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Posterior Tibial Artery
Cardiovascular System

Posterior Tibial Artery

Arteria tibialis posterior

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Quick Facts

Origin: Popliteal artery in the proximal portion of the posterior leg.

Course: Descends in the deep layer of the posterior compartment of the leg.

Branches: Circumflex fibular, fibular, nutrient, and plantar arteries, medial malleolar and calcaneal branches.

Supplied Structures: Fibula and tibia, muscles of the posterior and lateral compartments of the leg, the ankle and foot.

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Origin

At the distal margin of the popliteus muscle, the popliteal artery bifurcates into the anterior and posterior tibial arteries. However, the terminal bifurcation of the popliteal artery may occur proximal to popliteus muscle, or occasionally, it may trifurcate directly into the anterior and posterior tibial and fibular arteries (Standring, 2016).

The ratio of the diameter of the anterior and posterior tibial arteries may vary. In general, the posterior tibial artery is the larger of the two tibial arteries. The caliber of the fibular artery is inversely proportionate to the size of the anterior and posterior tibial arteries.

Course

The posterior tibial artery travels distally in a medial direction and lies deep to gastrocnemius and soleus muscles and the transverse intermuscular septum. It descends over the tibialis posterior muscle, then between the flexor digitorum longus and flexor hallucis longus muscles.

The posterior tibial artery continues distally, deep to the flexor retinaculum and accompanied by, from medial to lateral, the tendons of tibialis posterior and digitorum longus muscles, tibial nerve, and the tendon of the flexor hallucis longus muscle.

Distally, its terminal bifurcation occurs deep to abductor hallucis muscle, near the mid-point between the medial malleolus of the tibia and the calcaneal tubercle of the calcaneus. It divides into the medial and lateral plantar arteries.

Branches

The branches of the posterior tibial artery are listed from proximal to distal:

- circumflex fibular artery;

- fibular artery;

- nutrient artery;

- medial malleolar branches;

- calcaneal branches;

- medial and lateral plantar arteries.

Supplied Structures

The posterior tibial artery provides the bulk of the vascular supply to the deep muscles of the posterior compartments of the leg, including tibialis posterior, flexor hallucis longus, and flexor digitorum longus. It also supplies the soleus muscle.

It contributes to the supply of the knee joint, tibia, and fibula, ankle joint, and calcaneus, as well as the connective tissue structures and the overlying cutaneous tissue.

References

Standring, S. (2016) Gray's Anatomy: The Anatomical Basis of Clinical Practice. Gray's Anatomy Series 41st edition edn.: Elsevier Limited.

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Posterior Tibial Artery

ScienceDirect image

The posterior tibial artery then enters the calcaneal canal underneath the flexor retinaculum and bifurcates into the medial and lateral plantar arteries at the level of the transverse septum, between the abductor hallucis longus and the flexor digitorum brevis muscles.

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