Origin | Lateral condyle of the tibia Proximal two-thirds of the lateral surface of the tibia Anterior side of the interosseous membrane |
Insertion | Medial cuneiform Base of the first metatarsal |
Action | Dorsiflexion of ankle Inversion of foot Assists in maintaining the medial arch of the foot |
Nerve | Peroneal nerve (L4, L5, S1) |
Artery | Anterior tibial artery Medial tarsal arteries |
Location & Overview
The tibialis anterior muscle is also known as the tibialis anticus. It is a superficial muscle located lateral to the anterior body of the tibia. It is easily palpable and is the largest of the four muscles in the anterior compartment of the lower leg. The other three anterior compartment muscles are the extensor hallucis longus, extensor digitorum longus and the fibularis tertius [1] [2].
Pictured here we can see an anterior view of the tibialis anterior muscle.
Pictured here we can see a medial view of the tibialis anterior muscle.
Origin & Insertion
The tibialis anterior originates from the lateral condyle of the tibia, the proximal two-thirds of the lateral surface of the tibia, and the anterior side of the interosseous membrane (which is a membrane in between the tibia and fibula). It works its way inferiorly from this origin where it then passes the ankle joint and reaches the foot. On the foot, it then inserts on the medial cuneiform and the base of the first metatarsal. This tendinous insertion is the most medial tendon of the ankle and foot. This distal tendon is held against the front of the ankle and foot by the extensor retinaculum which covers the anterior aspect of the ankle and foot [3] [4] [5].
The tibialis anterior has some individual variation of its tendinous insertion. The most common variant is the occurrence of one additional band and sometimes two ore more additional insertions have been observed. There are variations which have been observed with the locations of the attachment points for both the origin and insertion of this muscle. The most common origin and insertion though is listed in the above paragraph [6].
Pictured here we can see the first two origin points of the tibialis anterior muscle marked out in red on the lateral condyle of the tibia and proximal two-thirds of the lateral surface of the tibia.
Pictured here we can see another origin point of the tibialis anterior marked out in red on the anterior side of the interosseous membrane.
Pictured here we can see the insertion point of the tibialis anterior marked out in blue on the medial cuneiform and the base of the first metatarsal.
Actions
The primary function of the tibialis anterior muscle is to cause dorsiflexion of the foot. Dorsiflexion is when you lift the front your foot upwards towards the shin and by doing so bend the ankle joint. The tibialis anterior is the strongest dorsiflexor muscle of the foot. The tibialis anterior can also work together with the tibialis posterior to cause inversion of the foot. Inversion would be turning the sole of the foot to the side in a medial direction (the opposite of eversion). Furthermore, due to the tibialis anterior inserting onto the medial border of the foot, the tibialis anterior can also assist in maintaining the medial arch of the foot [7] [8] [9] [10].
Innervation
The tibialis anterior muscle is innervated by the deep peroneal nerve (L4, L5, S1). The deep peroneal neve is also called the deep fibular nerve [11] [12] [13] [14].
Blood Supply
Blood is supplied to the proximal area of the tibialis anterior via the anterior tibial artery. Blood is supplied to the distal tendon via the medial tarsal arteries, which are branch of the dorsalis pedis artery [15] [16] [17] [18] .
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Tibialis Anterior Flashcards
References
↑1, ↑3, ↑7, ↑11, ↑15 | Juneja P, Hubbard JB. Anatomy, Bony Pelvis and Lower Limb, Tibialis Anterior Muscles. [Updated 2021 Aug 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513304/ |
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↑2, ↑4, ↑6, ↑8, ↑13, ↑17 | Zielinska N, Tubbs RS, Paulsen F, Szewczyk B, Podgórski M, Borowski A, Olewnik Ł. Anatomical Variations of the Tibialis Anterior Tendon Insertion: An Updated and Comprehensive Review. J Clin Med. 2021 Aug 19;10(16):3684. doi: 10.3390/jcm10163684. PMID: 34441980; PMCID: PMC8396864. |
↑5, ↑10, ↑14, ↑18 | Varghese A, Bianchi S. Ultrasound of tibialis anterior muscle and tendon: anatomy, technique of examination, normal and pathologic appearance. J Ultrasound. 2013 Dec 19;17(2):113-23. doi: 10.1007/s40477-013-0060-7. PMID: 24883132; PMCID: PMC4033720. |
↑9 | Day JT, Lichtwark GA, Cresswell AG. Tibialis anterior muscle fascicle dynamics adequately represent postural sway during standing balance. J Appl Physiol (1985). 2013 Dec;115(12):1742-50. doi: 10.1152/japplphysiol.00517.2013. Epub 2013 Oct 17. PMID: 24136108. |
↑12 | Becciolini M, Pivec C, Riegler G. Ultrasound Imaging of the Deep Peroneal Nerve. J Ultrasound Med. 2021 Apr;40(4):821-838. doi: 10.1002/jum.15455. Epub 2020 Sep 3. PMID: 32881065. |
↑16 | Azam M, Wehrle CJ, Shaw PM. Anatomy, Bony Pelvis and Lower Limb, Tibial Artery. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532871/ |