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hallucis on the outer side, and the tibialis posticus between them, covered by the flexor longus
hallucis, with the posterior tibial nerve and vessels with their branches.

The flexor longus digitorum arises from the inner part of the posterior surface of the tibia, below
the oblique line, down to within a short distance of the lower end of the bone.

The flexor longus hallucis, on the other hand, arises from the lower two-thirds of the outer
portion of the posterior surface of the fibula. Both muscles also take origin from the fibrous mem-
branes beside them, i.e. the fascia covering the tibialis posticus, and the posterior peroneal septum.
The tibialis posticus is concealed from view by the flexor longus hallucis. (See Nd, 3.) CD I d

of 2



The figures indicate



Muscles, etc. 1. Tendo Achillis.

2. Soleus.

3. Peroneus longus.

4. Flexor longus hallucis.

5. Flexor longus digitorum.

6. Tibialis posticus.

7. Popliteus.



Nerves, etc. 8. Posterior tibial nerve.

9. Muscular branches.

10. Posterior tibial vessels.

11. Peroneal vessels.

12. Posterior peroneal septum.

13. Nerve to popliteus.

14. External popliteal nerve.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY,



LOWER LIMB.

BACK OF LEO No. 3.



Section VIII. No. 28

BIOLOGY LIBRARY

THS GENERAL LIBRARY

UNIVERSITY (>! f.M.IFORNTA

, C4JJFOKMA 94720



THE FLEXOR LONGUS HALLUCIS MUSCLE HAS BEEN REMOVED. TO SHOW THE PERONEAL VESSELS, ETCl

The tibialis posticus muscle takes origin from both tibia and fibula, from the fascia which covers it and
from the interosseous membrane.

The surfaces of the two bones to which it is attached lie beside the interosseous ridge, and extend on each
side laterally as far as to the origin of the flexor longus digitorum on the tibia, and to that of the flexor
longus hallucis on the fibula.

The relations of its tendon are seen in another view (Inner Side of Ankle, No. 1).

The posterior tibial artery begins at the lower border of the popliteus muscle, and is the larger of the two
terminal branches of the popliteal artery. It passes downwards on the surface of the flexor longus digitorum
and tibialis posticus muscles, and then it comes to lie on the back of the tibia and of the ankle-joint, as these
two muscles pass to its inner side. It is covered above by the gastrocnemius and soleus, but in the lower part
it lies immediately below the deep fascia, and it is accompanied by the posterior tibial nerve, which is the
direct continuation of the internal popliteal nerve. The nerve is, throughout, superficial to the artery, and lies
to the inner side above, but soon crosses and lies on the outer side for nearly its whole length.

The artery gives off high up a large peroneal branch, which runs outwards and downwards in the
substance of the flexor longus hallucis muscle, and it also gives off muscular and cutaneous branches and a
nutrient artery to the tibia, and it communicates with the peroneal artery in the lower part of the leg by a
transverse communicating branch, A calcanean branch is given off just above the ankle joint.

The peroneal artery gives off muscular branches, and a nutrient artery to the fibula.

Each of these large vessels is accompanied by two venas comites, which are closely connected to the artery,
are of large size, and communicate freoly across the intervening artery by cross branches.

The posterior tibial nerve supplies all three deep muscles, and gives an articular branch to the ankle joint

The terminal branches of the vessels and nerves, and their further relations, are seen in the views of the ankle.



Muscles. 1. Soleus.

2. Flexor longus digitorunu

3. Tibialis posticus.

4. Flexor loogus hallucis



The figures Indicate

Muscles. 5. Peroneus longus,

Vesaels, etc. 6. Posterior tibial vessels.

7. Peroneal vessels.

8. Posterior tibial nerve.



Vessels, etc. 9. Communicating artery.
10. Division of perone&l
artery.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.

Section VHL No. 26

LOWER LIMB.

SOLE OF FOOT No. I.

