The branches of the internal pudendal artery are similar to those of the pudendal nerve in the perineum and include the inferior rectal and perineal arteries, and branches to the erectile tissues of the penis and clitoris (Fig. 5.77).
One or more inferior rectal arteries originate from the internal pudendal artery in the anal triangle and cross the ischio-anal fossa medially to branch and supply muscle and related skin (Fig. 5.77). They anastomose with middle and superior rectal arteries from the internal iliac artery and the inferior mesenteric artery, respectively, to form a network of vessels that supply the rectum and anal canal.
The perineal artery originates near the anterior end of the pudendal canal and gives off a transverse perineal branch, and a posterior scrotal or labial artery to surrounding tissues and skin (Fig. 5.77).
Terminal part of the internal pudendal artery
The terminal part of the internal pudendal artery accompanies the dorsal nerve of the penis or clitoris into the deep perineal pouch and supplies branches to the tissues in the deep perineal pouch and erectile tissues.
Branches that supply the erectile tissues in men include the artery to the bulb of the penis, the urethral artery, the deep artery of the penis, and the dorsal artery of the penis (Fig. 5.77).
The artery of the bulb of the penis has a branch that supplies the bulbo-urethral gland and then penetrates the perineal membrane to supply the corpus spongiosum.
A urethral artery also penetrates the perineal membrane and supplies the penile urethra and surrounding erectile tissue to the glans.
Near the anterior margin of the deep perineal pouch, the internal pudendal artery bifurcates into two terminal branches. A deep artery of the penis penetrates the perineal membrane to enter the crus and supply the crus and corpus cavernosum of the body. The dorsal artery of the penis penetrates the anterior margin of the perineal membrane to meet the dorsal surface of the body of the penis. The vessel courses along the dorsal surface of the penis, medial to the dorsal nerve, and supplies the glans penis and superficial tissues of the penis; it also anastomoses with branches of the deep artery of the penis and the urethral artery.
Branches that supply the erectile tissues in women are similar to those in men.
Arteries of the bulb of the vestibule supply the bulb of the vestibule and related vagina.
Deep arteries of the clitoris supply the crura and corpus cavernosum of the body.
Dorsal arteries of the clitoris supply surrounding tissues and the glans.
The external pudendal arteries consist of a superficial vessel and a deep vessel, which originate from the femoral artery in the thigh. They course medially to enter the perineum anteriorly and supply related skin of the penis and scrotum or the clitoris and labia majora.
In men, the testicular arteries originate from the abdominal aorta and descend into the scrotum through the inguinal canal to supply the testes. Also, cremasteric arteries, which originate from the inferior epigastric branch of the external iliac artery, accompany the spermatic cord into the scrotum.
In women, small cremasteric arteries follow the round ligament of the uterus through the inguinal canal.