Posterior Tibial Artery Flashcards
General
- Terminal branch of popliteal artery
- Originates from low border of popliteus muscle between tibia and fibula
- LARGE artery
- Passes deep to soleus as it descends in the posterior leg
- Protected anteriorly by the tibia
Ankle joint
- At the ankle joint, the posterior tibial artery is located posterior to the medial malleolus
0 Accompanied by the tibial nerve - Travels in a neurovascular fascial tunnel (“tarsal tunnel”) deep to the flexor retinaculum, but superficial to the flexor hallucis longus tendon
- In the tunnel, the artery is medial (AKA superficial) to the tibial nerve
- The artery is surrounded by venae comitantes
Communicating branch
Before bifurcating, the posterior tibial artery gives off small communicating branches
- These communicate with the peroneal artery
Artery of tarsal canal
- The artery of the tarsal canal also branches off the posterior tibial artery prior to bifurcation
- This provides blood supply to the talus
Peroneal (fibular) artery
- Branches from the posterior tibial artery 2.5 cm below popliteus muscle
- Located deep in the fibular side of teh leg
- Descends along the medial border of the fibula, between the tibialis posterior and flexor hallucis longus
Branches of peroneal (fibular) artery
- Gives off muscular, nutrient and perforating arteries in the leg as it descends
- It then crosses the posterior aspect of the distal tibiofibular joint to give off 2 branches - the perforating branch of the peroneal artery and the posterior branch of the peroneal artery
Perforating branch of peroneal artery
- Pierces the interosseous membrane 5 cm superior to lateral malleolus in the anterior leg
- Runs down deep to the peroneus tertius tendon
- Anastomoses with the anterior lateral malleolar branch of the anterior tibial artery and contributes to the lateral malleolar rete
- Terminal branches of the perforating branch of the peroneal artery anastomose with the lateral tarsal branch of the dorsalis pedis
NOTE: 1-5% of perforating branches become the dorsalis pedis or occasionally the lateral tarsal artery
Posterior branch of peroneal artery
Crosses the ankle joint and terminates into two branches:
- Posterior lateral malleolar artery
- Lateral calcaneal arteries
Posterior lateral malleolar artery
- Small twig around lateral malleolus
- Contributes to the lateral malleolar arterial rete
- Retes provide blood to distal end of tibia and fibula
Lateral calcaneal arteries
Considered the TERMINAL branch of the peroneal artery
- Runs along the lateral heel
- Branches between the anterior and posterior lateral malleolar branches
- Anastomoses with medial calcaneal branches, which both supply the calcaneus
Anterior and posterior malleolar arteries
Recall… (LATERAL)
- Anterior lateral malleolar artery is a branch of the anterior tibial artery
- Posterior lateral malleolar artery is a branch from the peroneal artery
Recall… (MEDIAL)
- Anterior medial malleolar artery is a branch of the anterior tibial artery
- Posterior medial malleolar artery is a branch of the posterior tibial artery
Posterior medial malleolar artery
- Arises directly from posterior tibial artery
- Courses across the tibialis posterior and flexor digitorum longus muscles
- Anastomoses with the anterior medial malleolar branch of the anterior tibial artery and contributes to the rete
Medial calcaneal artery
- Originates from the posterior tibial artery, posterior to the medial malleolus and proximal to the bifurcation into medial and lateral plantar arteries
- Can occasionally originate from the lateral plantar artery when the bifurcation is high
- Pierces the flexor retinaculum and supplies the tendocalcaneus and heel
- Terminates as an anastomosis with the posterior medial malleolar branches of the posterior tibial artery and the lateral calcaneal branches of teh peroneal artery
Artery of the tarsal canal
Originates from the posterior tibial artery, prior to bifurcation