SUPERFICIAL DISSECTION.

The skin and superficial fascia have been removed from the sole to show the deep fascia and the
cutaneous nerves and vessels.

The superficial fascia of the sole is thick and dense, consisting of a quantity of fat, arranged in lobules
in a network of strong connective tissue. At the root of the toes, the connective tissue framework is arranged
in a series of transverse bands, which constitute the superficial transverse ligament of the toes.

The deep, or plantar fascia is a strong sheet of fibrous tissue, which covers the superficial muscles of the
sole, and which in many respects is similar to the palmar fascia.

The central portion (3) is very strong, and is triangular in shape. It is attached behind to the internal
tuberosity of the os calcis, covers the flexor brevis digitorum muscle, and in front, divides into five slips
which pass to the toes. Between these slips the digital vessels and nerves and the lumbrical muscles emerge.

The lateral parts of the plantar fascia are much weaker.

The outer (4) invests the abductor minimi digiti muscle, and in connection with it a strong band passes
from the outer tuberosity of the os calcis to the base of the fifth metatarsal bone.

The inner portion (5) is a thin sheet, covering the abductor hallucis muscle.

The digital nerves which supply the toes have the following origin: on the .inner side of the foot
is a branch from the internal plantar nerve, supplying the inner margin of the great toe, and cutaneous
branches from the same nerve make their appearance in the adjacent three interspaces, and run forward to
supply the sides of the toes which bound the spaces, while oh the outer side of the foot is found a cutaneous
branch from the external plantar nerve, and in the adjacent space is a branch from the same nerve, whjcli
supplies the adjacent sides of the fourth and fifth toes.

Small digital vessels accompany these nerves.



The figures indicate



1. Os calcis, posterior part.

2. Base of fifth metatarsal bone.

3. Central part of plantar fascia.

4. External part of plantar fascia.
6. Internal part of plantar fascia.



6. Division of central portion of fascia into slips.

7. Superficial ransverse ligament of the toes.

8. Cutaneous branch of external plantar nerve.

9. Cutaneous branch of internal plantar nerve.
10. Digital artery and nerve running in company.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



Section VIII. No. 27



LOWER LIMB.



SOLE OF FOOT-NO. 2.

FIRST LAYER. THE DEEP FASCIA HAS BEEN REFLECTED, TO EXPOSE THE FIRST LAYER OP MUSCLES.

The muscles and tendons in the sole are arranged in four layers, of which this is the first or most
superficial.

The abductor hallucis muscle, on the inner side, takes origin from the inner tubercle of the os
calcis, and from the adjacent internal annular ligament, plantar fascia, and intermuscular septum, and
Is inserted into the base of the first phalanx of the great toe, where fibres of the flexor brevis hallucis
fcre blended with its tendon.

The flexor brevis digitorum arises from the inner tubercle of the os calcis, and from the plantar
fascia and the intermuscular septa on either side, and ends in four tendons which pass to trie four
outer toes, and which are inserted in the same manner as the tendons of the flexor subiimis digitorum
in the upper limb, to which it corresponds.

The abductor minimi digiti arises from both of the inferior tubercles of the os calcis, urider cover
of the flexor brevis digitorum, and from the adjacent bands of fascia, and is inserted into the outet
aspect of the base of the proximal phalanx of the little toe. A portion of the muscle is frequently
inserted into the base of the fifth metatarsal, forming the abductor ossis metatarsi quinti digiti.

The arch formed by the internal plantar nerve on the surface of the flexor brevis should bo
noted, but the blood vessels and nerves are more fully exposed in No. 3.

The short muscles play a part in supporting the arch of the foot, and the so-celled abductor



muscles have probably no action such as their name would indicate.



Muscles
etc.



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Tuberosity of os calcis.
Abductor minimi digiti.
Flexor brevis digitorum.
Abductor hallucis.
Outermost lumbrical.



