45 2 SURGICAL APPLIED ANATOMY. [Chap. xxn. 



malleolus. The position of the anterior tibial artery 

 may be indicated by a line drawn from a point midway 

 between the outer tuberosity of the tibia and the head 

 of the fibula to the centre of the front of the ankle 

 joint. Both the saphenous veins can often be made 

 out in the leg. The inner or larger vein passes in 

 front of the malleolus and ascends just behind the 

 internal border of the tibia. With it runs the long 

 saphenous nerve. The short saphenous vein lies 

 behind the outer malleolus, and passing up the middle 

 of the calf ends at the ham. It is accompanied by 

 the external saphenous nerve. 



The leg. The skin is somewhat more adherent to 

 deeper parts in the leg than it is in the thigh. The 

 difference in the degree of this adhesion is obvious 

 when skin-flaps are dissected up from the two parts 

 in cases of amputation. Over the internal surface of 

 the tibia and the greater part of the shin, the 

 integument lies directly upon the periosteum and 

 bone, nothing intervening save a scanty amount of 

 subcutaneous fascia. Thus blows and kicks over these 

 parts of the leg are apt to be associated not only 

 with much pain but also with much bruising or 

 tearing of the integument. A " graze on the shin " 

 is one of the commonest of lesions, and is produced by 

 a degree of violence that upon a well -covered part 

 would have little or no effect. It will be understood 

 that ulcers over these feebly protected parts may, 

 if they spread in depth, readily expose the bone and 

 lead to some disease of its substance, or to at least 

 some inflammation of its periosteum. Scars left by 

 deep ulcers or burns are also often found to be 

 quite adherent to the bone. 



The aponeurosis of the leg invests it like a 

 cightly-drawn buskin, being lacking only over the sub- 

 cutaneous surfaces of the bones. It is attached to the 

 head and the anterior and inner borders of the tibia, 



