Atlas of Human Anatomy in Cross Section: Section 7. Lower Limb

Plate 7.24

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
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This section is three below the preceding one (3 cm). It cuts the leg below the calf, and all muscle bellies except those of gastrocnemius are present. The definition of the three compartments of the leg can be appreciated in this section. The anterior compartment is defined by the tibia, interosseous septum (membrane), fibula, and a line of fascia (15) extending from it in an anterolateral direction. The lateral compartment lies between the fibula and the posterolateral line of fascia (12). The posterior compartment is the largest and lies behind the tibia, interosseous septum (membrane), fibula, and the posterolateral line of fascia (12).

The great saphenous vein (2) begins at the medial ends of the dorsal venous arch and, after receiving branches from the sole, which join it by crossing over the medial border of the foot, it turns proximally anterior to the medial malleolus. It ascends about one finger's breadth posterior to the medial border of the tibia along with the saphenous nerve, which becomes superficial Just distal to the knee. It is posterior to the medial condyle of the knee, accompanying the saphenous branch of the descending genicular artery, and continues along the medial side of the thigh with medial branches of the anterior cutaneous nerve to about 3 to 4 cm distal to the inguinal ligament. It perforates the cribriform fascia and passes through the saphenous opening in the fascia lata to join the femoral vein. Throughout its length there are numerous communications with deep veins. These communications occur in the thigh below its midlength, at the knee, below the calf (midlength of leg), ankle, and foot.

Valves within these communications are oriented so that blood flows from the superficial channels into deep ones. There are 10 to 20 valves in the great saphenous vein.

The great saphenous vein receives, immediately before entering the fossa ovalis, the superficial epigastric, the superficial circumflex iliac, the external pudendal, and the medial and lateral accessory saphenous veins. The manner in which these veins enter the great saphenous vein is variable.

Numerous small veins from lymph nodes and superficial fascia in the inguinal region join the great saphenous vein as it arches through the saphenous opening.

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