The figures indicate

G. Flexor longus hallucis iendon.



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Nerves and 7. External plantar nerve and artery;

blood vessels. 8. Inner digital branch of internal plantar nerv.

9. Outer branch of internal plantar nerve.

10. External plantar digital nerve.

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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.

LOWER, LIMB.

SOLE OF FOOT No; 3.



ScctioA VIIL-No. 28



SECOND LATER.

The muscles of the first layer have been reflected, to show the second layer, and -the blood-vessels and nerves.

The second layer includes the musculus accessorius, the lumbricals, and the long flexor tendons.

The musculus accessorius arises by two heads, from the inner and outer aspects of the os calcis, and from 'the long
plantar ligament between them, and is inserted into the tendon of the flexor longus digitorum.

The lenclon of the flexor longus digitorum widens out in the sole into a flat fibrous band from which four tendons
pass to the four outer toes, and are inserted, in the same way as the tendons of the flexor profundus digitorum in the upper
limb, into the base of the terminal phalanges.

The tendon of the flexor longus hallucis passes under cover of this tendon, and sends a slip to it, and passes on the
surface of the flexor brevis hallucis to the base of the terminal phalanx of the great toe.

Nerves an I vessels. The external plantar artery, which is larger than the internal, passes obliquely across the
sole, with the corresponding nerve, on the surface of the musculus accessorius, to the interval between the flexor brevis
digitorum and the abductor minimi digiti. Here it dips down into the sole, and forms the plantar arch. In this part, it
gives off only some branches to the adjacent muscles and superficial tissues.

The external plantar nerve resembles the ulnar nerve in the hand as regards its cutaneous distribution. It supplies
the musculus accessorius and the abductor minimi digiti, and at the base of the fifth metatarsal it divides into a superficial
and a deep branch, the superficial branch dividing into two others, which supply (1) the outer side of the little toe, and the
flexor brevis minimi digiti and muscles of the fourth interosseous space, and (2) the adjacent sides of the fourth and fifth toes,
respectively.

The inner branch communicates with an adjacent branch from the internal plantar nerve. The deep division accom-
panies the plantar arch.

Tii? internal plantar artery is usually very small, and often ends, as here, on the inner side of the great toe, though
it is usually described as giving three digital branches, which accompany the branches of the internal plantar nerve to the
toes, as well as branches to the skin and muscles near it and on the inner side of the sole. fi

The internal plantar nerve runs forwards with the artery, and gives off" four large digital branches, as seen, it giveg
muscular branches to the abductor hnllucis and flexor brevis digitorum, while the inner digital branch supplies the flexog
brevis hallucis, and the adjacent branch the first lumbrical muscle. coj jj;



The figures indicate

Wusclcs. 1. Tuberosity of os calcis.
'2. Abductor minimi digiti.

3. Tendon of flexor brevia and flexor longus .digitorum.

4. Abductor hallucis.

5. Musculus accessorius outer head.

6. Musculus accessoriua inner head.

7. Flexor longua digitorum and lumbricals



Muscles. 8. Flexor longus hallucis.

9. Flexor brevis hallucis.

Nerves. 10. External plantar.

Vessels. 11. N. to abductor minimi digiti.

etc. 12. Internal plantar nerve.

13. Internal plantar artery.

14. Abductor osais metatarsi quinti digiti (insertion).




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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.

LOWER LIMB. SOLE OF POOT No. 4.

PLANTAR ARCH AND FOURTH LAYER.

The second layer of muscles -md portions of the adductor obliquus hallucis and flexor brevis hallucis hav
been removed.

The third layer of the sole contains the following muscles :

Plexor brevis minimi digit! arises from the base of the fifth metat&rsal and the sheath of the peroncus
longus, and is inserted into the outer side of the base of the proximal phalanx of the little toe.

Flexor brevis hallucis arises from the cuboid bone and from a-slip of the tendon of the tibiaiis posticus.

