1192 



SURGICAL AND TOPOGRAPHICAL ANATOMY 



saplienous opening (page 1138 and fig. 769), where it joins the femoral. The 

 internal saphenous nerve joins it below the knee, having been under the sar- 

 torius above this point (page 1178 and fig. 752). The external saphenous vein 

 passes behind the external malleolus, runs upwards over the nnddle of the calf, 

 and joins the popliteal by ]ierforating the deep fascia in the lower part of the 

 popliteal space. This vein is also accompanied by a nerve of the same name 

 throughout its course. 



The popliteal artery bifurcates at the lower border of the popliteus, about on 

 a level with the tubercle of the tibia. About two inches lower down the peroneal 

 artery comes off from the posterior tibial (fig. 756). 



The course of the posterior tibial corresponds with a line drawn from the 

 centre of the lower part of the popliteal space to a point midway between the tip 

 of the internal malleolus and the inner edge of the calcaneum. In the lower 

 third, the artery becomes somewhat superficial, passing from beneath the calf 

 muscles, together with the tendons of the tibialis posticus and the flexor longus 

 digitorum; and in a thin person it can be felt beating in the hollow on the inner 

 side of the tendo Achillis (fig. 756). 



I 



Fig. 757. — Sectiox of the Right Leg in the Upper Third. (Heath.) 



Tibialis amicus 

 Extensor longus digitorum 

 Anterior tibial t;essels arid NERVE 

 Peroneus longus 



Flexor longus hallucis 

 Soleus with fibrous intersection 



Gastrocnemius 



Tibialis posticus 

 Flexor longus digitorum 



Internal saphenous vein 



COMMUNICANS PERONEI NER VE 



Tendon of plantaris 



Peroneal vessels\ Posterior tibial vessels and XERVE 

 External saphenous vein and SERVE 



The course of the anterior tibial artery corresponds with a line drawn from a 

 point midway between the outer tuberosity of the head of the tibia and the head of 

 the fibula to one on the centre of the ankle-joint. This line corresponds to the 

 outer border of the ti!)ialis anticus and the interval between it and the extensor 

 longus digitorum (figs. 755 and 758). This is shown when the first of these mus- 

 cles is thrown into action. 



The peroneal artery, given off from the posterior tibial about an inch below 

 the popliteus, or three inches below the head of the fibula, runs deeply along the 

 inner border of this bone, covered by the flexor longus hallucis. It gives oft' the 

 anterior peroneal to the front of the limb about an inch above the level of the ankle- 

 joint. 



The nutrient artery of the tibia arises from the ])Osterior tibial near its com- 

 mencement. It is the largest of all the nutrient arteries to the shafts of long 

 bones. 



As a general rule, in amputation one inch below the head of the fibula, only 

 one main artery — the pojjliteal — is divided. In amputations two inches below the 

 head of the fibula, two main arteries — the anterior and posterior tibials — are 



