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Posterior Tibial Artery. Artery of the Posterior Fascial Compartment of the Leg The posterior tibial artery is one of the terminal branches of the popliteal artery. It begins at the level of the lower border of the popliteus muscle The artery passes behind the medial malleolus
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Posterior Tibial Artery • Artery of the Posterior Fascial Compartment of the Leg • The posterior tibial artery is one of the terminal branches of the popliteal artery. • It begins at the level of the lower border of the popliteus muscle • The artery passes behind the medial malleolus • Terminates by dividing into medial and lateral plantar arteries. • Midway between the medial malleolus and the heel, the pulse of the posterior tibial artery is palable.
Posterior Tibial Artery cont.. • Peroneal artery • Muscular branches to the lateral compartment of the leg • Nutrient artery to the fibula • Ends by taking part in the anastomosis around the ankle joint. • A perforating branch pierces the interosseous membrane to reach the lower part of the front of the leg.
Branches ofPosterior Tibial Artery • Muscular branches (posterior compartment of the leg). • Nutrient artery to the tibia • Anastomotic branches, which join other arteries around the ankle joint • Medial and lateral plantar arteries • Venae comitantes of the posterior tibial artery join those of the anterior tibial artery in the popliteal fossa to form the popliteal vein.
Medial plantar arteries The medial plantar artery is the smaller of the terminal branches of the posteriortibial artery. Branches: Muscular Cutaneous Articular branches
The lateral plantar artery • The lateral plantar artery is the larger terminal branch of the posterior tibial artery. • During its course, it gives • muscular • cutaneous • articular branches. • It curves medially tojoins the dorsalispedis artery and form the plantar arch. • The plantar arch gives off • four plantar metatarsal arteries → digital branches to adjacent sides of toes 1stto 5th toes • three perforating arteries (anastomose with vessels on the dorsal aspect of the foot.
Venous drainage of the lower limb • Superficial and Deep veins: The superficial veins are between the two layers of superficial fascia The deep veins accompany the arteries. Both sets of veins are provided with valves
Superficial Veins • There are interconnected networks of deep and superficial veins in the foot. • Superficial veins drain into a dorsal venous arch . These veins are: • The great saphenous vein • The small saphenous vein
The great saphenous vein (long saphenous vein) • The longest vein in the body. • It drains the medial end of the dorsal venous arch of the foot • Passes upward in front of the medial malleolus • It passes behind the knee • Forward around the medial side of the thigh. • It passes through the saphenous opening and joins the femoral vein about 1.5 in. (4 cm) below and lateral to the pubic tubercle.
The great saphenous vein cont.. • It has numerous valves(10-20) and is connected to the small saphenous vein . • Several perforating veins connect the great saphenous vein with the deep veins along the medial side of the calf
Tributaries : • the superficial circumflex iliac vein, • the superficial epigastric vein, and • the superficial external pudendal vein. • The accessory vein ( usually joins the main vein about the middle of the thigh).
Small saphenous vein( short saphenous vein ) • Arises from the lateral part of the dorsal venous arch • Ascends behind the lateral malleolus to back of the leg to reach the popliteal fossa • Ends in the popliteal vein at the popliteal fossa • It has 9-12 valves • Tributaries: • Numerous small veins from the back of the leg. • Anastomotic branches that join the great saphenous vein • Communicating with the deep veins of the foot.
Deep veins Venae Comitantes They accompany the arteries and their branches as venae commitantes. They possess numerous valves. The deep plantar venous arch →medial and lateral plantar veins→The posterior tibialvein The posterior tibial vein is joined by the peroneal vein. The anterior tibial vein is the upward continuation of the venæcomitantesof the dorsalis pedisartery it unites with the posterior tibial vein to form the popliteal vein.
Deep veins cont.. Popliteal vein • Formed by union of venae comitantesof ant, post tibialarteries at the lower border of popliteus. • In the popliteal fossa it lies posterior to the popliteal artery • Continues as femoral vein at adductor opening. • TRIBUTARIES: • Veins accompany arteries. • Small saphenous v.
Deep veins cont.. The femoral vein • Enters the thigh by passing through the opening in the adductor magnusas a continuation of the popliteal vein • It passes behind the inguinal ligament to become the external iliac vein. • Tributaries: • The great saphenous vein • The deep femoral Vein • tributaries corresponding to the perforating branches of the profunda artery. • medial and lateral femoral circumflex veins. • Muscular branches
Veins of the sole of the foot • Medialand lateral plantar veins accompany the corresponding arteries, and they unitebehind the medial malleolus to form the posterior tibial venae commitantes
Peripheral pulses can be felt at four locations in the lower limb • Femoral pulse in the femoral triangle- • midway between the anterior superior iliac spine and the pubic symphysis. • Popliteal pulse in the popliteal fossa • deep in the popliteal fossa medial to the midline. • Posterior tibial pulse • between the medial malleolus and the heel (calcaneal tuberosity). • Dorsalispedis pulse • over the tarsal bones between the tendon of extensor hallucislongus and the tendon of extensor digitorumlongus to the second toe.
