Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
One or both gonadal arteries may arise from the renal arteries; more rarely, they arise from the middle suprarenal or lumbar arteries.
One may branch off higher than the other.
They may arise from a common stem, and one or both may be doubled, tripled, or quadrupled throughout or in a particular part of their course.
The right spermatic may run behind, instead of in front of, the inferior vena cava.
A left testicular artery was found that arose 1 cm cranial to the inferior phrenic artery or, more plainly stated, just beneath the diaphragm. This artery gave rise to two branches, one to the costal part of the diaphragm and the other to the suprarenal gland (Shinohara, et al). In another study of 405 testicular/ovarian arteries, forty originated from the aorta cranial to the renal vein (Notkovich) but none arose as high as the Shinohara, et al's case.
The gonadal arteries have been found arching over the left renal vein, and have been identified as the origin of inferior suprarenal branches.
One or both gonadal arteries might pass through a cleft formed by partially doubled gonadal veins. No sex-related differences in origin of these arteries have been reported.
The gonadal arteries usually arise from the anterior surface of the aorta below the renal vein, although cases have been reported of origins behind or above the renal vein. In one such case, a left testicular artery arose 1 cm cranial to the inferior phrenic artery.
In 15% of cases, the gonadal arteries arise from the renal artery, from one of the branches of the renal artery, or from a supernumerary or "accessory" renal artery.
The right gonadal may arise from a renal artery, the left from the aorta or vice versa.
More rarely, a gonadal can originate from a suprarenal, inferior phrenic, superior mesenteric, lumbar, common iliac, or internal iliac or inferior polar renal artery. Adachi reported that testicular and suprarenal arteries arose from a common trunk with a frequency of one in 26 suprarenal glands.
In some cases (17%), the gonadal arteries are doubled on one side; less commonly, they are doubled on both sides.
The two gonadals may have an aortic and a renal origin or both may have the same origin.
The inferior vessel of doubled gonadal arteries is usually of aortic origin, whereas the one arising superiorly can be from either the renal artery or the aorta. In one case, the superior (lateral) artery arose from the right renal artery and the inferior (medial) arose from an inferior renal polar artery.
Occasionally, gonadal arteries arising from the aorta have two or three roots which subsequently merge into one. Their origins are generally between the first and third lumbar vertebrae.
Gonadal arteries have been classified into three types according to their relationship to the renal vein. One clinically and surgically important fact is that gonadal arteries, by crossing the the renal vein, are frequently components of the renal pedicle (18% of all cases, on the left side about 34% and on the right about 16%).
Testicular or ovarian arteries may arise from the aorta or renal artery and take the following course: arising behind, and below, or above the renal artery and descending into the pelvis; arising behind or below the renal vein with the left artery ascending from behind the renal vein to curve over its upper border (lateral to the suprarenal vein) and then descending (anterior to the renal vein) to the pelvis; and as an arched artery passing in front of the renal vein when that vein passes behind the aorta.
When the gonadal arteries arise behind or below the renal vein, as just described, the right artery usually descends to the pelvis behind (posterior to) the renal vein. The arched ovarian or testicular artery (of Luschka) occurs in 22% of cases.
Image 406, Image 410, Image 411, Image 520
Image 48, Image 354, Image 474, Image 475
See Image 247
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