

THE POSTERIOR TIBIAL ARTERY 637 



Branches. The branches of the arteria dorsalis pedis are: 



Lateral Tarsal. Arcuate. 



Medial Tarsal. First Dorsal Metatarsal. 



Deep Plantar. 



The lateral tarsal artery (a. tarsea lateralis; tarsal artery) arises from the dorsalis 

 pedis, as that vessel crosses the navicular bone; it passes in an arched direction 

 lateralward, lying upon the tarsal bones, and covered by the Extensor digitorum 

 brevis; it supplies this muscle and the articulations of the tarsus, and anastomoses 

 with branches of the arcuate, anterior lateral malleolar and lateral plantar arteries, 

 and with the perforating branch of the peroneal artery. 



The medial tarsal arteries (aa. tarsece mediales) are two or three small branches 

 which ramify on the medial border of the foot and join the medial malleolar net-work. 



The arcuate artery (a. arcuata; metatarsal artery] arises a little anterior to the 

 lateral tarsal artery; it passes lateralward, over the bases of the metatarsal bones, 

 beneath the tendons of the Extensor digitorum brevis, its direction being influenced 

 by its point of origin ; and it anastomoses with the lateral tarsal and lateral plantar 

 arteries. This vessel gives off the second, third, and fourth dorsal metatarsal arteries, 

 which run forward upon the corresponding Interossei dorsales; in the clefts between 

 the toes, each divides into two dorsal digital branches for the adjoining toes. At 

 the proximal parts of the interosseous spaces these vessels receive the posterior 

 perforating branches from the plantar arch, and at the distal parts of the spaces 

 they are joined by the anterior perforating branches, from the plantar metatarsal 

 arteries. The fourth dorsal metatarsal artery gives off a branch w r hich supplies 

 the lateral side of the fifth toe. 



The first dorsal metatarsal artery (a. dorsalis hallucis) runs forward on the first 

 Interosseous dorsalis, and at the cleft between the first and second toes divides 

 into two branches, one of which passes beneath the tendon of the Extensor hallucis 

 longus, and is distributed to the medial border of the great toe; the other bifurcates 

 to supply the adjoining sides of the great and second toes. 



The deep plantar artery (ramus plantaris profundus; communicating artery) 

 descends into the sole of the foot, between the two heads of the first Interosseous 

 dorsalis, and unites with the termination of the lateral plantar artery, to complete 

 the plantar arch. It sends a branch along the medial side of the great toe, and is 

 continued forward along the first interosseous space as the first plantar metatarsal 

 artery, which bifurcates for the supply of the adjacent sides of the great and second 

 toes. 



The Posterior Tibial Artery (A. Tibialis Posterior) (Fig. 551). 



The posterior tibial artery begins at the lower Border of the Popliteus, opposite 

 the interval between the tibia and fibula; it extends obliquely downward, and, as 

 it descends, it approaches the tibial side of the leg, lying behind the tibia, and in 

 the lower part of its course is situated midw r ay between the medial malleolus and 

 the medial process of the calcaneal tuberosity. Here it divides beneath the origin 

 of the Adductor hallucis into the medial and lateral plantar arteries. 



Relations. The posterior tibial artery lies successively upon the Tibialis posterior, the Flexor 

 digitorum longus, the tibia, and the back of the ankle-joint. It is covered by the deep trans- 

 verse fascia of the leg, which separates it above from the Gastrocnemius and Soleus ; at its termi- 

 nation it is covered by the Abductor hallucis. In the lower third of the leg, where it is more 

 superficial, it is covered only by the integument and fascia, and runs parallel with the medial 

 border of the tendo calcaneus. It is accompanied by two veins, and by the tibial nerve, which 

 lies at first to the medial side of the artery, but soon crosses it posteriorly, and is in the greater 

 part, of its course on its lateral side. 



Behind the medial malleolus, the tendons, bloodvessels, and nerve are arranged, under cover 

 of the laciniate ligament, in the following order from the medial to the lateral side: (1) the 



