The posterior tibial artery of the

lower limb The human leg, in the general word sense, is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or gluteal region. However, the definition in human anatomy refers only to the section of the lower limb ex ...

is an

artery An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...

that carries

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...

to the

posterior compartment of the leg The posterior compartment of the leg is one of the fascial compartments of the leg and is divided further into deep and superficial compartments. Structure Muscles Superficial posterior compartment Deep posterior compartment Blood ...

and

plantar Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

surface of the

foot The foot ( : feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made ...

. It branches from the

popliteal artery The popliteal artery is a deeply placed continuation of the femoral artery opening in the distal portion of the adductor magnus muscle. It courses through the popliteal fossa and ends at the lower border of the popliteus muscle, where it branches ...

via the

tibial-fibular trunk Tibiofibular trunk (or tibioperoneal trunk) is an arterial trunk representing the direct continuation of the popliteal artery distal to where the anterior tibial artery (the first branch of the popliteal artery) branches off from it. The tibiofibul ...

Structure

The posterior tibial artery arises from the

in the

popliteal fossa The popliteal fossa (also referred to as hough, .html" ;"title="/sup>">/sup> or kneepit in analogy to the cubital fossa) is a shallow depression located at the back of the knee joint. The bones of the popliteal fossa are the femur and the tibia ...

. It is accompanied by a

deep vein A deep vein is a vein that is deep in the body. This contrasts with superficial veins that are close to the body's surface. Deep veins are almost always beside an artery with the same name (e.g. the femoral vein is beside the femoral artery). ...

, the

posterior tibial vein The posterior tibial veins are veins of the leg in humans. They drain the posterior compartment of the leg and the plantar surface of the foot to the popliteal vein. Structure The posterior tibial veins receive blood from the medial and lat ...

, along its course. It passes just posterior to the

medial malleolus A malleolus is the bony prominence on each side of the human ankle. Each leg is supported by two bones, the tibia on the inner side (medial) of the leg and the fibula on the outer side (lateral) of the leg. The medial malleolus is the promine ...

of the

tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...

, but anterior to the

Achilles tendon The Achilles tendon or heel cord, also known as the calcaneal tendon, is a tendon at the back of the lower leg, and is the thickest in the human body. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (h ...

. It passes into the

deep to the flexor retinaculum of the foot. It runs through the

tarsal tunnel The tarsal tunnel is a passage found along the inner leg underneath the medial malleolus of the ankle. Structure The roof of the tarsal tunnel is formed by the flexor retinaculum of the foot. The floor of the tarsal tunnel is formed by the medi ...

Branches

The posterior tibial artery gives rise to: *

medial plantar artery The medial plantar artery (internal plantar artery), much smaller than the lateral plantar artery, passes forward along the medial side of the foot. It is at first situated above the abductor hallucis, and then between it and the flexor digitoru ...

. *

lateral plantar artery The lateral plantar artery (external plantar artery), much larger than the medial, passes obliquely lateralward and forward to the base of the fifth metatarsal bone. It then turns medialward to the interval between the bases of the first and secon ...

. *

fibular artery In anatomy, the fibular artery, also known as the peroneal artery, supplies blood to the lateral compartment of the leg. It arises from the tibial-fibular trunk. Structure The fibular artery arises from the bifurcation of tibial-fibular trunk ...

, which is said to rise from the bifurcation of the

and the posterior tibial artery. * calcaneal branch to the medial aspect of the

calcaneus In humans and many other primates, the calcaneus (; from the Latin ''calcaneus'' or ''calcaneum'', meaning heel) or heel bone is a bone of the tarsus of the foot which constitutes the heel. In some other animals, it is the point of the hock. S ...

Function

The posterior tibial artery supplies oxygenated

to the

and the plantar surface of the foot.

Clinical significance

Palpation of the posterior tibial artery pulse

The posterior tibial artery

pulse In medicine, a pulse represents the tactile arterial palpation of the cardiac cycle (heartbeat) by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the n ...

can be readily

palpated Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...

halfway between the posterior border of the

and the

. It is often examined by clinicians when assessing a patient for

peripheral vascular disease Peripheral artery disease (PAD) is an abnormal narrowing of arteries other than those that supply the heart or brain. When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular dise ...

. It is very rarely absent in young and healthy individuals. In a study of 547 healthy individuals, only one person did not have a palpable posterior tibial artery.Robertson GS, Ristic CD, Bullen BR. The incidence of congenitally absent foot pulses. Ann R Coll Surg Engl. 1990 Mar;72(2):99-100. . It is easily palpated over

Pimenta's Point Pimenta's point is an anatomical landmark for easy location of the posterior tibial artery or tibialis posterior artery (a peripheral pulse on the inside of your ankle). An imagined line is drawn between the bony prominence of the medial malleolus a ...

Nerve block

The posterior tibial artery is used as a landmark for the

tibial nerve The tibial nerve is a branch of the sciatic nerve. The tibial nerve passes through the popliteal fossa to pass below the arch of soleus. Structure Popliteal fossa The tibial nerve is the larger terminal branch of the sciatic nerve with root val ...

as both structures enter the

Local anaesthetic A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general ...

is injected either side of the artery distal to the flexor retinaculum of the foot, close to the

Additional images

File:Gray440_color.png, Cross-section through middle of leg. File:Popliteal branches from posterior labeled.png, Major arteries of the

leg A leg is a weight-bearing and locomotive anatomical structure, usually having a columnar shape. During locomotion, legs function as "extensible struts". The combination of movements at all joints can be modeled as a single, linear element ca ...

(posterior view). File:Gray555.png, The plantar arteries. Deep view.

References

External links

* - "Arteries of the lower extremity shown in association with major landmarks."
Image at umich.edu - pulse
* http://www.dartmouth.edu/~humananatomy/figures/chapter_15/15-10.HTM * http://www.dartmouth.edu/~humananatomy/figures/chapter_17/17-3.HTM {{Authority control Arteries of the lower limb