1462 



SURFACE AND SUEGICAL ANATOMY. 



Vastus lateralis 



tendon 



Patella 



Lateral condyle 

 "of tibia 



of tibia 



Tibialis anterior 



surface is the commonest seat of varicose and callous ulcers, which are frequently 

 prevented from healing by adhesion of the floor of the ulcer to the periosteum. 



The shaft of the fibula, situated on a plane posterior to that of the tibia, is, with 

 the exception of the triangular subcutaneous surface proximal to the lateral malle- 

 olus, deeply placed amongst 

 the muscles. To examine the 

 fibula, the surgeon should 

 stand on the opposite side 

 of the patient and manipu- 

 late the bone along the line 



Quadriceps extensor of the intermusculajseptum 

 between the peronaei and the 

 muscles of the calf. 



The greater fulness of 

 the antero - lateral surface 

 of the leg, as compared with 



Ligamentum paten* its medial surface, is due to 

 the presence of the extensor 

 and peroneal groups of 

 muscles. When those 

 groups are thrown into 

 action, the individual 

 muscles are mapped out 

 upon the surface by the 

 grooves corresponding to 

 their intermuscular septa. 

 The posterior peroneal sep- 

 tum is seen as a well-marked 

 furrow, extending from the 

 posterior aspect of the head 



Peronaeus tertius of the fibllla to the hollow 



behind the lateral mal- 

 leolus; in front of it are 

 the peronsei muscles, the 

 longus giving rise to a pro- 

 minence on the proximal 

 half of the leg, while the 

 brews is prominent on the 

 distal half; behind the 

 septum is a prominence 

 formed by the lateral border 

 of the soleus, which projects 

 beyond the border of the 

 gastro-cnemius. 



It is along the line of 

 the posterior peroneal inter- 

 muscular septum that in- 

 cisions should be made to 

 expose the fibula ; to avoid the superficial peroneal nerve, however, the incision 

 must not extend to a more proximal level than 1 in. distal to the head of the 

 fibula. 



The furrow between the extensors and the two peronaei, the anterior peroneal 

 septum, is much less distinct, and runs in a line from the anterior border of the 

 head of the fibula to the anterior border of the lateral malleolus ; the cutaneous 

 portion of the superficial peroneal nerve corresponds to the distal half of this line. 

 At the junction of the middle and distal thirds of the leg the extensor muscles 

 incline medially over the anterior aspect of the tibia. 



The anterior tibial artery reaches the front of the interosseous membrane 2 in. 

 distal to the tuberosity of the tibia ; in the proximal two-thirds of its course it lies 



Lateral 

 malleolus 



Tip of 



lateral 



malleolus 



FIG. 1122. LATERAL ASPECT OF KNEE AND LEG. 



