Arteries and veins of the pelvis

The pelvis contains numerous structures, all supplied by the neurovascular structures of the pelvis, including nerves, arteries, veins, and lymph nodes. These structures are found on the posterolateral walls of the pelvic cavity.

Lymph nodes are usually clustered around the veins, and lymph vessels that come off these nodes ascend parallel to the veins. Let's focus our attention on the arteries and veins of the pelvis.

Now, the arteries of the pelvis originate from the abdominal aorta, which is the continuation of the thoracic aorta below the aortic hiatus in the diaphragm. The abdominal aorta gives branches to various organs in the abdomen, then divides at the level of the fourth lumbar vertebra into the right and left common iliac arteries.

Each artery runs inferolaterally, and ends at the level of the intervertebral disc between L5 and S1 by dividing into the internal and external iliac arteries. Let’s talk about each of those branches. First are the external iliac arteries, which descend on the medial border of a muscle called the psoas major.

After running for a short distance, each external iliac artery gives two branches, called the inferior epigastric and deep circumflex iliac arteries. These branches supply the anterolateral aspect of the abdominal wall. Then, each external iliac artery passes underneath the inguinal ligament to become the femoral artery, which is the main artery that supplies the lower limbs.

Next are the internal iliac arteries, which are the main arteries of the pelvis, and also supply parts of the gluteal region, medial thigh, and perineum. The branching pattern of the internal iliac arteries is one of the most variable in the body, so in order to identify each branch we must think about the structures they are nourishing.