Description

This video covers the Posterior Tibial Artery, Anterior Tibial Artery, and the Blood Supply of the Foot, including key branches and clinical relevance.

Posterior Tibial Artery (A. Tibialis Posterior):

• Circumflex Fibular Artery (R. Circumflexus Fibularis): Contributes to the anastomoses around the knee.
• Fibular/Peroneal Artery (A. Fibularis/A. Peronea): Major lateral branch supplying the posterior and lateral compartments of the leg.
  • Lateral Malleolar Arteries (Rr. Malleolares Laterales): Supplies the lateral malleolus.
• Medial Malleolar Arteries (Rr. Malleolares Mediales): Supplies the medial malleolus.
• Calcaneal Arteries (Rr. Calcanei): Supplies the heel.
• Lateral Plantar Artery (A. Plantaris Lateralis): Supplies the lateral part of the sole and contributes to the deep plantar arch.
• Medial Plantar Artery (A. Plantaris Medialis): Supplies the medial part of the sole and first toe.

Anterior Tibial Artery (A. Tibialis Anterior):

• Posterior Tibial Recurrent Artery (A. Recurrens Tibialis Posterior): Anastomoses with genicular arteries.
• Anterior Tibial Recurrent Artery (A. Recurrens Tibialis Anterior): Contributes to the knee joint supply.
• Anterior Lateral Malleolar Artery (A. Malleolaris Anterior Lateralis): Supplies the lateral ankle.
• Anterior Medial Malleolar Artery (A. Malleolaris Anterior Medialis): Supplies the medial ankle.
• Dorsalis Pedis Artery (A. Dorsalis Pedis): Terminal branch that supplies the dorsum of the foot.

Blood Supply of the Foot:

Dorsalis Pedis Artery:

• Lateral Tarsal Artery (A. Tarsalis Lateralis): Supplies lateral dorsum of the foot.
• Medial Tarsal Arteries (Aa. Tarsales Mediales): Supplies medial dorsum of the foot.
• Arcuate Artery (A. Arcuata): Forms an arch, giving rise to dorsal metatarsal arteries.
• Dorsal Metatarsal Arteries (Aa. Metatarsales Dorsales): Each divides into two dorsal digital arteries.
• 1st Dorsal Metatarsal Artery (A. Metatarsalis Dorsalis Prima): Divides into three dorsal digital arteries.
• Deep Plantar Artery (A. Plantaris Profunda): Contributes to the deep plantar arch.

Plantar Circulation:

• Lateral Plantar Artery: Forms the Deep Plantar Arch (Arcus Plantaris Pedis) by connecting with the deep plantar artery from dorsalis pedis.
  • Plantar Metatarsal Arteries: Supply toes by dividing into plantar digital arteries.
• Medial Plantar Artery: Primarily supplies the first toe.

Clinical Relevance:

• Peripheral Arterial Disease (PAD): Commonly affects tibial arteries, leading to ischemia and ulcers.
• Pulses for Circulatory Assessment:
  • Posterior Tibial Pulse: Palpated behind the medial malleolus.
  • Dorsalis Pedis Pulse: Palpated on the dorsum of the foot.
• Diabetic Foot Ulcers: Often result from impaired circulation in the plantar arch.

Sources Used:

• Memorix Anatomy (2nd Edition) – Hudák Radovan, Kachlík David, Volný Ondřej.
• Complete Anatomy by 3D4Medical.
• Biorender.
• University Notes and Lectures.

