 So this is basically a demonstration of the arterial supply inside the pelvis So this is the male pelvis will demonstrate the vessels on the right side This is the termination of the sigmoic colon and continue as a rectum and in front of this is the bladder So this is the rectum a cycle septum and the rectum a cycle pouch is the male We have retracted the urethra and everything so let's start off with the bifurcation of the abdominal aorta bifurcation the level of l4 This is the left common alia right common alia We'll focus on the right side the right common alia intern divides into an external alia Which comes out under the inguinal ligament and it becomes known as the femoral arch So we are standing on the left side of the cadaver, but we are showing the vessels on the Right side Let's focus on the internal alia with its accompanying way So this is the right side internal alia Let us look at the distribution of the right side internal alia The internal alia divides into two principal divisions The first one that we see here is this one here This is the posterior division of the internal alia The posterior division of the internal alia The posterior division has got the following branches and we can see them one by one The first one that we see here is this artery here This is the ilio lumber artery Which goes up and posteriorly it's the smallest branch and it's an astromosis with the l5 lumber artery and It also an astromosis indirectly with the Deep circumflex ilio artery that is the first branch of the posterior division The second branch of the posterior division is this one here This is the lateral sacral artery which runs medially It an astromosis with the medial sacral artery and an astromosis with the lateral sacral artery of the opposite side and forms an Anastomotic circle around the front of the sacral The accompanying vein of the lateral sacral artery the lateral sacral veins They are the sides of drainage of cancer from the pelvic organs to the vertebra and to the brain The third branch of the posterior division is This one here This is the superior gluteal artery which exits the pelvis to the Greater sciatic foramen About the piriformis. This is the superior gluteal artery. So we have the ilio lumber lateral sacral and the superior gluteal In this case the posterior division of the internal iliac is also giving rise to the inferior gluteal Though strictly speaking it should come out from the Anteater division and the inferior gluteal artery comes out from the greater sciatic foramen below the piriformis And it supplies the gluteal region and it participates in various types of anastomosis Now let us come to the anterior division. This is the anterior division of the internal iliac The first branch that we see here is the umbilical artery The proximal part of the umbilical artery is patent and it supplies the bladder and it gives a branch Which is known as the superior vesicle artery and we can see that here superior vesicle artery. This is the bladder the rest of the umbilical artery then becomes known as the umbilical ligament and it continues as the medial umbilical fold towards the umbilicus The next set of branches that we see here are Inferior vesicle artery. Inferior vesicle arteries are present only in the males in the females They are absent and they're replaced by vaginal arteries The third branch that we see here is this one This is the Optorator artery and we can see the operator artery with its accompanying operator vein and the operator nerve Exiting the pelvis through the operator canal in the operator foramen. So this is the operator artery The next branch that we see here is the middle rectal artery The middle rectal artery runs in the lateral ligament of the rectum and this is a branch from the middle rectal artery Incidentally, this is the superior rectal artery which is the downward continuation of the inferior miscentric artery Next we have this branch here from the anterior division This is the internal pudendal artery which also exits the pelvis through the greater sciatic foramen below the piriformis and Then it enters through the lesser sciatic foramen and enters the pudendal canal and it supplies the perineum and as I told you The last branch ideally should have been the inferior gluteal artery But in this case the inferior gluteal artery is arising from the posterior division The inferior gluteal artery is the last branch which also exits the pelvis through the greater sciatic foramen below the piriformis And it supplies the gluteal region. So these are the various branches that we can see arising from the internal idea I need to mention two other things Again on the right side This is the location of the internal Inguinal ring which is an opening in the fascia transversalis and we can see Emerging from the internal inguinal ring is this vascular structure here. This is the Testicular vein coming from the inferior vena keva and this is the testicular artery and both of them are emerging from the internal ring They're entering the problem and moving laterally Also entering is this structure here This is the doctor's difference which is moving immediately and Just below these two we have the external aliaic artery and the external aliaic vein So this triangular region that we saw here This is referred to as the triangle of doom During laparoscopic hernia surgery when the laparoscopic surgeon is operating from inside the abdomen This is the region that he has to operate in to remove the indirect inguinal hernia sac And in the process he is likely to injure the external aliaic vessels That is why this triangular region is referred to as the triangle of doom The next point which I want to mention was this artery that we see here and the accompanying vein This is the continuation of the inferior miscentric artery and we can see the other branches here The inferior miscentric artery continues into the pelvis and here it is known as the superior rectal artery And the accompanying vein is the superior rectal vein This is also an artery of the pelvis. The important point to be remembered is that the superior rectal vein Continuous as the Inferior miscentric vein which has been removed. So therefore the superior rectal vein belongs to the portal circulation The middle rectal vein which accompanies the middle rectal artery drains into the internal aliaic vein and The inferior rectal vein opens into the internal pudendal vein which also belongs to the systemic circulation So therefore the alorectal junction is an important site of portasystemic anastromosis Upper part being portal the lower part being systemic and that is the site of internal hemorrhoids So that is the other point which I wanted to show you regarding the vascular system Incidentally we can see this is The inferior epigastric artery which is a branch of the External aliaic and we can see it is coming out from the external aliaic As it is running on the posterior surface of the right rectus abdominis It is giving rise to one small accessory artery which is curving around and it is entering through the operative foramen This is referred to as the corona mortis artery which can be injured in surgery For the femoral hernia in females. So that is all for now. Thank you very much for watching Have a nice day. Dr. Sanjay Sanyal