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The obturator artery is a blood vessel that supplies blood to the pelvic muscles and the adductors of the thigh. It is a branch of the internal iliac artery, which arises in the pelvis and passes antero-inferiorly on the lateral wall of the pelvis. The obturator artery gives off several branches, including the iliac branch, which supplies the iliac bone and iliacus muscle; the vesical branch, which supplies the bladder; and the pubic branch, which ascends to the pubic region. The obturator artery also has an anterior branch and a posterior branch, which supply the muscles of the medial compartment of the thigh, such as the obturator externus, adductor magnus, and gracilis.
| Characteristics | Values |
|---|---|
| Type | Blood vessel |
| Name origin | Passes through the obturator foramen to reach the medial compartment of the thigh |
| Branch of | Internal iliac artery |
| Supplies blood to | Pelvic muscles, head of the femur, muscles and skin in the medial region of the thigh, and the knee capsule |
| Supplies blood to muscles | Obturator externus, adductor magnus, adductor minimus, adductor longus, adductor brevis, pectineus, gracilis, ischiocavernosus, and hip adductors |
| Variation | Common |
| Arises from | Main stem, anterior trunk of the internal iliac artery, superior gluteal artery, external iliac artery, or inferior epigastric |
| Connects to | Iliac fossa, ilio-lumbar artery, inferior gluteal artery, ligamentum teres, femur, bladder, pubic bone, inferior epigastric artery, obturator externus, medial circumflex femoral artery |
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What You'll Learn
The obturator artery is a branch of the internal iliac artery
The obturator artery usually arises from the internal iliac artery, but in around 20% of cases, it may be replaced by a large pubic branch of the inferior epigastric artery. This is known as an accessory or aberrant obturator artery. The obturator artery is highly variable, and these variations are clinically significant for abdominal and pelvic surgery.
Within the pelvis, the obturator artery gives off several branches, including:
- Iliac branches, which supply the iliac fossa and bone, as well as the iliacus muscle.
- A vesical branch, which runs backward to supply the bladder.
- A pubic branch, which is given off from the vessel just before it leaves the pelvic cavity.
At the obturator foramen, the obturator artery divides into its anterior and posterior branches. The anterior branch supplies the obturator internus and externus muscles, as well as the adductor muscles of the thigh, including the adductor brevis, adductor magnus, and pectineus muscles. The posterior branch passes around the lateral border of the obturator foramen, towards the ischial tuberosity, and gives off an acetabular branch that extends to the hip joint.
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It supplies structures in the pelvis and medial thigh regions
The obturator artery is a branch of the internal iliac artery, which arises in the pelvis. It passes through the obturator foramen to reach the medial compartment of the thigh. The obturator artery supplies structures in the pelvis and medial thigh regions, including the pelvic muscles and the adductors of the thigh.
The obturator artery gives off several branches, including the iliac, vesical, and pubic branches. The iliac branches supply the iliac bone and iliacus muscle, while the vesical branch supplies the medial part of the urinary bladder. The pubic branch ascends to the pubic region and forms an anastomosis with the pubic branch of the inferior epigastric artery.
The obturator artery also gives off an articular branch that enters the hip joint through the acetabular notch and supplies the head of the femur. This branch is important for enhancing the blood supply to the femoral head and neck, especially in children.
Within the medial compartment of the thigh, the obturator artery splits into anterior and posterior branches. The anterior branch supplies the adductor brevis muscle and the skin over the medial thigh, while the posterior branch gives rise to the artery of the ligamentum teres, which runs in the ligament of the head of the femur. The obturator artery also provides a small branch to the knee capsule.
The obturator artery is also known to have an anomalous origin in some cases, arising from the external iliac artery or as two roots from the external iliac artery and the iliac artery.
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It is at risk of injury during femoral hernia repair
The obturator artery is a branch of the internal iliac artery that passes through the pelvis and supplies the medial thigh muscles. It divides into an anterior branch and a posterior branch, which encircle the obturator foramen. The obturator artery usually arises from the internal iliac artery, but in some cases, it may arise from the inferior epigastric artery or the external iliac artery. This variation in the origin of the obturator artery is important for surgeons to be aware of, especially when performing femoral hernia repair.