Transcript

Introduction
0:00
in this video we’re going to look at the
0:02
anterior and the posterior tibial
0:04
arteries
0:05
as well as the arterial blood supply of
0:07
the foot and ankle
0:08
and to do that we first need to look at
0:10
the posterior aspect of the knee
0:12
because as the femoral artery comes down
0:15
it becomes the popliteal artery in the
0:17
popliteal fossa
0:19
where it branches out supplying the knee
0:21
with blood
0:22
then in front of the popliteus muscle it
0:25
will end up by dividing into two
0:27
terminal branches
0:28
and these are the anterior and the
0:30
posterior tibial arteries
0:32
and those are the arteries we’re going
0:34
to focus on in this video
0:36
so let’s repeat some bone anatomy first
0:38
by looking at the scheme a little bit
0:41
here you see the tibia and the fibula
0:43
the medial and the lateral malleolus
0:46
then the talus and the calcaneus and
0:48
between the tibia and the fibula
0:51
there’s going to be the interoserus
0:52
membrane so now we got the popliteal
0:55
artery
0:56
coming down and giving off the anterior
0:58
tibial artery
1:00
while continuing as the posterior tibial
1:02
rv
1:03
so both the anterior and the posterior
1:05
tibial arteries are
1:07
terminal branch of the popliteal artery
Posterior Tibial Artery
1:10
the posterior tibial artery descends
1:13
between the deep flexors and the soleus
1:15
muscle
1:16
and then curves posteriorly to the
1:18
medial malleolus
1:20
where it now goes to the plantar surface
1:22
of the foot
1:23
and divides into two terminal branches
1:25
the medial plantar artery and the
1:27
lateral plantar artery as is here
1:30
now the tibialis posterior supplies
1:32
mainly the posterior compartment of the
1:34
leg the muscles of the posterior
1:36
compartment of the leg and it does that
1:37
by giving off some side branches
1:39
the first one is the circumflex feebler
1:41
archery you’re probably already familiar
1:44
with this one if you know the patellar
1:46
network
1:47
because this one will wind around the
1:49
feebler head
1:50
as you see here and it will go
1:52
anteriorly to supply the knee with blood
1:55
then there’s the feebler artery or
1:57
sometimes also referred to as the
1:58
perineal artery
2:00
it starts from the upper third part of
2:02
the posterior tibial
2:04
and then it descends along the posterior
2:06
medial aspect of the fibula
2:08
and end up at the calcaneus as a
2:10
terminal branch
2:11
called the calcaneal artery another side
2:15
branch is the medial molecular artery
2:17
for the
2:17
medial malaria network on the ankle and
2:20
the lateral malarial artery from the
2:22
tibial artery for the
2:24
lateral malaria network then
2:27
there’s the calcaneal branch to form the
2:30
arterial network over the calcaneus
2:33
so the posterior tibial artery give off
2:36
the cocanyl branch
2:37
and the tibial artery terminates as they
2:39
calculate artery
2:41
then the last branches are the nutrient
2:43
branches for the bone marrow
2:45
both the fibular artery and the
2:47
posterior tibial artery
2:48
have these branches so that was all for
Anterior Tibial Artery
2:52
the posterior tibial artery
2:54
let’s do the anterior tibial again the
2:56
popliteal artery comes down and divides
2:59
the anterior tibial artery will sneak
3:02
out between the tibia and the fibula
3:04
and wind anteriorly where it ends ends
3:07
at the first metatarsal space as you see
3:09
here
3:10
where it now becomes the dorsal pedus
3:12
artery now let’s do the side branches
3:14
now the anterior tibial will mainly
3:17
supply the anterior muscles of the leg
3:19
but the first side branch is the
3:21
posterior tibial recurrent
3:23
which branches out right before the
3:26
anterior tibial artery
3:27
reaches anterior surface as you see here
3:30
and we also have the anterior
3:32
tibial recurrent artery which branch out
3:35
when the anterior tibial artery reaches
3:38
the anterior surface
3:39
these two will go up and supply the knee
3:42
with blood
3:43
then we have the anterior lateral malair
3:46
and the anterior medial malleolus artery
3:49
for the blood supply around the ankle
3:51
and
3:52
that was mainly all the side branches of
3:54
the anterior tibial artery
3:56
now let’s do the dorsal pedus artery and
Dorsal Foot Arteries
3:59
to do
4:00
that i think it’s better if we change up
4:02
the scheme a little bit
4:04
now the dorsal pedis artery as you know
4:07
is a terminal branch of the anterior
4:09
tibial artery
4:10
there are only three side branches of
4:13
the dorsal pedus artery
4:14
the first side branch is the lateral
4:16
tarsal artery
4:18
which starts at the level of the kaput
4:19
tully and goes
4:21
laterally to supply the structures there
4:24
then
4:24
since we have a lateral tarsal artery we
4:27
will also have a medial tarsal artery
4:29
which supplies structures on the medial
4:31
side of the foot
4:32
and muscles of the first toe on the pla
4:34
on the plantar surface
4:36
so it winds around going to the plantar
4:38
surface
4:40
then there’s the arkwit artery which
4:43
passes laterally as you see here and
4:45
anastomos with the lateral tarsal artery
4:48
so those three are the side branches of
4:51
the dorsal pedis artery
4:53
now as the dorsal pedis artery continues
4:56
it ends up by splitting into two
4:58
terminal branches
5:00
one is called the first dorsal
5:01
metatarsal artery
5:03
and the other one is called the deep
5:05
plantar artery which
5:06
pierces the muscles of the first toe and
5:08
ends up in the
5:10
plantar surface now for the arterial
5:13
supply of the toes
5:15
the arcuate artery will give off the
5:17
dorsal metatarsal arteries
5:19
which give off perforating arteries and
5:22
then
5:22
continue dividing into the dorsal
5:25
digital arteries
5:26
three dorsal digester arteries for the
5:28
first dorsal metatarsal
5:30
and two for each of the other dorsal
5:33
metatarsal arteries
Plantar Foot Arteries
5:34
so that was all for the dorsal pedis
5:37
artery now let’s do the posterior tibial
5:39
artery which
5:40
remember divides into two plantar
5:42
arteries
5:43
the medial and the lateral plantar
5:45
artery
5:47
at the base of the fifth metatarsal bone
5:50
the
5:50
lateral plantar artery turns medially
5:53
and anesthetized with the deep plantar
5:55
artery of the dorsal pedis as you see
5:57
here
5:58
and they form an important arch on the
6:01
planetary surface
6:02
called the deep plantar arch so let’s
6:05
look a little bit into that
6:07
on the plantar surface we have the
6:09
lateral plantar artery
6:11
and on the dorsal surface we have the
6:14
dorsal pedis artery
6:16
they connect through the deep plantar
6:18
artery
6:19
and they form the deep plantar arch so
6:22
the deep plantar arch
6:24
starts from the from the fifth
6:25
metatarsal to the first interossera
6:28
space
6:29
the perforating arteries from the dorsal
6:31
metatarsal
6:32
will connect with the deep plantar
6:34
surface to get a
6:35
nice collateral blood flow and then
6:38
again just like the dorsal surface
6:40
the deep plantar arch will give off five
6:42
plantar metatarsal arteries
6:44
which will divide into proper digital
6:46
arteries
6:47
but for the medial plantar artery
6:49
however the artery anastomose with the
6:52
first
6:52
dorsal metatarsal artery and supplies
6:55
the muscles of the first toe as well as
6:57
supplying the rest of the first toe with
6:59
blood
7:00
so that was everything i had for the
7:02
posterior and the anterior tibial
7:04
arteries
7:05
and i hope this was helpful