Anatomy
The dorsal artery of the foot (a. dorsalis pedis), the continuation of the anterior tibial artery, extends from the termination of that vessel at the bend of the ankle, to the posterior end of the first metatarsal space, where it divides into two branches, of which one proceeds forwards in the first interosseous space, whilst the other dips into the sole of the foot, and terminates by inosculating with the plantar arch. This vessel, in its course forwards, rests upon the astragalus, the scaphoid, and internal cuneiform bones and their respective articulations. It lies in the interval between the tendon of the proper extensor of the great toe, and that of the long extensor of the other toes ; and is covered by (besides the integument) the fascia of the foot, and by a layer of dense cellular membrane, which binds it to the parts beneath. Near its end, it is crossed by the innermost tendon of the short extensor of the toes.
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The femoral artery is accessible to the surgeon for the application of a ligature without serious difficulty in its entire length ; but as the lower half is deeply placed, the difficulty of reaching this part is greatest, at the same time that the depth at which the vessel lies renders it necessary to divide and disturb the surrounding structures to a greater extent than where the vessel is nearer the surface. For these reasons the upper part of the artery is to be preferred for the performance of the operation adverted to, in all cases in which other circumstances do not control the choice of the surgeon. But the upper part of the femoral artery is not equally eligible for the application of a ligature at all points, in consequence of the position of the branches — an important consideration in the surgical anatomy of this vessel.
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The anterior tibial artery, [a. tibialis antica,] placed along the fore part of the leg, is at first deeply seated, but, as it descends, gradually approaches nearer to the surface. It extends from the division of the popliteal artery to the bend of the ankle, whence it is afterwards prolonged to the interval between the first and second metatarsal bones, under the name of dorsal artery of the foot.
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The external circumflex artery, [circumfiexa femoris interna s. posterior,] a branch of considerable size, arises from the outer side of the profunda, and, after passing outwards for a short distance beneath the sartorius and rectus muscles, and through the divisions of the anterior crural nerve, gives branches, which may be divided into three sets, according to the directions which they take.
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Terminal branches of the posterior tibial artery.
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The deep femoral artery (a. profunda femoris), is the principal nutritious vessel of the thigh; its branches being mainly distributed to that part of the lower limb, whereas the femoral artery supplies the leg and foot. It is a vessel of considerable calibre, being nearly equal in size to the continuation of the femoral after the origin of this great branch (The artery of the lower limb, after emerging from the abdominal cavity, was described bv Murray as the common femoral, and was regarded by him as dividing into two parts, which he named respectively, the superficial, and the deep femoral arteries. These terms are often conveniently used by surgical writers for easy reference to different parts of the vessel).
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The peroneal artery, [a. peronea] lies deeply along the back part of the leg, close to the fibula : hence its names, peroneal or fibular. Arising from the posterior tibial artery, about an inch below the lower border of the popliteus muscle, it inclines at first obliquely towards the fibula, and then descends nearly perpendicularly along that bone and behind the outer ankle, to reach the side of the os calcis.
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The femoral artery gives off the following branches. Some, small and superficial, which are distributed to the integument and glands of the groin, or ramify on the lower part of the abdomen, viz., the external pudic (superior and inferior), the superficial epigastric, and the superficial circumflex iliac ; the great nutrient artery of the muscles of the thigh, named the deep femoral; several small muscular branches; and lastly, the anastomotic artery, which descends on the inner side of the knee-joint.
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The posterior tibial artery [a. tibialis postica] is situated along the back part of the leg, between the superficial and deep layers of muscles, being firmly bound down to the latter by the deep fascia.
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The circumflex iliac artery [Latin : circumflexa ilii], smaller than the preceding vessel, arises from the outer side of the iliac artery near Poupart's ligament, and is directed outwards behind that structure to the anterior superior spine of the ilium.
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The popliteal artery [a. poplitea], at the back of the knee-joint, extends along the lower third of the thigh and the upper part of the leg, reaching from the opening in the great adductor to the lower border of the popliteus muscle. It is continuous above with the femoral, and divides at the lower end into the anterior and posterior tibial arteries.
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The epigastric artery (French : Artère épigastrique ; Latin :epigastrica inferior) arises from the fore part of the external iliac artery, usually a few lines above Poupart's ligament.
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The spleen is a large blood-vascular