Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
Int. I (I.I.), Internal iliac artery; I.G., inferior gluteal artery; P, pudendal artery; S.G., superior gluteal artery.
Type 1: The superior gluteal artery arises separately from the internal iliac artery, and the inferior gluteal and internal pudendal vessels are given off by a common trunk. If the latter divides within the pelvis it is considered to be Type 1a, whereas if the bifurcation occurs below the pelvic floor it is classified as Type 1b.
Type 2: The superior and inferior gluteal arteries arise by a common trunk and the internal pudendal vessel separately. In this category, as in the previous one, two subtypes are described. Type 2a includes those specimens in which the trunk common to the two gluteal arteries divides within the pelvis, and Type 2b those in which the division occurs outside the pelvis.
Type 3: The three branches arise separately from the internal iliac artery.
Type 4: The three arteries arise by a common trunk. The subtyping in this group is based on the sites of origin of the superior gluteal and the internal pudendal arteries from the parent stem. In Type 4a the trunk first gives rise to the superior gluteal artery before bifurcating into the other two branches; in Type 4b the internal pudendal is the first vessel to spring from the common trunk, which then divides into superior and inferior gluteal arteries.
Type 5: The internal pudendal and the superior gluteal arteries arise from a common trunk, and the inferior gluteal has a separate origin.
Braithwaite provides the following summary:
1. The sites of origin of the superior gluteal, inferior gluteal, internal pudendal, and obturator arteries have been investigated in 169 specimens (108 males and 61 females).
2. The superior gluteal, inferior gluteal, and internal pudendal arteries are comparatively constant in their origins, conforming to a Type [1] arrangement on the Aclachi scale in 58.5% of cases, Type [3] pattern being found in 22.5% and Type [2] in 15.3%. Type [4] is less frequent and occurs in 3.6% of specimens. In 52.7% of instances, a similar origin of vessels is noted on both sides.
3. The obturator artery is more variable and arises as a direct branch from the anterior division of the internal iliac artery in 41.4% of instances, from the inferior epigastric artery in 19.5%, from the superior gluteal artery in 10%, from the inferior gluteal-internal pudendal trunk in 10%, and by a double origin in 6.4%. In only 23% of instances is a similar origin noted on both sides.
4. The present findings show a lower incidence from the inferior epigastric artery and a higher rate of occurrence of a vessel with a double origin than previous series. Reasons are suggested to explain these differences.
Redrawn from Braithwaite, J.L. Variations in origin of the parietal branches of the internal iliac artery. J. Anat. 86:423-430, 1952.
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