WINDSOR UNIVERISITY SCHOOL OF MEDICINE
 The
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posterior tibial artery,
the larger and more
direct terminal branch of the popliteal artery, provides the
blood supply to the posterior compartment of the leg and to
the foot
It begins at the distal border of the popliteus
Branches
largest branch, the fibular artery .
During its descent, the posterior tibial artery is
accompanied by the tibial nerve and veins.
The artery runs posterior to the medial malleolus, from
which it is separated by the tendons of the tibialis posterior
and flexor digitorum longus(tarsal tunnel)
Inferior to the medial malleolus, it runs between the
tendons of the flexor hallucis longus and flexor digitorum
longus.
Deep to the flexor retinaculum the posterior tibial artery
divides into medial and lateral plantar arteries
 The
posterior tibial pulse can usually be palpated
between the posterior surface of the medial
malleolus and the medial border of the calcaneal
tendon
 Palpation of the posterior tibial pulses is essential
for examining patients with occlusive peripheral
arterial disease.
 intermittent claudication, characterized by leg
pain and cramps, develops during walking and
disappears after rest. These conditions result from
ischemia of the leg muscles caused by narrowing or
occlusion of the leg arteries
 Anterior
tibial artery supplies structures in
the anterior compartment
 Begins at the inferior border of popliteus
muscle
 Passes anterior through the gap in the
superior part of the interroseous membrane
to descend between the tendons of tibialis
anterior and extensor digitorum longus
muscles
 Continues in the foot as the dorsalis pedis
artery
The dorsal artery of the foot (L. arteria dorsalis
ped is the direct continuation of the anterior
tibial artery
 The dorsal artery begins midway between the
malleoli and runs anteromedially, deep to the
inferior extensor retinaculum between the
extensor hallucis longus and the extensor
digitorum longus tendons on the dorsum of the
foot.
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it divides into the 1st dorsal metatarsal artery
and a deep plantar artery.
 The deep plantar artery enters the sole of the
foot, where it joins the lateral plantar artery to
form the deep plantar arch
 The
lateral tarsal artery
 The 1st dorsal metatarsal artery
 The arcuate artery
 perforating branches
 dorsal digital arteries
 Is
evaluated during a physical examination of the
peripheral vascular system.
 The pulses are usually easy to palpate because the
dorsal arteries of the foot are subcutaneous and
pass along a line from the extensor retinaculum to
a point just lateral to the Extensor Hallucis Longus
tendons
absent dorsalis pedis pulse usually suggests
vascular insufficiency resulting from arterial
disease.
The five P signs of acute arterial occlusion are
 By
perforating branches of anterior tibial
artery proximally
 Distally by perforating bracnches of fibular
artery
Significance of venous return from the lower limbantigravity.
The are subdivided superficial and deep veins the
superficial veins are between the two layers of
superficial fascia while the deep veins accompany
the arteries.
Both sets of veins are provided with valves more
numerous in the deep than in the superficial set.
The great saphenous vein (long
saphenous vein)
is the longest vein in the body. Begins in
the medial marginal vein of the dorsum of
the foot and ends in the femoral vein
about 3 cm below the inguinal ligament. It
passes in front of the medial malleolus and
along the medial side of the leg in relation
with the saphenous nerve behind the
medial condyles of the tibia and femur and
along the medial side of the thigh to end
in the femoral vein.
Main Tributaries:
-superficial circumflex iliac
-superficial external pudendal
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Small saphenous vein ( short
saphenous vein)
begins behind the lateral malleolus as
a continuation of the lateral marginal
vein,ascends and then crosses it to
reach the middle of the back of the
leg. It perforates the deep fascia at
the popliteal fossa and ends in the
popliteal vein
Tributaries
-Branch from great saphenous vein
-Lateral marginal vein
- Numerous tributaries from the back
of the leg.
The great and small saphenous veins and their tributaries
Deep veins
They accompany the arteries and their branches; they
possess numerous valves.
The deep plantar venous arch lies alongside the plantar
arterial arch drains into the medial and lateral plantar
veins
The posterior tibial vein accompanies the posterior
tibial artery and joined by the peroneal vein.
The anterior tibial vein is the upward continuation of the
venæ comitantes of the dorsalis pedis artery. They
leave the front of the leg by passing between the tibia
and fibula, over the interosseous membrane, and unite
with the posterior tibial vein to form the popliteal
vein.
The Popliteal Vein ascends through the popliteal fossa to
the opening in the Adductor magnus, where it becomes
the femoral vein. It receives tributaries corresponding
to the branches of the popliteal artery, and the small
saphenous vein.
The femoral vein accompanies the femoral artery
through the upper two-thirds of the thigh. It receives
many muscular tributaries, and about 4 cm below the
inguinal ligament is joined by the deep femoral vein
and is joined by the great saphenous vein before it
terminates. The deep femoral vein receives tributaries
corresponding to the perforating branches of the
profunda artery, and through these establishes
communications with the popliteal vein below and the
inferior gluteal vein above. It also receives the medial
and lateral femoral circumflex veins.
Formed by union of venae
comitantes of ant, post
tibial arteries.
 At the lower border of
popliteus.
 Continues as femoral vein
at adductor opening.
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TRIBUTARIES:
1- Veins accompany arteries.
2- Small saphenous v.
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Clinical application
clinical study- angiography
palpation for pulses
gangrene
varicose veins