|Henry Gray (18251861). Anatomy of the Human Body. 1918.|
|of the posterior tibial artery becomes evident near the lower end of the back of the tibia, and is easily detected behind the medial malleolus.|
Veins.By compressing the proximal trunks, the venous arch on the dorsum of the foot, together with the great and small saphenous veins leading from it (see page 669), are rendered visible.
Nerves.The only nerve of the lower extremity which can be located by palpation is the common peroneal as it winds around the lateral side of the neck of the fibula.
|14. Surface Markings of the Lower Extremity|
Bony Landmarks.The anterior superior iliac spine is at the level of the sacral promontorythe posterior at the level of the spinous process of the second sacral vertebra. A horizontal line through the highest points of the iliac crests passes also through the spinous process of the fourth lumbar vertebra, while, as already pointed out (page 1315), the transtubercular plane through the tubercles on the iliac crests cuts the body of the fifth lumbar vertebra. The upper margin of the greater sciatic notch is opposite the spinous process of the third sacral vertebra, and slightly below this level is the posterior inferior iliac spine. The surface markings of the posterior inferior iliac spine and the ischial spine are both situated in a line which joins the posterior superior iliac spine to the outer part of the ischial tuberosity; the posterior inferior spine is 5 cm. and the ischial spine 10 cm. below the posterior superior spine; the ischial spine is opposite the first piece of the coccyx.
| With the body in the erect posture the line joining the public tubercle to the top of the greater trochanter is practically horizontal; the middle of this line overlies the acetabulum and the head of the femur.|
FIG. 1243 Nélatons line and Bryants triangle. (See enlarged image)
| A line used for clinical purposes is that of Nélaton (Fig. 1243), which is drawn from the anterior superior iliac spine to the most prominent part of the ischial