Slideshow: Tibia

The Tibia

The leg is the region between the knee joint

and ankle joint

Ankle Joint

Knee Joint

Leg

The region above the knee joint is the thigh

Hip Joint

Knee Joint

Thigh

Leg

Ankle Joint

There are two bones in the leg

There are two bones in the leg

Tibia

There are two bones in the leg

Fibula

There are two bones in the leg

The Fibula

• Lies Laterally • Is shorter• Is not a weight-bearing

bone

There are two bones in the leg

The Tibia

• Lies medially • Is longer than the fibula• Is a weight-bearing bone• Is derived from the Latin

word meaning flute

The Fibula and Tibia are held together by the

Interosseous Membrane

The Tibia is a long bone with expanded proximal and distal

ends with a shaft in between

Proximal end

Distal end

Shaft

right Tibia, anterior view

The Tibia is a long bone and may be divided into

thirds for descriptive purposes

Proximal end

Distal end

Proximal Third

right Tibia, anterior view

Proximal end(Head of the Fibula)

Distal end

Proximal Third

Middle Third

right Tibia, anterior view

The Tibia is a long bone and may be divided into

thirds for descriptive purposes

Proximal end(Head of the Fibula)

Distal end

Proximal Third

Middle Third

Distal Third

right Tibia, anterior view

The Tibia is a long bone and may be divided into

thirds for descriptive purposes

The Tibia articulates proximally at the Knee

Joint

Tibia

FibulaInterosseous Membrane

right Tibia, anterior view

Tibia

FibulaInterosseous Membrane

The Tibia articulates distally at the Ankle Joint

right Tibia, anterior view

The Proximal Tibia

Proximal Tibia

Anterior View Posterior View

right Tibia

The proximal end of the Tibia has two

shelf-like projections known as Condyles

Anterior View

Proximal Tibia right Tibia

Proximal Tibia

Anterior View

Medial Tibial Condyle

Posterior View

right Tibia

Proximal Tibia

Anterior View Posterior View

Lateral Tibial Condyle

right Tibia

The upper surface of the Tibia is referred to as the Tibial

Plateau

Bird’s-Eye View

posterior

anterior

Proximal Tibia right Tibia

The upper surface of the Tibia is referred to as the Tibial

Plateau

Bird’s-Eye View

posterior

anterior

Proximal Tibia

Medial half of Tibial Plateau

right Tibia

The upper surface of the Tibia is referred to as the Tibial

Plateau

Bird’s-Eye View

posterior

anterior

Proximal Tibia

Lateral half of Tibial Plateau

right Tibia

The Tibial Plateau has two articular facets that articulate with the Condyles of the

Femur

Bird’s-Eye View

posterior

anterior

Proximal Tibia right Tibia

Lateral half of Tibial PlateauMedial half of Tibial Plateau

Bird’s-Eye View

posterior

anterior

Proximal Tibia

Between the facets is a non-articular area that features the Intercondylar Eminence

also known as the Tibial Spine

right Tibia

Lateral half of Tibial PlateauMedial half of Tibial Plateau

Menisci 2 crescent-shaped intra-capsular fibrocartilaginous structures

situated one on each Tibial Facet

Superior view proximal Tibia

Medial Meniscus

Lateral Meniscus

anterior

posterior

right Tibia

Menisci Each meniscus has an anterior and posterior horn that provide attachments to stabilise the meniscus

Superior view proximal Tibia

Medial Meniscus

Lateral Meniscus

Anterior horns

Posterior horns

right Tibia

Menisci are wedge-shaped in cross-section

The menisci widen and deepen the

Tibial articular surface that receives the Femoral Condyles

Between the facets is a non-articular area which features the Intercondylar Eminence

also known as the Tibial Spine

Posterior View

Proximal Tibia

LateralMedial

right Tibia

Anteriorly, below the Tibial Plateau is a

prominence of bone

The Tibial Tuberosity

Proximal Tibia

Anterior View

right Tibia

Proximal Tibia

Below the Tibial Plateau is a

prominence of bone

The Tibial Tuberosity

medial view lateral view

right Tibia

The Quadriceps Muscle converges distally onto the Patella, which is the largest sesamoid bone

in the body

The Patella then attaches to the Tibial

Tuberosity via the Patellar Ligament

Tibial Tuberosity

Patellar Ligament

Quadriceps Muscle

right Knee

Gerdy’s Tubercle is a faceted prominence on the anterior surface of

the Lateral Tibial Condyle

Lateral Tibial Condyle

Gerdy’s Tubercle

It receives the distal end of the Iliotibial Tract (band)

