SUPERFICIAL MARKINGS OF LEG. 175 



patella is inserted ; and on each side of this the tuberosities of the 

 bone are superficial. The internal tuberosity is a uniform rounded 

 prominence ; but the external forms a marked projection at the 

 outer and fore part of the knee. Below, the tibia ends on the 

 inner side of the ankle in the internal malleolar projection. On 

 the outer side of the leg the lower half of the fibula may be felt 

 with ease, but the upper half with more difficulty in consequence 

 of the prominence of the muscles of the calf. The head of this bone and the 

 may be recognised below the knee ; and the lower end forms the jjart ' 

 malleolus on the outer side of the ankle-joint. 



At the sides of the ankle are the prominent malleoli, the external Ankle-joint, 

 being nearer to the heel ; and when the joint is extended, the head 

 of the astragalus can be felt below the tibia. 



Muscles ami vessels of the leg. On the back of the leg is the swell Behind are 

 of the calf : this is formed by the gastrocnemius and soleus hTgfand he 

 muscles, and therefrom descends the firm band of the tendo tendo 

 Achillis, by which those muscles are connected with the heel. Achillis - 

 Between the tendon and the edge of the tibia, but nearer the fib^ nor 

 former, is placed the superficial part of the posterior tibial artery, vessels. 

 In front, between the tibia and fibula are the flexor muscles of the Line of 

 ankle and the extensors of the toes, amongst which the anterior tibia" 01 

 tibial artery lies deeply, and the position of the vessel is indicated artery, 

 by a line from a point midway between the head of the fibula and 

 the projection of the external tuberosity of the tibia to the centre 

 of the ankle-joint. 



Prominences of the foot. At the inner border of the foot, about inner 

 an inch and a half in front of the internal malleolus, is the 

 tuberosity of the navicular bone ; while one inch and a half further 

 forwards is a slight depression marking the articulation between the 

 internal cuneiform and the metatarsal bone of the great toe. About 

 the centre of the outer border of the foot is the tuberosity of the Outer 

 fifth metatarsal bone. A line along the dorsum of the foot, from ** 

 the centre of the ankle-joint to the interval between the inner two 

 toes, will lie over the position of the main artery. 



Position. The limb is to be raised to a convenient height by Position of 

 blocks beneath the knee, and the foot is to be extended in order the limb- 

 that the muscles on the front of the leg may be put on the stretch. 



Dissection. To enable the dissector to raise the skin from the Raise the 

 front of the leg and foot, one incision should be made along the 

 middle line from the knee to the toes, and this should be intersected 

 by cross cuts at the ankle and the root of the toes. 



After the flaps of skin are reflected, the cutaneous vessels and Seek the 

 nerves are to be looked for. At the upper and inner part of the nervesn S 

 leg are some filaments from the great saphenous nerve ; and at the the le g '> 

 outer side others, still smaller, from the external popliteal nerve. 

 Perforating the fascia in the lower third, on the anterior aspect, 

 the musculo-cutaneous nerve will be found, the branches of which 

 should be pursued to the toes. 



On the dorsum of the foot is a venous arch, which ends laterally on the foot 

 in the sapheiious veins. On the outer side below the malleolus 