The adductor obliquus hallucis arises from the bases of the 2nd, 3rd, and 4th metatarsals and the sheath
of the peroneus longus tendon.

The adductor transversus hallucis arises from the inferior metatarso-phalangeal ligaments of the 3rd, 4th,
and 5th toes.

The insertion of these muscles is as follows the flexor brevis hallucis divides into two tendons, in which
large sesamoid bones are developed, and which are inserted into the sides of the first phalanx of the great toe.
The inner tendon joins the tendon of the abductor hallucis, and the outer is joined by the tendons of the
transverse and oblique adductor muscles.

In the fourth layer are found the interosseous muscles and the tendons of the peroneus longus and ti 1 ialis
posticus muscles.

The peroneus longus passes obliquely across the soln to be inserted into the internal cuneiform and base of
the first and sometimes also the second metatarsal bones, while the tibalis posticus is inserted principally into
the tubercle of the scaphoid, but sends slips forwards to the bases of the 2nd, 3rd, and 4th metatarsal bones,
and to the os calcis, cuboid, and cuneiform bones.

The plantar arch runs deeply across the sole from the base of the fifth metatarsal bone to the first inter-
osseous space where it is joined by the dorsalis pedis, and gives off four digital branches, which go to the
outer side of the little toe und to the three adjacent spaces, some articular branches and three posterior
perforating which ascend to the dorsum of the foot. The arteria magna hallucis is seen in the first interos-
seous space as a branch from the dorsalis pedis in the sole.

The deep division of the external plantar nerve runs with the plantar arch, and gives off muscular branches j
to adductors, transversus, and obliquus, to the three outer lumbricals, and to the interosseous muscles of the v
three inner spaces.



1. Tuberosity of os calcis.

2. Base of fifth metatarsal.

3. Base of tirst metatarsal.

4. Long plantar ligament.

5. Tendon of peroneus longus.
,6. Tendon of tibiaiis posticus.



The figures indicate

7. Flexor longus hallucis.

8. Flexor longus dig.torum.

9. Internal plantar nerve.

10. External plantar nerve.

11. Flexor brevis minimi digiti.

12. Adductor obliquus hallucis.



13. Adductor transversus.

14. Sesamoid bones of flexor brevia hallucis

15. Deep plantar arch and nerve.

16. Arteria magna hallucis.

17. Prolongations of tendon of tibialiu postfc

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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY,



Section VIII No. 30



LOWER LIMB.



LIGAMENTS SEEN ON THE OUTER

The ligaments which connect the leg with the foot, and the different bones of the skeleton of
the foot with one another are extremely numerous, and vary considerably in their comparative
strength and importance.

1. Ankle-joint. The anterior ligament was represented here by a strong band of fibrous tissue
passing from the front of the tibia to the neck of the astragalus, and the remainder of the capsule in
this aspect was very thin and indefinite.

The external lateral ligament is represented by three bands, an anterior in two fasciculi, a middle,
and a posterior (vide No. 3), of which the anterior passes to the neck of the astragalus and the middle
to the outer surface of the os calcis. The different bands are attached above to the external malleolus.

2. Foot. The astragalus is connected to the os calcis and to the scaphoid on this aspect by the
interosseous ligament, a strong band whose margin is seen at the. bottom of the sinus pedis, or tarsal
pit, by the external astragalo-calcanean, and by a dorsal astragalo-scaphoid band. Further
forward is a ligament uniting the os calcis and cuboid bones on their dorsal and outer aspect, and
in front, are the numerous bands, variable in their size, uniting the scaphoid and cuneiform bones,
and metatarsals together (not defined).



The figures indicate



1. Anterior inferior tibio-fibular ligament.

2. External ligament of ankle^ anterior band.

3. External ligament of ankle, middle band.

4. Outer edge of interosseous ligament.

5. Anterior annular ligament divided.

6. External astragalo-calcanean ligament.

7. Anterior ligament of ankle.



8. Dorsal astragalo-scaphoid ligament.

9. External calcaneo-scaphoid ligament.

10 and 11. Superior calcaneo-cuboid ligament.