The obturator artery is at risk of injury during femoral hernia repair due to its proximity to the femoral ring. In about two out of seven cases, the obturator artery lies lateral to the femoral ring, which predisposes it to injury during hernia repair surgery. This variation is more commonly found in patients from Europe compared to Asia. Therefore, surgeons must be cautious during the dissection of the Bogros space and mesh stapling onto Cooper's ligament to avoid accidental injury to the obturator artery.
The obturator artery supplies blood to the obturator externus and obturator internus muscles, which are located in the pelvic region and play a role in the external rotation of the hip. The obturator externus originates from the bony margin of the obturator foramen and inserts as a tendon onto the greater trochanter of the femur. It may also provide some reinforcement to the hip joint. The obturator internus helps to stabilize the femoral head in the acetabulum and plays a role in the external rotation and abduction of the femur.
During femoral hernia repair surgery, it is crucial for surgeons to have a sound knowledge of the retropubic pelvic vascular anatomy to avoid complications. Anomalies in the origin and course of the obturator artery can increase the risk of injury during surgical procedures. In addition to the obturator artery, surgeons must also be cautious of unexpected sources of hemorrhage, such as an aberrant obturator vein or unexpected iliopubic vessels, and take appropriate precautions to ensure a successful outcome.
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It has anterior and posterior branches
The obturator artery is a branch of the internal iliac artery that passes antero-inferiorly (forwards and downwards) on the lateral wall of the pelvis, to the upper part of the obturator foramen. It then escapes the pelvic cavity through the obturator canal, dividing into an anterior branch and a posterior branch.
The anterior branch of the obturator artery is a small artery in the thigh that runs forward on the outer surface of the obturator membrane and then curves downward along the anterior margin of the obturator foramen. It supplies the obturator externus muscle, hip adductors, and the skin over the medial thigh.
The posterior branch of the obturator artery is also a small artery in the thigh. It follows the posterior margin of the foramen and turns forward on the inferior ramus of the ischium, where it anastomoses with the anterior branch. It supplies muscles attached to the ischial tuberosity, such as the ischiocavernosus muscle, and anastomoses with the inferior gluteal artery.
The obturator artery provides vascular supply within the pelvis and medial lower limb. It supplies blood to the pelvic muscles, head of the femur, muscles, and skin in the medial region of the thigh, as well as the knee capsule. The obturator artery also gives off side branches, including the pubic branch and the acetabular branch, which runs through the acetabular notch to the ligament of the head of the femur, supplying the head of the femur.
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It is crucial for pelvic and abdominal surgery
The obturator artery is a branch of the internal iliac artery that provides vascular supply within the pelvis and medial lower limb. It supplies the muscles of the pelvis and the adductors of the thigh, including the obturator externus, adductor magnus, adductor minimus, adductor longus, adductor brevis, pectineus, and gracilis muscles. It also provides a branch that supplies the head of the femur.
The obturator artery presents multiple anatomical variations, which can include atypical origins, variable anastomosis, or abnormal courses within the pelvis. These variations are clinically important and must be considered during surgical procedures, especially those involving femoral hernias, gynecologic, trauma, or orthopedic procedures near the lateral wall of the lesser pelvis.
During pelvic and abdominal surgery, it is crucial to identify the obturator artery to avoid accidental injury and significant blood loss. The obturator artery can be at risk of injury during operations to repair femoral hernias, and its laceration may result in unrecognized bleeding, leading to substantial blood loss into the peritoneal cavity. Additionally, injuries to the obturator artery may occur in cases of pelvic trauma or fractures, which are the most common cause of hemorrhage within the pelvis.
Furthermore, familiarity with the occurrence of an aberrant obturator artery, which is common in human anatomy, is essential for pelvic and groin surgeries requiring appropriate ligation. Instructors teaching pelvic anatomy must also be aware of these variations to provide accurate information to students and surgeons on identifying these variants and their prevalence. Overall, the obturator artery's anatomical variability underscores its crucial role in pelvic and abdominal surgery, necessitating a comprehensive understanding to ensure successful surgical outcomes and patient safety.
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Frequently asked questions
The obturator artery is a branch of the internal iliac artery that passes antero-inferiorly on the lateral wall of the pelvis. It provides vascular supply within the pelvis and medial lower limb.
The obturator artery supplies blood to the obturator internus and externus muscles and the adductor muscles of the thigh, including the adductor brevis, adductor magnus, and pectineus muscles.
The obturator artery has anterior and posterior branches, as well as an acetabular branch and a pubic branch.