Proximal Tibia right Tibia

Attaches to Gerdy’s Tubercle

on the anterior aspect of theLateral Tibial Condyle

Iliotibial Tract

Tensor Fasciae Latae

Gerdy’s Tubercle

Proximally it receives two muscles• Tensor Fasciae Latae• Gluteus Maximus

Iliotibial Tract

right side

Proximal Tibia Posterior View

lateralmedial

Soleal Line

Provides attachment for the Soleus Muscle

right Tibia

Tibial Shaft

The Tibia has 3 borders and 3 surfaces

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

When a patient lies in the scanner, the foot usually points

outwards due to the natural resting position of the body,

and not directly forwards as in the standing position

This means that when interpreting scans remember

that the anterior surface rotates anticlockwise for the right leg and clockwise for the left leg

The Fibula has 3 borders and 3 surfaces

MRI of cross-section through right legLooking up towards the head

Fibula

anterior

posterior

medial

lateral

The Tibia has 3 borders and 3 surfaces

MRI of cross-section through right legLooking up towards the head

Tibiaanterior

posterior

medial

lateral

The Tibia has 3 borders and 3 surfaces

MRI of cross-section through right legLooking up towards the head

Tibiaanterior

posterior

medial

lateral

Anterior

The Tibia has a sharp Anterior Border

Mid-Shaft Tibia cross-section

Posterior

Anterior Border

lateral view

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

The Tibia has a Posterior Border also referred to as the Medial

Border

Mid-Shaft Tibia cross-section

Posterior Border

medial view

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

Anterior Posterior

Anterior

Mid-Shaft Tibia cross-section

Posterior

LateralBorder

lateral view

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

The Tibia has a Lateral Borderalso referred to as the Interosseous Border

Anterior

Mid-Shaft Tibia cross-section

Posterior

LateralBorder

lateral view

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

The Interosseous Membrane attaches here

Interrosseous Membrane

Mid-Shaft Tibia cross-section

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

Anterior border

Posterior border

Lateral border

Mid-Shaft Tibia cross-section

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

Anterior border

Posterior border

Lateral border

Medial Surface

There are no muscle attachments to this surface

Medial Surface

Mid-Shaft Tibia cross-section

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

Anterior border

Posterior border

Lateral border

Lateral Surface

Also known as the Extensor Surface

Cross section through leg approx 10 cm distal to knee joint

anterior

posterior

medial

lateral

Extensor muscles

Mid-Shaft Tibia cross-section

MRI of cross-section through right legLooking up towards the head

anterior

posterior

medial

lateral

Anterior border

Posterior border

Lateral border

Posterior Surface

Also known as the Flexor Surface

Cross section through leg approx 10 cm distal to knee joint

anterior

posterior

medial

lateral

Flexor muscles

Distal Tibia

Anterior View The most prominent feature of the distal Tibia is the Medial

Malleolus

The most prominent feature of the distal Tibia is the Medial

Malleolus

Anterior View

The lateral surface of the Medial Malleolus is covered in articular hyaline cartilage and

articulates with the Talus at the Ankle Joint

Lateral view of distal right Tibia

Lateral surface

The Inferior surface of the Tibia is smooth, covered in articular

hyaline cartilage and articulates with the Talus

Medial Malleolu

s

mediallateral

The Tibia and Medial Malleolus form the medial part of the

articulation of the Ankle Joint

On the lateral aspect, the distal

Tibia articulates with the distal Fibula at the Fibular Notch

mediallateral

lateral view of distal Tibia

Muscle Attachments

Proximal Tibia Anterior View

Iliotibial Band or Tract

Proximally it receives two muscles• Tensor Fasciae

Latae• Gluteus Maximus

Proximal Tibia Anterior View

Iliotibial Band or TractDistally inserts onto

Gerdy’s Tubercle

Iliotibial

Tract

Tensor Fasciae Latae

Gerdy’s Tubercle

Proximal Tibia Lateral View

anteriorposterior

Iliotibial Band or TractDistally inserts onto

Gerdy’s Tubercle

Iliotibial

Tract

Tensor FasciaeLatae

Gerdy’s Tubercle

Proximal Tibia Anterior View Tibialis Anterior

lateral medial

Originates from • Lateral Condyle of Tibia• proximal 2/3rds of lateral surface of Tibia • Interosseous membrane

Proximal Tibia Anterior View Tibialis Anterior

lateral medial

Inserts onto Medial Cuneiform and base of 1st Metatarsal

Originates from • Lateral Condyle of Tibia• proximal 2/3rds of lateral surface of Tibia • Interosseous membrane

Proximal Tibia Anterior View Tibialis Anterior

lateral medial

Inserts onto Medial Cuneiform and base of 1st Metatarsal

• Dorsiflexes ankle• Inverts foot

Originates from • Lateral Condyle of Tibia• proximal 2/3rds of lateral surface of Tibia • Interosseous membrane

Proximal Tibia Lateral View

anteriorposterior

Tibialis Anterior

Inserts onto Medial Cuneiform and base of 1st Metatarsal

• Dorsiflexes ankle• Inverts foot

Originates from • Lateral Condyle of Tibia• proximal 2/3rds of lateral surface of Tibia • Interosseous membrane

