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The posterior tibial artery arises from the popliteal artery in the popliteal fossa. [1] It is accompanied by a deep vein, the posterior tibial vein, along its course. It passes just posterior to the medial malleolus of the tibia, but anterior to the Achilles tendon. [1] It passes into the foot deep to the flexor retinaculum of the foot. [1]
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 the ankle). An imagined line is drawn between the bony prominence of the medial malleolus and the insertion of the achilles tendon.
Dorsalis pedis pulse: located on top of the foot, immediately lateral to the extensor of hallucis longus (dorsalis pedis artery). Tibialis posterior pulse: located on the medial side of the ankle, 2 cm inferior and 2 cm posterior to the medial malleolus (posterior tibial artery). It is easily palpable over Pimenta's Point.
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 into the anterior and posterior tibial arteries.
The tibial nerve, posterior tibial artery, posterior tibial vein, and flexor tendons travel in a bundle along this pathway through the tarsal tunnel, in the following order from anteromedial to posterolateral: Tibialis posterior tendon. [2] Flexor digitorum longus tendon. [2] Posterior tibial artery. [2] Posterior tibial vein. [1] Tibial nerve. [2]
Dorsalis pedis artery pulse – on dorsal surface of the foot, running lateral to the tendon of the first toe; Posterior tibial artery pulse – posterior and inferior to the medial malleolus; Popliteal artery pulse – behind the knee, typically done with both hands
tibial nerve; common fibular nerve (also known as the common peroneal nerve) [3] popliteal vein; popliteal artery, a continuation of the femoral artery; small saphenous vein (termination) [3] Popliteal lymph nodes and vessels [3] It is of note that the common fibular nerve also begins at the superior angle of the popliteal fossa. [4]
The tibiofibular trunk terminates by bifurcating into two terminal branches: the posterior tibial artery, and the fibular artery. This is the most common configuration of the origins of these arteries, however, many other anatomical variations exist. [1]
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