Tibialis anterior muscle

Origin and insertion

Tibialis anterior arises from several sites; 

• Lateral tibial condyle 
• Superior two thirds of the lateral surface of tibia
• Anterior surface of interosseous membrane 
• Deep surface of deep fascia of the leg
• Anterior intermuscular septum. 

It courses inferiorly down the leg, giving off a cord-like tendon at the distal third of the tibia. The tendon travels across the ankle and dorsum of the foot to insert on the medial cuneiform bone and the adjoining of base of the first metatarsal.

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Relations

Tibialis anterior muscle lies medial to extensor digitorum longus and extensor hallucis longus, which makes it the most medial muscle in the anterior compartment of the leg. It also covers the anterior tibial vessels and deep fibular nerve in the proximal part of the leg.

The tendon of tibialis anterior usually passes beneath the extensor retinaculum which holds it in place. However, in some cases, the superficial and deep layers of the extensor retinaculum form a separate tunnel for the muscle’s tendon. It’s worth mentioning that this is the only extensor tendon that has its own synovial sheath at the level of the superior extensor retinaculum. The sheath extends from above the superior extensor retinaculum to the level of the talonavicular joint.

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Innervation

The deep fibular (peroneal) nerve (L4, L5), a branch of the common fibular nerve, innervates the tibialis anterior muscle.

Blood supply

Arterial supply of the tibialis anterior is rather complex; 

• The body of the muscle is entirely supplied by the branches of anterior tibial artery; anterior muscular, medial muscular branches and anterior tibial recurrent artery 
• The tendon is mainly supplied by the branches of anterior tibial artery but also by the branches of posterior tibial artery. The former are the anterior medial malleolar artery and network, dorsalis pedis artery and medial tarsal arteries. The latter are the medial malleolar and calcaneal arteries.

Function

Tibialis anterior dorsiflexes the foot at the talocrural joint and inverts it at the subtalar joint. It plays an important role in the activities of walking, hiking and kicking the ball by stabilizing the ankle joint as the foot hits the floor and pull it clear of the ground as the leg continues moving. It also supports the medial part of the longitudinal arch of the foot during any movement.