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The anterior tibial artery commences at the bifurcation of the popliteal, at the lower border of the Popliteus, passes forward between the two heads of the Tibialisposterior, and through the aperture above the upper border of the interosseous membrane, to the deep part of the front of the leg: it here lies close to the medial side of the neck of the fibula. It then descends on the anterior surface of the interosseous membrane, gradually approaching the tibia; at the lower part of the leg it lies on this bone, and then on the front of the ankle-joint, where it is more superficial, and becomes the dorsalis pedis.
Relations.—In the upper two-thirds of its extent, the anterior tibial artery rests upon the interosseous membrane; in the lower third, upon the front of the tibia, and the anterior ligament of the ankle-joint. In the upper third of its course, it lies between the Tibialis anterior and Extensor digitorum longus; in the middle third between the Tibialis anterior and Extensor hallucis longus. At the ankle it is crossed from the lateral to the medial side by the tendon of the Extensor hallucis longus, and lies between it and the first tendon of the Extensor digitorum longus. It is covered in the upper two-thirds of its course, by the muscles which lie on either side of it, and by the deep fascia; in the lower third, by the integument and fascia, and the transverse and cruciate crural ligaments.
The anterior tibial artery is accompanied by a pair of venæ comitantes which lie one on either side of the artery; the deep peroneal nerve, coursing around the lateral side of the neck of the fibula, comes into relation with the lateral side of the artery shortly after it has reached the front of the leg; about the middle of the leg the nerve is in front of the artery; at the lower part it is generally again on the lateral side.
Peculiarities in Size.—This vessel may be diminished in size, may be deficient to a greater or less extent, or may be entirely wanting, its place being supplied by perforating branches from the posterior tibial, or by the perforating branch of the peroneal artery.
Course.—The artery occasionally deviates toward the fibular side of the leg, regaining its usual position at the front of the ankle. In rare instances the vessel has been found to approach the surface in the middle of the leg, being covered merely by the integument and fascia below that point.
Branches.—The branches of the anterior tibial artery are:
The posterior tibial recurrent artery
The fibular artery
The anterior tibial recurrent artery
The muscular branches
The anterior medial malleolar artery
The anterior lateral malleolar artery