358 THE INFERIOR EXTREMITY 



I Sunerficial veins / Great saphenous vein. 

 ins ' \Smallsaphenousvein. 



2. Cutaneous nerves. 



3. Deep fascia. 



fGastrocnemius. 



4. Superficial muscles of the calf, -! Plantaris. 



[Soleus. 



5. Tendo calcaneus (Achillis) and its bursa. 



6. Posterior tibial vessels. 



7. Tibial nerve. 



( Popliteus. 



8. Deep muscles, J i. r . hallu f cis lon g us ' 



j Tibiahs posterior. 



\, Flexor digitorum longus. 



9. Ligamentum laciniatum. 



Dissection. Reflection of Skin. The limb must now be 

 placed on its anterior aspect, and the muscles of the calf rendered 

 tense by dorsi-flexing the foot at the ankle joint. That position 

 should be maintained by the aid of hooks, fastened to the toes 

 and to the under surface of the table. The skin has already been 

 reflected to the medial and lateral borders of the leg and foot. 

 Now make a transverse incision across the distal part of the 

 heel and carry the extremities of the incision forwards, along 

 the medial and lateral borders of the foot respectively, then 

 remove the skin from the whole of the back of the leg, com- 

 mencing the reflection either from the medial or lateral border 

 as may be most convenient. As the reflection proceeds keep 

 the edge of the knife always against the skin to avoid injury to 

 the superficial veins and nerves. 



Superficial Fascia. The superficial fascia of the posterior 

 crural region presents no special or peculiar features, but it 

 contains the following structures which must be displayed by 

 the dissector : 



Superficial ( Part of the great saphenous vein, 

 veins, \ Part of the small saphenous vein. 



Superficial lymph vessels. 



Part of the saphenous nerve. 



The terminal part of the posterior branch of the medial 



cutaneous nerve of the thigh. 

 Cutaneous J The terminal part of the posterior cutaneous nerve of the thigh, 

 nerves, | The medial cutaneous nerve of the calf. 

 The anastomotic peroneal nerve. 

 The sural nerve, 

 ^he medial calcanean nerves. 



Dissection. The superficial veins and the cutaneous nerves 

 must now be followed and cleaned. The lymph vessels cannot 

 be demonstrated in an ordinary dissection ; the majority of 

 them accompany the veins and their tributaries. The great 

 saphenous vein and the saphenous nerve have already been 

 traced across the distal third of the medial surface of the tibia 



