Wednesday, February 6, 2013

Uterine Vascular Supply

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Each of these vessels may become of great importance, either because of the general increase in blood supply accompanying the growth, or in consequence of the shutting off of other supply, by ligature or otherwise.

 The artery of the round ligament, or the external spermatic , is of least importance .
  It unites the external iliac artery with the uterine artery, and through this with the internal iliac, arising as it does from the epigastric or circumflex iliac. 

Quain speaks of it as an unimportant branch given off from the ovarian artery. It gives off three branches :

 1. Ramifies under the peritoneum. 
 2. Unites circumflex iliac with epigastric. 
 3. Largest, and most anterior, penetrates the round ligament, and courses within it towards the uterus. 

Some branches of this, before entering, also supply the peritoneum. When the round ligament is split longitudinally, the artery is seen in its centre.

 The vessel is very convoluted and is about the same size at each end. It is accompanied by a vein.
 Ending by anastomosis with the salpingo-ovarian branch of the uterine artery, or with the anterior tubal branch of the same artery, it thus forms a direct communication between the external iliac and uterine arteries. 

The union, says Fredet, is by a large opening between one or two branches. The subperitoneal branches given off at first, very fine and numerous, inosculate with similar ones given off from the uterine. The Ovarian or Internal Spermatic Artery. — The ovarian artery leaves the aorta in the neighbourhood of the renal artery, about half-way between this and the inferior mesenteric.

 It crosses the ureter obliquely, and lies upon the psoas muscle, as it passes downwards and outwards ; at the brim of the true pelvis it turns inwards ; at first straight,
 it becomes tortuous and ends at the outer corner of the ovary, where it anastomoses with the ovarian and tubal branches of the uterine artery. 

It also sends a special anastomotic branch to the uterine artery. The veins accompany- ing it are much larger. Some branches are given off from it at

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