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They drain the posterior compartment of the leg and the plantar surface of the foot to the popliteal vein, which it forms when it joins with the anterior tibial vein. [1] The posterior tibial vein is accompanied by an homonym artery, the posterior tibial artery, along its course. [2] It lies posterior to the medial malleolus in the ankle. [2]
The reflected ultrasound is received by the probe, transformed into an electric impulse as voltage, and sent to the engine for signal processing and conversion to an image on the screen. The depth reached by the ultrasound beam is dependent on the frequency of the probe used. The higher the frequency, the lesser the depth reached. [9]
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]
The popliteal vein is a vein of the lower limb. It is formed from the anterior tibial vein and the posterior tibial vein. It travels medial to the popliteal artery, and becomes the femoral vein. It drains blood from the leg. It can be assessed using medical ultrasound. It can be affected by popliteal vein entrapment.
On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
Unlike arterial ultrasonography, venous ultrasonography is carried out with the probe in a transversal position, (perpendicular to the vein axis), displaying cross-sections of the veins. [4] All collateral veins are better detected this way, including perforator veins, but of most importance is the detection of venous thrombosis.
Tarsal tunnel release is a form of a nerve decompression to relieve pressure on the tibial nerve. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot. The posterior tibial nerve is identified above the ankle. It is separated from the accompanying artery and vein and then followed into the tunnel.
Bancroft's sign, also known as Moses' sign, [1] is a clinical sign found in patients with deep vein thrombosis of the lower leg involving the posterior tibial veins.The sign is positive if pain is elicited when the calf muscle is compressed forwards against the tibia, but not when the calf muscle is compressed from side to side. [2]