12. External calcaneo-cuboid ligament.

13. Long plantar ligament.

1.4. Dorsal scapho-cuneiform ligament.
15. Peroneus longus tendon.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



Section YIH.-No. 31



LOWER LIMB.
ARTICULATIONS, ANKLE AND FOOT No. 2.

LIGAMENTS SEEN ON THE INNER SIDE.

1. Ankle. The internal lateral ligament is a strong triangular band which radiates from the
mder part of the internal malleolus, and is attached to the scaphoid bone in front, and then to the
istragalus, sustentaculum tali of the os calcis, and to the astragalus again at the back.

2. Foot. Several important bands are seen on this aspect. Below the internal lateral ligament
is the inferior calcaneo-scaphoid or spring ligament, so called from its action in maintaining tho
antero-posterior arch of the foot x by supporting the head of the astragalus. The ligament is covered
in part by the tendon of the tibialis posterior muscle, a bursa intervening, and it is attached
behind and below to the front of the sustentaculum tali, and its fibres pass in spiral fashion to the
under and inner parts of the scaphoid bone.

On the under aspect of the toot are seen the long and short plantar ligaments. The former is
attached to the under surface of the os calcis in front of the tuberosities, and passes forwards to
be attached to the under surface of the cuboid, from which fibres are continued forwards to be
attached to the bases of the three middle metatarsal bones

The short plantar ligament lies at a deeper level, and passes from the under surface of the os
calcis near the front to the cuboid bone behind the ridge. It is partly covered by the long plantar
ligament, but a portion can be 'seen to the inner side of that band.



The figures Indicate

1. Internal lateral ligament of ankle. 7. Termination of long plantar ligament

2. Posterior astragalo-calcanean ligament. 8. Peroneus longus tendon.

3. Groove for tibialis posticus tendon. 9. Slips from tibialis posticus tendon.

4. Inferior calcaneo-scaphoid ligament. 10. Tibialis posticus tendon.

5. Short plantar ligament. 11. Scapho-cuneiform articulation.

6. Long pkntar ligament.




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Section YIIL-NO. 32



LOWER LIMB.

AETICULATIONS, ANKLE AND FOOT No. 3.

LIGAMENTS SEEN FROM BEHIND.

1. Ankle. The posterior, almost horizontal, fasciculus of the external lateral ligament is seen
passing to the back of the os calcis. It lies below the posterior inferior tibio-fibular ligament, which
unites the two bones of the leg, and which conceals almost entirely the transverse ligament, which
lies on a deeper plane.

2. Foot. The posterior astragalo-calcanean ligament unites 'these two bones, passing from a
tubercle on the back of the astragalus to the upper and inner part of the posterior portion of the
ps calcis.

The joints on this aspect are greatly strengthened by the strong tendons of muscles which pass
in close relation to them, frequently grooving the bones

Thus the tibialis posticus and flexor longus digitorum tendons lie in a groove on the back of the
lower end of the tibia, while the flexor longus hallucis occupies a deep groove on the back of the
astragalus, and the tendons of the peroneus longus and brevis lie in a groove on the back of
external malleolus.



The figures indicate



1. Groove for tibialis posticus tendon".

2. Groove for flexor longus hallucis.

3. Posterior inferior tibio-fibular ligament.

4. Peroneal groove.

5. External lateral ligament, middle band.



6. External lateral ligament, posterior band.

7. Posterior astragalo-calcanean ligament. %

8. Internal lateral ligament of ankle.,

9. Tendo Achillis, and bursa between it and th^

os calcis.



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Online LibraryD. J. (Daniel John) CunninghamStereoscopic studies of anatomy (Volume 8) → online text (page 3 of 3)