What is the origin and course of the anterior tibial artery?

The anterior tibial artery originates as the smaller terminal branch of the popliteal artery at the lower border of the popliteus muscle. It enters the anterior compartment by passing through the interosseous membrane and descends vertically, continuing as the dorsalis pedis artery midway between the medial and lateral malleoli.

What are the key anatomical relations of the anterior tibial artery in the leg?

The artery lies between different muscles along its course. In the upper third, it's between tibialis anterior and extensor digitorum longus. In the middle third, it's between tibialis anterior and extensor hallucis longus, with the deep peroneal nerve anterior to it. In the lower third, it's between extensor hallucis longus and extensor digitorum longus. It is also crossed by the tendon of extensor hallucis longus and accompanied by two venae comitantes.

What are the main branches of the anterior tibial artery?

The branches include recurrent branches (anterior and posterior tibial recurrent) that participate in the knee joint anastomosis, muscular branches supplying the anterior compartment muscles, and anterior medial and lateral malleolar arteries contributing to the ankle joint anastomosis. A perforating branch from the peroneal artery may also reinforce blood supply.

How does the anterior tibial artery relate to the deep peroneal nerve?

The deep peroneal nerve lies lateral to the artery in the upper and lower thirds of the leg. In the middle third, it is positioned anterior to the artery, highlighting their close anatomical relationship.

What are some clinical variations or notes regarding the anterior tibial artery?

Clinically, the anterior tibial artery may be underdeveloped and terminate early, with the dorsalis pedis artery then arising from perforating branches of the peroneal or posterior tibial artery. There is also an inverse size relationship between the peroneal and anterior tibial arteries.

What does the anterior tibial artery become distally?

The anterior tibial artery continues distally as the dorsalis pedis artery, which occurs midway between the medial and lateral malleoli at the ankle.

What structures does the anterior tibial artery supply?

It supplies the muscles of the anterior compartment of the leg via muscular branches. Its branches also contribute to anastomoses around the knee and ankle joints.

Anterior Tibial Artery – Course & Branches

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