Book - An Atlas of Topographical Anatomy 24

From Embryology

XXIV. Transverse section through the lower third of the left leg and the malleoli

Fig. 1. Transverse section through the lower third of the left leg of the the same body. Fig. 2. Transverse section through the malleoli of the same.


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Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.

Plates: 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term
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Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)


FIG. 1 represents a section through the lower third of the left leg near the joint. From the decrease in the masses of the muscles and the increase of the tendinous structures the section of the limb has become considerably smaller. Although individual muscles, such as the extensor and flexor longus pollicis with the peroneus brevis, have become stronger than in the preceding plate, they do not make up for the want of those of the calf which determine the size and shape of the leg. The soleus and gastrocnemius are no longer separate, a longitudinally directed tendinous mass spreads over the posterior surface of the soleus ; this is the termination of the gastrocnemius, which becoming blended with the fibres of the soleus, forms the tendo Achillis.


The largest surface shown is that of the flexor longus pollicis, which is here divided at its greatest bulk. In flexing the great toe in walking this muscle contracts so forcibly that its power exceeds that of the other flexors of the toes. Its position has altered from the last plate, being further back and more beneath the tibialis posticus, so that after completely crossing it in the malleolar region it lies at last most internally.


The position of the deep flexors is essentially distinct from that of the extensors. The tibialis anticus lies close on the tibia, and gains the inner border of the foot without crossing its neighbours, the extensor longus pollicis and extensor communis digitorum ; whilst the tibialis posticus lies in the middle on the interosseous ligament, the flexor longus pollicis on the fibula, and the flexor longus digitorum on the tibia, and these muscles cross each other before their ultimate insertion. This position is connected with their passage at the inner malleolus. As they are pushed aside by the sustentaculum -tali, they would obtain a very insufficient hold beneath the short internal malleolus if the flexor longus pollicis and tibialis posticus lay on the inner border of the leg, and if the flexor longus digitorum arose from the fibula it would act at a great disadvantage. This defect is remedied in a simple manner by the crossing of the tendons.


The arteries have the same muscular separations as before, notwithstanding that they have materially altered their position with regard to the tibia ; and, in consequence of the diminution of the bulk of the overlying muscles they are considerably nearer the surface, so that their ligature is easier than above. The anterior tibial artery can be reached between the tibialis anticus and extensor longus pollicis, and the posterior tibial can be readily found if the border of the soleus be detached and pulled back from the flexor longus digitorum. The position of the peroneal artery is the most unfavorable for ligature, as it must be searched for behind the peronei, after separating the flexor longus pollicis from the fibula, when it can be drawn out from behind the bone.


Fig. 2. This section of the leg in the region of the malleolus terminates this series. It divides the tibia and fibula immediately above the astragalus, hence the comparatively large size of the tibia. Both are strongly bound together by ligaments, and in front is an opening into the cavity of the ankle-joint.


The muscles now almost entirely present their tendons, only the outer portion of the extensor of the toes, the peroneus tertius, and the extensor flexor longus pollicis, still show muscular tissue. With the tendons are associated their bursse which are shown as dark chinks, and the ligamentous apparatus which renders secure the position of these tendons at the ankle. The upper portion of the annular ligament is met with, the point of origin of which from the os calcis lies deeper and is consequently not seen, and under the middle fasciculus which encloses the extensor longus pollicis, lies the anterior tibial artery which may be here readily reached from the surface. To expose the posterior tibial artery for ligature, the division of one fasciculus only of the internal annular ligament is necessary. It lies between the flexor longus digitorum and flexor longus pollicis, and the bursal sheaths of both muscles can be completely avoided in looking for the artery. The tendo Achillis lies some way further back, so that its division is easily accomplished without wounding the vessel.


The two plates here given are sufficient to show the most important points in the lower half of the leg. On the other hand, the relations given of the foot are insufficient, and perhaps a further series of sections might have been shown. From numbers of sections which I have made and had drawn, and have before me, as well also from the examination of Pirogoff's plates, I have come to the conclusion, that sections of the foot are not of very much use for the comprehension of its structure, although a clear idea of the arrangement and form of its bony arches may be obtained ; but for the relations of the soft parts they are only of subordinate importance. Flat preparations are in this respect of more value and are indispensable. The numerous small muscular masses of the sole are divided from each other merely by fasciae and cellular tissue, and the number of tendons on the dorsum which can be but inadequately separated from the ligaments by transverse section, would give unreliable plates. Again, the arrangement of the annular ligament would be absolutely unintelligible if studied on sections only. The arteries, as has already been mentioned in fig. 1, lie much nearer the surface than in the preceding plate, and therefore have far simpler landmarks for their ligature than in the upper half of the leg. They form a triangle with two nearly equal sides. The base of this triangle is formed by a line passing from the anterior tibial artery to the peroneal, directed outwards, as seen in fig. 1. This arterial triangle, in consequence of the termination of the peroneal artery, ceases in fig. 2, and is not seen in Plate XXIII, fig. 1. On the other hand, it is very clear from Plate XXIII, fig. 2, that if this triangle be compared in this and the preceding plate, the direction of its base and the length of its sides remain exactly the same. It so happens that these arteries in their course in the lower half of the leg remain in the same position with regard to each other ; and that they run as parallel vascular tubes, and do not from their own change of position get nearer the surface, but from the continually decreasing masses of the muscles as they proceed downwards.



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Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)
Braune Plates (1877): 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term

Reference

Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.


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Cite this page: Hill, M.A. (2019, September 21) Embryology Book - An Atlas of Topographical Anatomy 24. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Book_-_An_Atlas_of_Topographical_Anatomy_24

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