The superior pubic ligament connects together the two pubic bones superiorly, extending laterally as far as the pubic tubercles. The inferior ligament in the pubic arch is also known as the arcuate pubic ligament or subpubic ligament; it is a thick, triangular arch of ligamentous fibers, connecting together the two pubic bones below, and forming the upper boundary of the pubic arch. Above, it is blended with the interpubic fibrocartilaginous lamina; laterally, it is attached to the inferior rami of the pubic bones; below, it is free, and is separated from the fascia of the urogenital diaphragm by an opening through which the deep dorsal vein of the penis passes into the pelvis. Fibrocartilage
Fibrocartilage is composed of small, chained bundles of thick, clearly defined, type I collagen fibers. This fibrous connective tissue bundles have cartilage cells between them; these cells to a certain extent resemble tendon cells. The collagenous fibers are usually placed in an orderly arrangement parallel to tension on the tissue. It has a low content of glycosaminoglycans (2% of dry weight). Glycosaminoglycans are long, unbranched polysaccharides (relatively complex carbohydrates) consisting of repeating disaccharide units. Fibrocartilage does not have a surrounding perichondrium. Perichondrium surrounds the cartilage of developing bone; it has a layer of dense, irregular connective tissue and functions in the growth and repair of cartilage. Hyaline cartilage
Hyaline cartilage is the white, shiny gristle at the end of long bones. This cartilage has poor healing potential, and efforts to induce it to repair itself frequently end up with a similar, but poorer fibrocartilage.
National Institute for Health and Clinical Excellence (NICE) guidelines recommend that people with moderate to severe (50–99% blockage) stenosis, and symptoms, should have "urgent" endarterectomy within 2 weeks.When the plaque does not cause symptoms, people are still at higher risk of stroke than the general population, but not as high as people with symptomatic stenosis. The incidence of stroke, including fatal stroke, is 1–2% per year. The surgical mortality of endarterectomy ranges from 1–2% to as much as 10%. Two large randomized clinical trials have demonstrated that carotid surgery done with a 30-day stroke and death risk of 3% or less will benefit asymptomatic people with ≥60% stenosis who are expected to live at least 5 years after surgery. Surgeons are divided over whether asymptomatic people should be treated with medication alone or should have surgery.The common carotid artery is the large vertical artery in red. The blood supply to the carotid artery starts at the arch of the aorta (bottom). The carotid artery divides into the internal carotid artery and the external carotid artery. The internal carotid artery supplies the brain. Plaque often builds up at that division and causes a narrowing (stenosis). Pieces of plaque can break off and block the small arteries above in the brain, which causes a stroke. Plaque can also build up at the origin of the carotid artery at the aorta. Diagnosis
Carotid artery stenosis is usually diagnosed by color flow duplex ultrasound scan of the carotid arteries in the neck.