THE LOWER LIMB 497 



Achillis, which stands out boldly beneath the integument, and 

 subsides at the tuber calcis. Upon either side of the projection 

 formed by the tendo Achilhs there is an elongated furrow. 

 The furrow on the outer side indicates the situation of the short 

 saphenous vein and nerve and the peroneal artery, whilst that on 

 the inner side corresponds with the position of the posterior tibial 

 vessels and nerve. 



The course of the anterior tibial artery on the front of the leg is 

 indicated by a hne drawn from the superior tibio-fibular articula- 

 tion to the centre of the front of the ankle-joint, midway between 

 the two malleoU. This practically coincides with the outer border 

 of the tibiahs anticus. The course of the posterior tibial artery 

 corresponds with a line drawn from the centre of the popliteal space 

 to a point midway between the tip of the internal malleolus and 

 the inner part of the point of the heel. 



It is to be noted that another large artery is situated upon the 

 back of the leg. This is the peroneal branch of the posterior tibial, 

 and in operations it will be caught upon the back of the fibula, the 

 posterior tibial being between the tibia and fibula, except in the 

 lower part of the leg, where it hes on the back of the tibia. 



The anterior and posterior tibial arteries can readily be com- 

 pressed with one hand by placing the thumb in front of the ankle- 

 joint midway between the two malleoh, and the middle finger 

 midway between the tip of the internal malleolus and the inner 

 part of the point of the heel. 



The long saphenous vein may be visible in front of the internal 

 malleolus, and from this point it may be traceable upwards along 

 the internal subcutaneous surface of the tibia. 



The short saphenous vein is rarely perceptible. It hes behind 

 the external malleolus, then in the hollow upon the outer side of 

 the tendo Achillis, after emerging from which it soon gains the 

 middle line, where it lies in the groove between the two heads of 

 the gastrocnemius. 



Deep Fascia. — The deep fascia is in part a prolongation of the 

 fascia lata of the thigh, the continuity being estabUshed at the inner 

 and posterior aspects of the knee-joint. Elsewhere it is attached 

 superiorly to the head of the fibula, external tuberosity of the tibia, 

 lower part of the patella, ligamentum patellae, and tubercle, and 

 front of the internal tuberosity, of the tibia. In the leg it is 

 attached to the crest of the tibia, from which it is prolonged back- 

 wards over the inner surface to be attached to the internal border. 

 It is also attached to the antero-extemal and postero-external 

 borders of the fibula. At the ankle the deep fascia is attached to 

 the internal and external malleoli. Over the inner surface of the 

 tibia and at its malleolar attachments it becomes closely incorporated 

 with the periosteum. The chief direction of the fibres of the fascia 

 is vertical. There are, however, superadded transverse fibres 

 behind the knee-joint and in the vicinity of the ankle-joint, in 

 which latter region important annular hgaments are formed. 



