XXIII. Transverse section through the upper third and middle of the left leg

Fig. 1. Transverse section through the upper third of the left leg of the same body. Fig. 2. Transverse section through the middle of the left leg of the same body.

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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.

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Pages where the terms "Historic" (textbooks, papers, people, recommendations) 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, interpretations and recommendations may not reflect our current scientific understanding. (More? Embryology History \| Historic Embryology Papers)

FIG. 1 is a section through the upper third of the leg taken from the same subject as the last.

Similar plates will be found in Volz (a a 0, taf. ix, fig. 1) and in Pirogoff (fasc. 4, tab. viii, fig. 8),

The strong framework from which the muscles spring is formed by the tibia and fibula, the inter-osseous membrane, the strong fibular intermuscular aponeurosis, which passes obliquely outwards and forwards from the fibula between the peroneal and extensor muscles, and the dense fascia, from which the fibres of the tibialis anticus in particular arise.

The strongly developed muscles divide themselves into three groups. Anteriorly are the extensors, tibialis anticus, and extensor communis digitorum bounded behind by the interosseous membrane, the extensor longus pollicis is not yet seen, as it arises lower down. Externally and lying on the fibula is the peroneus longus, which belongs to the second group separated from the extensor communis by the intermuscular ligament. Posteriorly to both bones is the third group, in which the flexors preponderate, and their deep layer is analogous to that of the extensor side in having only two muscles.

The tibialis posticus lies on the interosseous ligament between the tibia and fibula, and the flexor longus digitorum, of which only a small portion is seen, on the tibia. Behind them are the large expanded surfaces of the soleus and gastrocnemius, and on the posterior aspect of the tibia is a strip of the popliteus. This muscle lies almost entirely between this and the last section (Plate XXII).

The nerves belonging to the three groups are marked white. The superficial peroneal nerve lies between the peroneus longus and the fibula; and the deep peroneal nerve, which is separated from it by the fibular inter-muscular septum lies on the interosseous ligament and fibula. The posterior tibial nerve is seen between the flexor longus pollicis and the soleus.

The three arteries, the anterior tibial, posterior tibial and peroneal, are seen together with their veins. The two latter arteries lie close to each other, as the section passed immediately below their origins, separated from the interosseous ligament by the tibialis posticus, and they divide the deep layer of the flexor group from the muscles of the calf which form the superior layer. The anterior tibial artery lies on the interosseous membrane. The furrow running between the tibialis anticus and extensor digitorum longus indicates the position of this vessel, hence it may be readily found, its depth being the only difficulty.

Fig. 2. This section through the middle of the left leg may be compared with the plates of Henle (' Muskellehre,' fig. 142), and Voltz (a a 0, tab. ix, fig. 2).

The relations of the muscles, vessels and nerves can be so readily made out that it does not seem worth while explaining the plate.

Beneath the muscles of the calf, in this section, all the flexors are seen together. The flexor longus digitorum has now considerable bulk, and so also has the flexor longus pollicis, which has already the peroneal artery between it and the fibula ; and the anterior tibial artery lies between the extensor communis and the tibialis anticus. The artery is still so deep that its ligature at this place, though practicable, is not to be recommended. Farther down, and nearer the ankle, the muscular tissue ceases somewhat, and the vessel is more easily reached.

The peronei muscles are completely developed, and the superficial peroneal nerve is already approaching so near the surface that it seems about to perforate the fascia.

If the two sections be compared which represent the position of the individual structures in the upper half of the leg, the superficial position of the tibia is evident and can be readily felt, hence affections of this bone from disease and accident are easy of diagnosis. The fibula, on the other hand, is unfortunately situated in this respect. The thick masses of the surrounding muscles do not favour its examination, and we must in its instance use some other diagnostic means, such as fixed, deep-seated pain.

The course the knife must take in order to expose the fibula is indicated by the fibular intermuscular septum. The muscles which bound this septum, the peroneus brevis and extensor proprius pollicis, are easily made out at the outer surface of the bone, and the plate assists the surgeon in judging of the depth the wound should be in muscular individuals. In this proceeding no vessels of large size will be met with, but the peroneal nerve must be carefully avoided, as it would fall in the line of incision.

The superficial position of the tibia also demands attention with regard to the treatment of ulcers, as the periosteum is all the more likely to be involved the fat being so sparingly developed, whilst in almost all other points of the section it is more abundant and consequently the skin is further from the subjacent fasciae.

The main arteries, with their accompanying veins, at this level are still tolerably near their origins, and not very far separated from each other. In the inner portion of the section they lie so near the interosseous ligament, and are so protected from external pressure by the bones of the leg, that they are not so liable to be wounded as elsewhere. At the same time from their position they are not readily compressible against the skeleton, so that in amputation or any operation where much bleeding is expected a toiirniquet must be applied above the knee.

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Pages where the terms "Historic" (textbooks, papers, people, recommendations) 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, interpretations and recommendations may not reflect our current scientific understanding. (More? Embryology History \| Historic Embryology Papers)

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. (2024, April 25) Embryology Book - An Atlas of Topographical Anatomy 23. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Book_-_An_Atlas_of_Topographical_Anatomy_23

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