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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.
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]
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 neck (carotid artery), wrist (radial artery or ulnar artery), at the groin (femoral artery), behind the knee (popliteal artery), near the ankle joint (posterior tibial artery), and on foot (dorsalis pedis artery).
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
The fibular artery typically arises from the posterior tibial artery. [3] Therefore, the posterior tibial artery proximal to the fibular artery origin is sometimes called the tibial-peroneal trunk or tibial-fibular trunk and it could be said that the popliteal artery bifurcates into the tibial-fibular trunk and anterior tibial artery.
The most common location for injuries was the lower back. Other frequent sites were the head, upper back, internal body (from swallowing items, for example) and shoulders.
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]
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