TIBIAL NERVE 827 
veins which almost always accompany the artery here is usually very large, and the layer of muscle 
which intervenes between it and the nerve is often exceedingly thin. In the distal part of the leg 
the nerve is in direct contact with the vein, and on the front of the hock it lies behind the vessels. 
In very exceptional cases the nerve lies for a variable distance in the middle of the leg in the lateral 
part of the tibialis anterior. 
TIBIAL NERVE 
The tibial nerve (N. tibialis)! is the direct continuation of the great sciatic 
nerve (Figs. 576, 580, 583, 584, 659). It passes down between the two heads of the 
gastrocnemius, and accompanies the recurrent tibial vessels to the distal third of 
the leg, where it divides into the two plantar nerves. In the proximal third of the 
Vy. 
Long digital extensor 
eroneus tertius 
Anterior tibial vessels 
Deep peroneal nerve 
Superficial peroneal 
nerve 
Intermuscular septum 
Fibrous band 
Lateral extensor 
; Saphenous vein’ 
rmuscular s 2 
Tntermuscular septum Saphenous artery 
Deep head of deep 
flexor (flex. hall, 
longus) Posterior tibial vessels 
Tendon of long digital 
flexor 
Tibialis posterior Recurrent tibial vein 
Recurrent tibial artery 
Tibial nerve 
N. cutaneus sure 
Recurrent tarsal vein 
and artery 
Tarsal tendon of biceps femoris 
Soleus 
and semitendinosus 
Superficial flecor tendon 
Gastrocnemius tendon 
Fic. 659.—Cross-section oF Distat Turrp or Lerr Lec or Horse. 
The deep fascia is shown by red line. 
leg it lies along the medial side of the superficial flexor under cover of the medial 
head of the gastrocnemius; lower down it is covered by the common deep fascia 
and is situated in the space between the deep flexor and the medial border of the 
tendo calcaneus (Achillis). 
At the usual point of election for tibial neurectomy, 7. e., about a handbreadth above the 
level of the tuber calcis, the nerve lies in areolar tissue and fat in a fascial compartment formed by 
the special fascia of the deep flexor in front and by the common fascia and the tarsal tendon of the 
semitendinosus and biceps femoris behind and medially. 
At its origin the tibial nerve gives off a muscular branch (Ramus muscularis 
distalis), the divisions of which pass between the two heads of the gastrocnemius 
1 Also termed the posterior tibial nerve. 
