198 THE LOWER EXTREMITIES. 



the upper fibula and being inserted into the first metatar- 

 sal and the internal cuneiform, the latter arising from the 

 lower fibula and being inserted into the fifth metatarsal. 

 The foot is flexed, adducted, and rotated inward by 

 means of the tibialis anticus, which rises from the outer 

 tuberosity and the upper two-thirds of the outer surface 

 of the tibia and is inserted into the internal cuneiform 

 bone. 



In the foot, and corresponding to the palmar fascia in 

 the hand, is the plantar fascia, the densest of all fibrous 

 membranes. There are also various annular ligaments, 

 and the foot muscles are arranged similarly to those in the 

 hand. 



The Blood Supply of the Lower Extremity. The 

 blood supply of the lower extremity comes from the 

 external iliac artery , a branch of the common iliac, 

 which passes obliquely downward and outward along 

 the border of the psoas muscle to Poupart's ligament, 

 where it enters the thigh and becomes the femoral artery. 

 Its only important branches are the deep epigastric, 

 which goes up along the internal abdominal ring, and the 

 deep circumflex iliac. As the femoral artery it passes 

 down the inner side of the thigh to the internal condyle 

 of the femur, being very superficial at Scarpa's triangle, 

 where it can be compressed with the thumb to stop 

 hemorrhage below. If a tourniquet is applied, it should 

 be applied a little lower down. The first and most 

 important branch of the femoral is the profunda femoris. 



About two-thirds of the way to the knee the artery 

 takes the name popliteal. It lies superficially in the 

 popliteal space back of the knee, but above and below it 

 is covered with muscles. Its branches supply the knee- 

 joint and nearby muscles and are unimportant. At the 

 lower border of the popliteus muscle, a small muscle at the 

 knee, it divides into the anterior and posterior tibial 

 arteries. The course of the former of these may be marked 

 by a line from the inner side of the head of the fibula to 

 midway between the malleoli at the front of the ankle, 



