56 LANDMARKS MEDICAL AND SURGICAL. 



of the artery in any part of its course may be defined with 

 the greatest precision. The artery can be felt beating and 

 can be compressed where it crosses the front of the tibia and 



ankle. 



122. Posterior tibial artery. The posterior tibial com- 

 mences about one inch and a quarter below the head of the 

 fibula. Its subsequent course corresponds with a line drawn 

 from the middle of the upper part of the calf to the hollow 

 behind the inner ankle, where it can be felt beating distinctly 

 about half an inch behind the edge of the tibia. A vertical 

 incision down the middle of the calf would reach the artery 

 under cover of the gastrocnemius and soleus. A vertical 

 incision along the middle third of the leg, about half an inch 

 from the inner edge of the tibia, would enable the operator to 

 reach the artery sideways, by detaching from the bone the 

 tibial origin of the soleus. 



123. Saphena veins. The subcutaneous veins on the 

 dorsum of the foot form an arch convex towards the toes (as 

 on the back of the hand), from which issue the two main sub- 

 cutaneous trunks of the lower limb, the internal and external 

 saphena veins. The internal saphena vein can be always plainly 

 seen over the front of the inner ankle. Its further course up 

 the inner side of the leg, knee, and thigh to its termination in 

 the femoral is not in all persons manifest. 



The external saphena vein runs behind the outer ankle 

 and up the middle of the calf to empty itself (generally) into 

 the popliteal vein. 



THE FOOT. 



What are the bony landmarks which guide us in the sur- 

 gery of the foot ? 



124. Points of bone. Along the inner side of the foot, 

 beginning from behind, we can feel I, the tuberosity of the 

 os calcis ; 2, the projection of the internal malleolus ; 3, the 

 projection of the os calcis, termed ' sustentaculum tali,' about 

 one full inch below the malleolus ; 4, about one inch in front 

 of the malleolus internus, and a little lower, is the tubercle 



