerosis. Protrusions form on the walls of large vessels, weakened by plaques. The canal wall becomes less elastic and is replaced by connective tissue. An aneurysm can be caused by trauma or hypertension. This pathology may not manifest itself for a long time. As the saccular protrusions grow, they put pressure on the organs, making blood flow difficult.

Possible complications:

aneurysm rupture;
bleeding;
strong pressure drop;
collapse.

In the event of a violation of the blood supply in the aneurysm, thrombosis of the femoral artery or vessels of the pelvic organs can form. This leads to a violation of the sensitivity of the legs, lameness, paresis.

An aneurysm can be diagnosed with:

Ultrasound with duplex scanning;
Computed tomography;
angiography.

Treatment of diseases of the iliac artery

With occlusion of the iliac artery, it is necessary to normalize blood clotting, stop pain and relieve vasospasm. Medical treatment or surgery will be required.

For conservative treatment use:

painkillers;
antispasmodics (No-shpa, Papaverine);
drugs to reduce blood clotting.

If conservative methods fail, the patient is scheduled for surgery. The plaques are surgically removed and the affected area is excised, replaced with a graft.

An aneurysm is treated with surgery to prevent thrombosis and rupture of the vessel.

To maintain the health of veins and arteries, you need to monitor the general condition of the body. It is important to eat natural products, give up fats in order to avoid an increase in cholesterol in the blood, spend more time in the fresh air and play sports.

The abdominal aorta at the level of the IV lumbar vertebra is divided into two common iliac arteries (aa. iliacae communes) with a diameter of 11 - 12 mm and a length of 7 cm, each following along the medial edge of m. psoas major. At the level of the upper edge of the sacroiliac joint, these arteries are divided into internal (a. iliaca interna) and external (a. iliaca externa) iliac arteries (Fig. 408).

internal iliac artery

The internal iliac artery (a. iliaca interna) is a steam room, 2–5 cm long, located on the lateral wall of the pelvic cavity. At the upper edge of the large sciatic foramen, it is divided into parietal and visceral branches (Fig. 408).

408. Arteries of the pelvis.
1 - aorta abdominalis; 2-a. iliaca communis sinistra; 3-a. iliaca communis dextra; 4-a. iliaca interna; 5-a. iliolumbalis; 6-a. sacralis lateralis; 7-a. glutea superior; 8-a. glutea inferior; 9-a. prostatica; 10-a. rectalis media; 11-a. vesicae urinariae; 12-a. dorsalis penis; 13 - ductus deferens; 14-a. deferentialis; 15-a. obturatoria; 16-a. umbilicalis; 17-a. epigastric inferior; 18-a. circumflexa ilium profunda.

3. Superior gluteal artery (a. glutea superior) - the largest branch of the internal iliac artery, penetrates from the pelvic cavity into the gluteal region through for. suprapiriforme.

4. The lower gluteal artery (a. glutea inferior) goes to the back of the pelvis through for. infrapiriforme along with the internal pudendal artery and sciatic nerve. It supplies blood to the gluteus maximus and quadratus femoris, the sciatic nerve and the skin of the gluteal region. All parietal branches of the internal iliac artery anastomose with each other.

6. The internal pudendal artery (a. pudenda interna) is the terminal branch of the visceral trunk of the internal iliac artery. Through for. infrapiriforme extends to the posterior surface of the pelvis through for. ischiadicum minus penetrates into the fossa ischiorectalis, where it gives branches to the muscles of the perineum, rectum and external genitalia. It is divided into branches:
a) perineal artery (a. rerinealis), which supplies blood to the muscles of the perineum, scrotum or labia majora;
b) the artery of the penis (a. penis) at the site of fusion of the right and left mm. transversi perinei superficiales penetrates under the symphysis and divides into the dorsal and deep arteries. The deep artery supplies blood to the cavernous bodies. In women, the deep artery is called a. clitoridis. The dorsal artery is located under the skin of the penis, supplies blood to the scrotum, skin and glans penis;
c) the arteries of the urethra supply blood to the urethra;
d) the vestibulo-bulbous artery supplies blood to the vagina and spongy tissue of the bulb of the vestibule of the vagina.