428 SURGICAL APPLIED ANATOMY. [Chap.xxi* 



was burst across the front of the knee, and a wound 

 was produced that was seven inches in length, and 

 was as cleanly cut as if made by a scalpel. 



There is but little subcutaneous fat in front of 

 the articulation, and thus it happens that in amputa- 

 tions through the knee-joint the anterior flap is very 

 thin, and is composed of little other than the simple 

 integument. 



As blisters, and various forms of counter-irri- 

 tant, are often applied to the front of the knee in 

 cases of disease, it may be well to take note of the 

 blood-supply of this part, and of the relations between 

 the surface vessels and those of the joint. The 

 vessels that give branches to the front of the knee, 

 and that are concerned in the supply of the part to 

 which blisters are usually applied, are the anastomotic, 

 the four articular branches of the popliteal, and the 

 anterior tibial recurrent. Now of these arteries, and 

 especially of the anastomotica magna and superior 

 articular, it may be said that, shortly after their 

 origin, they divide into two branches, or two sets of 

 branches, one going to the surface and the other to 

 the articulation of the knee and deeper parts about 

 it. It may be supposed, therefore, that, in applying 

 a counter-irritant in front of the knee for the relief 

 of a joint affection, a greatly increased quantity of 

 blood is drawn into the superficial divisions of the 

 above-named vessels, and less blood is thereby left 

 to flow by their deeper branches to the seat of 

 disease. 



The superficial lymphatics in the region of the 

 knee lie for the most part on the inner aspect of the 

 joint, and follow the course of the long saphenous 

 vein. Ulcers, and other inflammatory affections of 

 the skin over the articulation, are more apt to be 

 associated with lymphangitis and with enlargement of 

 the inguinal glands when situate on the inner aspect 



