MCQ 15

A 75 year old man with a 40 pack year history of smoking and hypercholestremia is diagnosed with severe atherosclerosis. Atherosclerotic occlusion of which of the following arteries would result in insufficient perfusion o f the urinary bladder?

a. External iliac
b. Inferior epigastric
c. Internal iliac
d. Internal pudendal
e. Lateral sacral

Answer and explanation

Correct answer is 'c'.

The bladder is supplied by the vesicular branches of the internal iliac arteries. The internal iliacs arise from the common iliac artery.

Note that this is a simple fact question (which artery supplies the urinary bladder) embedded in a clinical scenario   .

The external iliac(choice 'a') also arises from the common  iliac artery. It makes no contribution to the blood supply of the bladder.

The inferior epigastric(choice 'b') is a branch of the external iliac artery. It serves as a landmark in the inguinal region. Indirect inguinal hernia lie lateral to the inferior epigastric arteries whereas the direct inguinal hernia lie medial to the vessel. A good mnemonic is MDs don't Lie (Medial- Direct; Lateral- Indirect).

The Internal pudendal(choice 'd')  is a branch of the ant division of the internal iliac artery. It gives rise to the inferior rectal artery, perineal artery, artery of the bulb in the men, urethral artery, deep artery of the penis or clitoris, and the dorsal artery of the penis or clitoris.

The lat sacral(choice 'e') is a branch of the post division of the iliac internal iliac artery. it supplies sacral structures