THE ANTERIOR TIBIAL ARTERY. 



84: 



Ftg. 7d2. 



rarely the subject of aneurism. Ligation may be done at ( i) the upper; (2) the middle; 

 or (^ 3) the lower third. The line oi" the artery is from a point midway between the exter- 

 nal tibial tuberosity jnd 

 the head of the hbula to 

 the middle of the anteri- 

 or intermalleolar space. 

 I. When through 

 an incision made at 

 this line the deep fascia 

 is reached and divided, 

 the interspace in which 

 the artery lies should 

 be sought for. It is 

 that between the tibi- 

 alis anticus and the 

 extensor longus digi- 

 torum, is the only in- 

 termuscular interstice 

 in the upper anterior 



Superior external articular 

 External condyle 



Inferior external articular 

 Tendon of biceps 



tibial 



is about 



Anterior tibial recurrent' 



Peroneus longus 



\nterior tibial artery 



Extensor longus digitorum 



Tibialis anticus 



Extensor proprius hallucis 



Peroneus brevis 



Peroneus longus tendon 



Anterior peroneal artery 



External malleolar artery 



External calcanean or 

 posterior peroneal artery 

 External malleolus 



Tarsal artery 

 Extensor brevis digitorum 



Peroneus brevis tendon 

 Metatarsal artery 



Posterior 



perforating arteries 



Dorsal interosseous arteries 



■Branch of superior 



internal articular 



Tendo patellae 



Inferior internal articular artery 



Tibialis anticus 



Interosseous membrane 



Infernal malleolar artery 



Inner malleolus 



region, 

 an inch or an inch and 

 a quarter external to 

 the tibial crest, and a 

 half to three-quarters 

 of an inch internal to 

 the septum which di- 

 vides the extensor lon- 

 gus from the peroneus 

 longus. This septum 

 is often marked by a 

 white line visible before 

 the deep fascia is di- 

 vided-; or it may be 

 recognized by slipping 

 a director outward be- 

 neath the aponeurosis 

 until its point is firmly 

 arrested. The inter- 

 space containing the 

 anterior tibial artery 

 will then be internal to 

 this and (^n be felt as 

 a line of lessened resist- 

 ance when the fore- 

 finger is pressed length- 

 wise along the muscles 

 (Treves). On the 

 other hand, the apon- 

 eurotic partition be- 

 tween the extensor 

 and the peroneus — 

 external to the inter- 

 space sought for — 

 resists and vibrates 

 under the point of the 

 director or the fore- 

 finger (Farabeuf). At 



the bottom of the interspace the artery will be found lying upon the interosseous 

 membrane to the outer side of the tibia and with the nerve external to it. 



Innermost tendon of 



extensor brevis digitorum 



Dorsalis pedis 



Communicating artery 



Dorsalis hallucis 



Anterior perforating arteries 



Tendons of extensor 

 longus digitorum 



Arteries of front of leg and dorsum of foot. 



