When internal iliac A. is ligated to control pelvic hemorrhage, ligation doesn't stop the blood flow due to the 3 arterial anastomosis (lumbar to iliolumbar, median sacral to lateral sacral & superior rectal to middle rectal) this maintain blood supply to pelvic viscera, gluteal region & genital organs.

 

artery

External

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P6rin**l artery

sErstal ariBry

PoslErior

scmtal artBry

o lnferior Vesical artery: lt supplies the seminal vesicles,

prostate, urinary bladder & artery of the Vas.

G- Branches specific to Females

o Vaqinal afterv: to the vagina & urinary bladder.

o Uterine artery: to the uterus. lt anastomoses with the ovarian

a.

D- Two terminal branches of anterior division

a. lnferior gluteal aftery @elow Piriformis).

b. lnternal pudendal artery @elow Piriformis).

Il. Posterior division

1) lliolumbar artery: it gives

- lleal branch to iliacus muscle.

- Lumbar branch to quadrates lumborum.

Lateral sacral artery (2 branches)

Superior gluteal artery (passes through gi'eater sciatic forarncn)

N.B.

When internal iliac A. is ligated to control pelvic hemorrhage, ligation doesn't stop the

blood flow due to the 3 arterial anastomosis (lumbar to iliolumbar, median sacral to

lateral sacral & superior rectal to middle rectal) this maintain blood supply to pelvic

viscera, gluteal region & genital organs.

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I PELVTS & PEFUNEUM

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The functional requirements of the

lower limb are weight bearing,

locomotion, and maintenance of

equilibrium. As such, it is constructed

for strength at the cost of mobility.

The lower limb is divided into four

parts: hip, thigh, leg, and foot .

THE HIP BONE: f rium

Features: lt is formed by fusion of 3 Oonesl Pubis

A.ilium: has: L Ischium

1. Body: forms the upper 215 ol the acetabulum.

2. 3 borders: anterior, posterior & superior (iliac crest).

3. 3 surfaces: iliac fossa, sacro-pelvic surface & gluteal surface.

B.lschium: has:

1 . Body: forms the posterior 215 of the acetabulum.

2. lschial spine: separates the greater sciatic notch from the lesser sciatic

notch.

3. lschialtuberosity: gives origin to the hamstring muscles.

4. lschial ramus:joins the inferior pubic ramus to form conjoined ischiopubic ramus.

C. Pubis: has:

1. Body: its upper border forms the pubic crest which ends laterally by

pubic tubercle.

2. Superior ramus: reaches the acetabulum & forms the anterior 115.

3. lnferior ramus:joins the ischial ramus.

Surqical importance:

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Occurs most commonly due to crushing force and leads to fracture of ala

of ilium & the conjoined ischio-pubic ramus.

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THE FEMUR:

Features:

The femur is the longest and strongest bone in the body.

It consists of upper end, shaft and lower end.

1. Upper end: consists of:

. Head: has a fovea for the round ligament.

. Neck: forms an angle af 12A" with the shaft.

. Greater trochanter: projects laterally.

. Lesser trochanter: projects postero-medially.

2. Shaft:

o lt has 3 surfaces (anterior, medial & lateral).

. lts posterior border is thick & shows spiral line called linea aspra.

. The posterior aspect of upper % shows spiral line (medially) & gluteal

tuberosity (laterally).

. The posterior aspect of lower % shows popliteal surface between medial &

lateral supra-condylar ridges.

3. Lowerend: shows:

o 2 condyles: medial & lateral.

o 2 epicondyles.

o Adductor tubercle: at the lower end of the medial supra-condylar ridge.

LOWE LrMB I

Surgical importance:

Blood supply of the head of femur:

1) An artery in the round ligament of the head (little supply).

2) The retinacular vessels in the reflected part of capsule (main

supply)

3) Ascending branch of the nutrient artery in the shaft.

Fracture neck of femur: occurs commonly in old females & leads to

avascular necrosis of the femoral head.

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I LOWE UMB

2 condyles & tibial tuberosity Head, neck & styloid process,

3borders&3surfaces 3borders&3surfaces

Large & projects down medially

forming the medial malleolus.

Smaller than that of tibia &

called lateral malleolus

Surqical

importance

Liable to fracture as its medial *

su rface a anterioiio;;;;;' *

subcutaneous (has no muscular

attachment)

Upper end of tibia is one of the most

common sites of acute osteomyelitis

ldeal bone for grafting as it is

not weight bearing

Lower end of fibula is fractured

spirally in the 1't stage of Pott's

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