Posterior Tibial Artery

The posterior tibial artery (A. tibialis posterior) is much the smaller of the two terminals of the popliteal. It lies at first between the tibia and the popliteus, then between that muscle and the deep and inner heads of the deep flexor. Lower down it descends along the tendon of the inner head, becomes superficial in the distal third of the leg, and passes behind the tendon. At the level of the tuber calcis it forms an ᔕ-shaped curve, runs downward along the deep flexor tendon accompanied by the plantar nerves, and divides at the lower part of the hock into internal and external plantar arteries. The collateral branches are as follows:

1. The nutrient artery of the tibia (A. nutritia tibiæ).

2. Muscular branches (Rami musculares) to the popliteus and deep flexor.

3. The external tarsal artery (A. tarsea lateralis) arises at the distal end of the leg and is distributed to the outer surface of the hock. It gives off a small recurrent branch which ascends along the external border of the gastrocnemius tendon and anastomoses with a branch of the posterior femoral artery.

4. The recurrent tibial artery (A. tibialis recurrens) is given off from the second part of the curve, ascends in relation to the tibial nerve, and anastomoses with the descending branch of the posterior femoral and with the saphenous artery.

5. Small branches (internal calcaneal) to the inner aspect of the hock.

6. The plantar arteries, internal and external (A. plantaris medialis, lateralis), are the small terminals of the posterior tibial. They descend along the sides of the tarsal sheath of the deep flexor with the plantar nerves to the proximal part of the metatarsus, where they unite with the perforating tarsal artery to form the plantar arch (Arcus plantaris). Four plantar metatarsal arteries proceed from this arch. The two slender superficial plantar metatarsal arteries (A. metatarsea plantaris superficialis medialis, lateralis) descend on either side of the deep flexor tendon with the plantar nerves and unite with the great metatarsal or with the corresponding digital artery. The two deep or interosseous plantar metatarsal arteries (A. metatarsea plantaris profundus medialis, lateralis) descend between the suspensory ligament and the corresponding small metatarsal bone and unite near the fetlock with the great metatarsal. The inner artery is the larger of the two and usually appears to be the continuation of the perforating tarsal. It supplies the nutrient artery of the large metatarsal bone. In other cases it is the direct continuation of the internal plantar artery, the external artery only uniting with the perforating tarsal.