THE LEG 333 



prominent of the two ; it does not pass so far distally, 

 but its anterior border is situated more anteriorly than the 

 lateral malleolus. This is due to its greater breadth ; because, 

 when examined from behind, the posterior borders of the two 

 projections are seen to occupy very nearly the same transverse 

 plane. 



On the posterior aspect of the leg the prominence known 

 as the " calf of the leg " is visible. This is largely due to the 

 fleshy bellies of the gastrocnemius muscle. Distal to the calf, 

 and immediately proximal to the heel, the powerful tendo 

 calcaneus can be felt. Anterior to that tendon a slight hollow 

 is apparent on each side of the limb. 



The skin will be reflected from the dorsum of the foot 

 during the dissection of the leg ; therefore the present oppor- 

 tunity should be seized for studying the surface anatomy of the 

 foot, The individual tarsal bones cannot be recognised through 

 the integument which covers the dorsum of the foot ; but if 

 the foot is powerfully extended, the head of the talus will 

 be brought into view, in the shape of a slight prominence, 

 which lies below and anterior to the ankle joint. The 

 margins of the foot require careful study, because it is by 

 the recognition of certain bony projections in them that 

 the surgeon is enabled to determine the point at which to 

 enter the knife when he is called upon to perform partial 

 amputation of the foot. Examine the medial margin first. 

 Begin posteriorly, at the projection formed by the medial process 

 of the calcaneus, and proceed forwards. About one inch 

 below the medial malleolus the medial edge of the sustenta- 

 culum tali may be recognised, and about one inch, or a little 

 more, anterior to that, is the tubercle of the navicular. Then 

 comes the first cuneiform bone, which is succeeded by 

 the first metatarsal bone. None of these bony points can 

 be said to form visible prominences on the surface. In 

 order to distinguish them the medial margin of the foot must 

 be carefully palpated. On the lateral margin of the foot the 

 tuberosity on the base of the fifth metatarsal bone stands out 

 as a distinct landmark. Posterior to it is the cuboid, and 

 still more posterior the lateral surface of the calcaneus, which 

 is almost completely subcutaneous. When present in a well- 

 developed form, the trochlear process (O.T. peroneal tubercle) 

 on this surface may be distinguished, about one inch distal 

 and a little anterior to the lateral malleolus. If the foot is 



