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The anterior tibial artery is a branch of the popliteal artery. [1] It originates at the distal end of the popliteus muscle posterior to the tibia. The artery typically passes anterior to the popliteus muscle prior to passing between the tibia and fibula through an oval opening at the superior aspect of the interosseus membrane.
It arises at the anterior aspect of the ankle joint and is a continuation of the anterior tibial artery. [1] [2] It ends at the proximal part of the first intermetatarsal space. Here, it divides into two branches, the first dorsal metatarsal artery, and the deep plantar artery. [2] It is covered by skin and fascia, but is fairly superficial. [2]
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.
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.
An increased amount of anterior tibial translation compared with the opposite limb or lack of a firm end-point may indicate either a sprain of the anteromedial bundle or complete tear of the ACL. [2] If the tibia pulls forward or backward more than normal, the test is considered positive.
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The tibial tuberosity thus forms the terminal part of the large structure that acts as a lever to extend the knee-joint and prevents the knee from collapsing when the foot strikes the ground. [1] The two ligaments, the patella, and the tibial tuberosity are all superficial, easily palpable structures. [2]
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