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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]
Pain radiating up into the leg, [1] behind the shin, and down into the arch, heel, and toes; Hot and cold sensations in the feet; A feeling as though the feet do not have enough padding; Pain while operating automobiles; Pain along the posterior tibial nerve path; Burning sensation on the bottom of foot that radiates upward reaching the knee
A knee dislocation is an injury in which there is disruption of the knee joint between the tibia and the femur. [3] [4] Symptoms include pain and instability of the knee. [2] Complications may include injury to an artery, most commonly the popliteal artery behind the knee, or compartment syndrome. [3] [4] [7]
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]
Medial tibial stress syndrome: Pain occurs over the shin bone (the tibia) with running or other sport-related activity. [17] Fibular and tibial stress fracture: Non-displaced microscopic fracture of the fibular and tibia occurs in many athletes, especially runners, and also in non-athletes who suddenly increase their activity level. [18]
Arteriosclerosis obliterans is an occlusive arterial disease most prominently affecting the abdominal aorta and the small- and medium-sized arteries of the lower extremities, which may lead to absent dorsalis pedis, posterior tibial, and/or popliteal artery pulses. [1]: 842
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
More rarely, excessive physical activity and other forms of foot trauma/chronic ankle injury are thought to be the cause. [1] [6] In the case of posterior tibial tendon dysfunction causing flatfoot, sinus tarsi syndrome can also develop due to the disruption in the entire structure of the foot. [4]