The artery known as the arteria pudenda plays a crucial role in supplying blood to the perineal region, including the external genitalia and surrounding muscles. Understanding its origin, course, and branches is fundamental for medical professionals, especially those specializing in anatomy, surgery, and urology. The question De dónde viene la arteria pudenda?” or “Where does the pudendal artery come from?” is key in grasping pelvic vascular anatomy. This artery originates from a larger arterial trunk and follows a distinct path that allows it to supply important areas of the pelvis and perineum. In this topic, we explore the origin, anatomy, and clinical significance of the arteria pudenda, providing a clear and detailed explanation that benefits both students and healthcare providers.
Origin of the Arteria Pudenda
The arteria pudenda, specifically the internal pudendal artery, is a branch of the internal iliac artery. The internal iliac artery itself is a major vessel that arises from the common iliac artery, which bifurcates from the abdominal aorta at the level of the fourth lumbar vertebra. The internal iliac artery descends into the pelvis and divides into anterior and posterior trunks, with the internal pudendal artery typically arising from the anterior division.
Common Iliac Artery and Internal Iliac Artery
The abdominal aorta bifurcates into two common iliac arteries, one on each side of the body. Each common iliac artery further divides into an external iliac artery, which continues toward the lower limb, and the internal iliac artery, which supplies the pelvic organs and perineum. The internal iliac artery is essential in pelvic circulation and gives rise to several important branches, including the arteria pudenda interna (internal pudendal artery).
Anatomy and Path of the Internal Pudendal Artery
After arising from the anterior division of the internal iliac artery, the internal pudendal artery follows a complex course to reach the perineal region. It exits the pelvis through the greater sciatic foramen, passing below the piriformis muscle. Immediately afterward, it curves around the sacrospinous ligament and re-enters the pelvis through the lesser sciatic foramen, entering the pudendal canal (also known as Alcock’s canal) in the lateral wall of the ischioanal fossa.
Course Through the Pudendal Canal
Within the pudendal canal, the internal pudendal artery travels alongside the pudendal nerve and internal pudendal veins. This canal acts as a protective sheath for these neurovascular structures as they supply the perineal muscles, external genitalia, and skin. The artery then gives off several branches that supply blood to various parts of the external genitalia, including the penis or clitoris, perineum, and anal region.
Branches of the Internal Pudendal Artery
The internal pudendal artery is responsible for multiple smaller branches that cater to different tissues and structures in the perineal area. Some of the main branches include
- Inferior Rectal ArterySupplies the lower rectum and anal canal.
- Perineal ArterySupplies the superficial perineal muscles and skin.
- Artery of the Bulb of the Penis (or Vestibule)Supplies the bulb of the penis in males and vestibular bulbs in females.
- Deep Artery of the Penis (or Clitoris)Supplies erectile tissue in the penis or clitoris.
- Dorsal Artery of the Penis (or Clitoris)Supplies the skin and fascia of the dorsal surface of the penis or clitoris.
Clinical Importance of Knowing the Origin of the Arteria Pudenda
Understanding the origin and course of the internal pudendal artery is vital in various clinical settings. This knowledge is essential for surgeons performing pelvic or perineal surgeries, urologists managing erectile dysfunction, and interventional radiologists conducting embolization procedures. Injuries or occlusions of this artery can lead to complications such as ischemia, erectile dysfunction, or inadequate healing of perineal wounds.
Surgical Considerations
During surgeries such as hemorrhoidectomy, prostatectomy, or perineal repairs, the internal pudendal artery and its branches must be carefully preserved to maintain proper blood flow and prevent excessive bleeding. Additionally, this artery’s location near the sacrospinous ligament is a key landmark during pudendal nerve blocks, which are used for anesthesia in childbirth or perineal surgeries.
Interventional Radiology
In cases of pelvic trauma or tumors causing hemorrhage, selective embolization of the internal pudendal artery or its branches may be performed. Accurate knowledge of its origin and anatomy allows radiologists to navigate catheters effectively and safely to control bleeding.
Summary
The arteria pudenda, specifically the internal pudendal artery, originates from the anterior division of the internal iliac artery, a branch of the common iliac artery from the abdominal aorta. Its complex course through the pelvis and perineum enables it to supply critical blood flow to the external genitalia, perineal muscles, and lower rectum. The artery’s branches have important physiological roles and clinical relevance, particularly in surgical procedures and interventions involving the pelvic region.
Key Points to Remember
- The internal pudendal artery arises from the anterior division of the internal iliac artery.
- It exits the pelvis via the greater sciatic foramen and re-enters through the lesser sciatic foramen.
- Travels through the pudendal canal alongside the pudendal nerve and veins.
- Supplies blood to the external genitalia, perineum, and lower rectum through various branches.
- Understanding its anatomy is crucial for pelvic surgeries, nerve blocks, and interventional procedures.
the question “De dónde viene la arteria pudenda?” finds a clear answer in anatomical studies, highlighting the internal iliac artery as the source. This artery’s vital role in pelvic and perineal vascularization makes it a cornerstone in both anatomy education and clinical practice.