A 41-year-old woman with one healthy child presents with a 3-year history of an inability to conceive despite normal menstrual cycles. A biphasic basal body temperature cha is recorded. She denies having any sexually transmitted disease, and a hysterosalpingogram shows patent uterine tubes and a normal uterine cavity. Her husbands semen analysis is normal. In the presence of several normal test results for infeility, a laparoscopic examination of the pelvic cavity is scheduled. The physician performing the procedure carefully places the trocar lateral to the rectus abdominis muscle and its sheath to avoid injury to a major aery. What aery is being avoided?
The presence of several normal test results indicates a need to rule out endometriosis in this infeile couple. This tissue responds to a woman's hormonal cycles in the same way that the lining of the uterus responds. The aeries, their companion veins, and the nerves supplying the muscles of anterior abdominal wall are all found in the interval between the internal abdominal oblique and the transverses abdominis muscles (neurovascular plane). Superficial and deep circumflex iliac aeries arise from the femoral and external iliac aeries course parallel to the inguinal ligament and supply the inferior abdominal wall in the inguinal region. The superficial epigastric aeries lie in the superficial fascia between the umbilicus and the pubic bone. The internal thoracic aeries divide into two terminal branches: the superior epigastric and musculophrenic aeries.
Superior epigastric aery
Inferior epigastric aery
Superficial epigastric aery
Superficial circumflex iliac aery
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