[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) › Anterior tibial artery [Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) # Anterior tibial artery The anterior tibial artery runs down the front of the leg and becomes the dorsalis pedis artery on top of the foot. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=lower_limb&select=anterior_tibial_artery&side=r) Opens in the Durgical app, no sign-up needed. ## What it is An artery that passes to the front of the leg and runs down beside the tibia. ## What it does Supplies the muscles at the front of the leg and continues onto the top of the foot as the dorsalis pedis artery. ## Key points - Reaches the front of the leg through the gap above the interosseous membrane; tethered there, it is injured in proximal tibial fractures and knee dislocations - Runs with the [deep fibular nerve](https://durgical.com/en/anatomy/deep-fibular-nerve/): the nerve lies lateral to it above, in front of it in the middle third, and lateral again at the ankle - In anterior compartment syndrome the foot pulses often stay present until late, so a pulse does not exclude it ## Key facts **Origin** [Popliteal artery](https://durgical.com/en/anatomy/popliteal-artery/) at lower border of popliteus; passes above interosseous membrane to front of leg **Branches** Anterior and posterior tibial recurrent, muscular, anterior medial and lateral malleolar **Supplies** Anterior compartment of leg; continues as dorsalis pedis in front of ankle ## Relations **Course** From the popliteal bifurcation at the lower border of the [popliteus](https://durgical.com/en/anatomy/popliteus-muscle/) it passes forward between the heads of the [tibialis posterior](https://durgical.com/en/anatomy/tibialis-posterior-muscle/) and above the interosseous membrane, descends on the membrane and then on the front of the [tibia](https://durgical.com/en/anatomy/tibia/), and becomes the [dorsalis pedis artery](https://durgical.com/en/anatomy/dorsalis-pedis-artery/) midway between the malleoli **Medial** The [tibialis anterior](https://durgical.com/en/anatomy/tibialis-anterior-muscle/); near the ankle, the [extensor hallucis longus](https://durgical.com/en/anatomy/extensor-hallucis-longus/) tendon, which crosses in front of it from lateral to medial **Lateral** The [extensor digitorum longus](https://durgical.com/en/anatomy/extensor-digitorum-longus/) and, higher up, the extensor hallucis longus **Deep** The interosseous membrane, then the lower tibia and the front of the ankle joint **Superficial** Deep fascia and, near the ankle, the [extensor retinacula](https://durgical.com/en/anatomy/superior-extensor-retinaculum-of-ankle/) ## How to find it Too deep to feel along most of the leg. Its line runs from a point midway between the tibial tuberosity and the head of the [fibula](https://durgical.com/en/anatomy/fibula/) down to the midpoint between the malleoli, where its pulse becomes that of the dorsalis pedis artery. ## Examination - Ankle–brachial index: one of the two ankle pressures is taken over the dorsalis pedis, its continuation; after a knee dislocation or upper tibial fracture an abnormal value leads to vascular imaging - A handheld Doppler at the front of the ankle confirms flow when the dorsalis pedis pulse cannot be felt ## On imaging Duplex ultrasound follows it down the interosseous membrane without contrast. CT angiography is the quick study after knee or upper tibial trauma; catheter angiography shows best how it runs on into the dorsalis pedis. Heavy wall calcification can blur both. ## Common problems - Can be injured in fractures of the tibia or knee dislocations. - Pressure in a tight muscle compartment (compartment syndrome) can cut off its flow. ## Clinical notes - A common target for distal bypass in limb-salvage surgery - In high tibial osteotomy and surgery on the upper fibula it lies close behind the bone at the interosseous gap - In diabetes, artery disease often hits the vessels below the knee, this one included, with long blockages; in the angiosome model it feeds the top of the foot ## Anatomical variants - High origin, above the lower border of the popliteus or even at the level of the knee joint - Hypoplastic or absent, with the perforating branch of the [fibular artery](https://durgical.com/en/anatomy/fibular-artery/) supplying the dorsalis pedis artery - May give rise to the fibular artery (rare) - A dorsalis pedis pulse that cannot be felt in a minority of healthy people, because the artery is small, absent or off its usual line ## Development The first arterial [axis](https://durgical.com/en/anatomy/axis/) of the leg is the sciatic artery, which continues below the knee as the fibular artery; the femoral route takes over later and the tibial arteries arise from the axis. This explains why the fibular artery can replace a small or absent anterior tibial artery. ## Memory aid Front of the ankle, medial to lateral: «Tom, Harry And Nervous Dick»: Tibialis anterior, extensor Hallucis longus, Artery, Nerve (deep fibular), extensor Digitorum longus. ## Related conditions - [Acute compartment syndrome](https://durgical.com/en/conditions/acute-compartment-syndrome/) - [Tibial shaft fracture](https://durgical.com/en/conditions/tibial-shaft-fracture/) - [Peripheral artery disease](https://durgical.com/en/conditions/peripheral-artery-disease/) - [Acute limb ischaemia](https://durgical.com/en/conditions/acute-limb-ischaemia/) - [Popliteal Artery Injury](https://durgical.com/en/conditions/popliteal-artery-injury/) ## Test yourself Think of the answer, then tap the question to see it. ## How does the anterior tibial artery reach the front of the leg? From the popliteal bifurcation at the lower border of the popliteus, it passes forward above the interosseous membrane. ## Why is the anterior tibial artery injured in proximal tibial fractures and knee dislocations? It is tethered where it passes through the gap above the interosseous membrane. ## Where does the anterior tibial artery become the dorsalis pedis artery? In front of the ankle, midway between the malleoli. ## Does a palpable foot pulse rule out anterior compartment syndrome? No; the foot pulses often stay present until late. ## Which ankle pressure in the ankle–brachial index depends on the anterior tibial artery? The dorsalis pedis pressure, taken over its continuation on the top of the foot. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/anterior-tibial-artery/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** arteria tibialis anterior TA2 4708 **Official Spanish (DeCS)** Arteria tibial anterior DeCS D016909 **English (TA2)** Anterior tibial artery ## Related - [Deep fibular nerve](https://durgical.com/en/anatomy/deep-fibular-nerve/) - [Dorsalis pedis artery](https://durgical.com/en/anatomy/dorsalis-pedis-artery/) - [Tibialis anterior](https://durgical.com/en/anatomy/tibialis-anterior-muscle/) - [Extensor digitorum longus](https://durgical.com/en/anatomy/extensor-digitorum-longus/) - [Extensor hallucis longus](https://durgical.com/en/anatomy/extensor-hallucis-longus/) - [Fibularis tertius](https://durgical.com/en/anatomy/fibularis-tertius-muscle/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=29778&filter=ths_termall&q=Arterias%20Tibiales); [Anatomy, Bony Pelvis and Lower Limb: Tibial Artery](https://www.ncbi.nlm.nih.gov/books/NBK532871/); [20.5 Circulatory Pathways](https://openstax.org/books/anatomy-and-physiology-2e/pages/20-5-circulatory-pathways) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/); Anatomy of the Human Body (20th ed.): The Anterior Tibial Artery (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain; Anatomy of the Human Body (20th ed.): Development of the Vascular System (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/anterior-tibial-artery/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/anterior-tibial-artery/