Entirety of the Uterine Arterial Blood Supply

Description

Running along the lateral uterine wall, the uterine artery, typically a branch of the anterior division of the internal iliac artery, approaches the uterus at the level of the cervix and then ascends in a tortuous course toward the fundus. Cervical and vaginal branches arise inferiorly, while multiple arcuate arteries sweep medially within the myometrium and give off radial arteries that project toward the endometrium. Superiorly, the uterine artery anastomoses with the ovarian artery near the uterine cornu, and smaller tubal branches track laterally along the uterine tube within the mesosalpinx. This is the core uterine arterial blood supply. That distribution matters because the uterine artery crosses superior to the ureter near the cervix (the classic water under the bridge relationship), a point of predictable risk during hysterectomy and uterine artery ligation. The ascending segment and its anastomoses also explain why postpartum hemorrhage can persist despite unilateral ligation, and why uterine artery embolization for fibroid-related menorrhagia targets the uterine arterial tree rather than a single terminal branch. Tortuosity is not decoration, it accommodates uterine enlargement in pregnancy. Use this artwork to teach pelvic vasculature in gross anatomy, OB-GYN blocks, and surgical anatomy courses, or to support figures in hysterectomy, myomectomy, and interventional radiology publications discussing uterine artery embolization and collateral flow. It also fits patient-facing education on uterine fibroids and abnormal uterine bleeding when paired with simplified callouts of the fundus, body, and cervix. Anatomical accuracy verified by SciePro's Medical Advisory Board.