THE LOWER LIMB 601 



to be divided, after which the limb can be separated. The first duty of 

 the dissector is to trim the femoral muscles, and revise their attachments 

 and relations. On the inner side of the knee-joint, if not previously displayed, 

 he should show the long saphenous vein and nerve, the posterior division 

 of the internal cutaneous nerve, and the superficial branch of the arteria 

 anastomotica magna. The deep branch of the last-named artery, if not 

 previously dissected, should now be followed out. The relation of the long 

 external lateral hgament of the knee-joint to the tendon of insertion of the 

 biceps femoris, as well as the bursa in this situation, and the expansion from 

 the tendon to the deep fascia of the leg, should be shown. 



Front and Sides of the Leg and Dorsum ol the Foot. — The dissector is to make 

 himself thoroughly familiar with the landmarks of the leg and foot. The skin is 

 then to be removed by making the following incisions : a vertical incision along 

 the anterior border of the tibia, and along the dorsum of the foot as far as the 

 web between the second and third toes ; a transverse incision at the ankle- 

 joint, and another at the webs of the toes ; a median incision along the dorsum 

 of each toe ; and a transverse incision across the dorsum of each toe close to 

 the nail. The skin is to be reflected to either side, and the following structures 

 should be exposed on the inner aspect of the tibia : ( i ) the long saphenous 

 vein, which should be shown passing 'in front of the internal malleolus, and 

 traced as far as the inner end of the dorsal venous arch ; (2) the long saphenous 

 nerve, accompanjdng the foregoing vein as far as the centre of the inner border 

 of the foot ; (3) the posterior division of the internal cutaneous nerve, ramify- 

 ing in the integument of the upper half of the leg ; and (4) the superficial 

 branch of the arteria anastomotica magna, ramifying in the upper third. 

 Communications are to be sought for between the long and short saphenous 

 veins, and also between the former and the deep-seated veins on the front of 

 the leg. 



The venous arch on the dorsum of the foot should next be displayed, 

 care being taken to preserve the cutaneous nerves. The long saphenous vein 

 will conduct to it, and the small tributary veins from the superficial plantar 

 venous plexus may be shown turning round the inner border of the foot to 

 join the long saphenous vein. The short saphenous vein should be traced 

 from the outer end of the arch to a point below and then behind the external 

 malleolus ; the small tributary veins from the superficial plantar venous plexus 

 may be shown turning round the outer border of the foot to join it ; and 

 an endeavour may be made to show the following tributaries of the dorsal 

 venous arch, namely, (i) the dorsal digital veins; (2) smaU veins from the 

 dorsum of the foot ; and (3) the efferent or interdigital veins from the plantar 

 transverse venous arch. 



The dissector should now display the musculo-cutaneous nerve. He will 

 find it piercing the deep fascia on the outer side of the leg about the junction 

 of the upper two-thirds and lower third. Branches should be traced to the 

 integument of the front of the leg in its lower third, and the main nerve 

 should be followed on in two divisions, to be distributed to the inner side of 

 the great toe and the contiguous sides of the second and third, third and 

 fourth, and fourth and fifth toes, as well as to the integument of the malleoli 

 and dorsum of the foot. 



The external or short saphenous nerve should next be dissected along the 

 outer border of the foot as far as the outer side of the Uttle toe. Upon the 

 outer side of the leg the dissector will find the lateral cutaneous branch of 

 the external popliteal nerve, which ramifies in the integument of about the 

 upper two- thirds. The deep fascia of the front and sides of the leg should 

 next be studied. Three intermuscular septa are to be noted, namely, 

 anterior, antero-extemal, and postero-extemal. In the region of the ankle- 

 joint the follo\ving parts of the deep fascia are to be specially dissected, 

 namely, (i) the external annular Ugament, strapping down the tendons of 

 the peroneus longus and peroneus brevis ; and (2) the anterior annular liga- 

 ment, which will be found in two divisions — one above the ankle-joint and 

 the other in front of it. The following points are to be specially noted in 

 connection wth the two divisions of the anterior annular Ugament, namely. 