SemimembranosusOriginates from superior lateral

quadrant on the posterior surface of the Ischial Tuberosity

Proximal right Tibia Posterior View

lateralmedial

SemimembranosusOriginates from superior lateral

quadrant on the posterior surface of the Ischial Tuberosity

Inserts onto the posterior aspect of the

Medial Tibial Condyle

Proximal right Tibia Posterior View

lateralmedial

SemimembranosusOriginates from superior lateral

quadrant on the posterior surface of the Ischial Tuberosity

• Extends Hip• Flexes and rotates Knee

Proximal right Tibia Posterior View

lateralmedial

Inserts onto the posterior aspect of the

Medial Tibial Condyle

Proximal right Tibia Medial View

posterioranterior

Pes Anserinus

SartoriusGracilis

Semitendinosus

(Meaning Goose’s Foot)

Refers to the partially confluent manner in which the three tendons insert onto the

medial surface of the proximal Tibia

posterioranterior

Pes Anserinus

SartoriusGracilis

Semitendinosus

A useful mnemonic to remember the order

from anterior to posterior is

SayGrace beforeTea

(Meaning Goose’s Foot)

Refers to the partially confluent manner in which the three tendons insert onto the

medial surface of the proximal Tibia

Proximal right Tibia Medial View

posterioranterior

Pes Anserinus

SartoriusGracilis

Semitendinosus

A useful mnemonic to remember the order

from anterior to posterior is

Say - SartoriusGrace - Gracilisbefore Tea - SemiTendinosus

(Meaning Goose’s Foot)

Refers to the partially confluent manner in which the three tendons insert onto the

medial surface of the proximal Tibia

Proximal right Tibia Medial View

posterioranterior

Pes Anserinus

Sartorius

Gracilis

Semitendinosus

(Meaning Goose’s Foot)

Refers to the partially confluent manner in which the three tendons insert onto the

medial surface of the proximal Tibia

Proximal right Tibia Medial View

Proximal right Tibia Posterior View

lateralmedial

PopliteusOriginates from posterior surface of

Tibia superior to soleal line

lateralmedial

PopliteusOriginates from posterior surface of

Tibia superior to soleal line

The tendon passes upward and laterally and courses

through the knee joint before inserting onto the

Lateral Condyle of the Femur

Proximal right Tibia Posterior View

lateralmedial

Popliteus

The tendon passes upward and laterally and courses

through the knee joint before inserting onto the

Lateral Condyle of the Femur

Unlocks the extended knee by laterally rotating the Femur on the Tibia

Originates from posterior surface of Tibia superior to soleal line

Proximal right Tibia Posterior View

lateralmedial

SoleusOriginates from • posterior aspect of Fibular Head • upper 1/3 of posterior surface of

Fibular shaft • along the full length of soleal line• middle 1/3 medial border of Tibial

Shaft

Proximal right Tibia Posterior View

lateralmedial

Soleus

Unites with gastrocnemius aponeurosis to form the Achilles

tendon, inserts middle 1/3 posterior calcaneum

Originates from • posterior aspect of Fibular Head • upper 1/3 of posterior surface of

Fibular shaft • along the full length of soleal line• middle 1/3 medial border of Tibial

Shaft

Proximal right Tibia Posterior View

lateralmedial

Soleus

Plantarflexes the ankle

Originates from • posterior aspect of Fibular Head • upper 1/3 of posterior surface of

Fibular shaft • along the full length of soleal line• middle 1/3 medial border of Tibial

Shaft

Proximal right Tibia Posterior View

Unites with gastrocnemius aponeurosis to form the Achilles

tendon, inserts middle 1/3 posterior calcaneum

lateralmedial

Tibialis PosteriorProximal right Tibia

Posterior View

Originates from• Posterior aspect interosseous

membrane • superior half of posterior surface of tibia distal to soleal line • medial half of posterior surface of

fibula

lateralmedial

Tibialis PosteriorProximal right Tibia

Posterior View

Originates from• Posterior aspect interosseous

membrane • superior half of posterior surface of tibia distal to soleal line • medial half of posterior surface of

fibula

lateralmedial

Tibialis PosteriorOriginates from• Posterior aspect interosseous

membrane • superior half of posterior surface of tibia distal to soleal line • medial half of posterior surface of

fibula

Inserts onto tuberosity of the navicular with extensions to other tarsal bones

and metatarsals 2 - 4

Inverts, adducts, supinates foot Plantar flexes ankle

Proximal right Tibia Posterior View

anteriorposterior

Tibialis Posterior

Inverts, adducts, supinates foot Plantar flexes ankle

Proximal right Tibia Lateral View

Originates from• Posterior aspect interosseous

membrane • superior half of posterior surface of tibia distal to soleal line • medial half of posterior surface of

fibula

Inserts onto tuberosity of the navicular with extensions to other tarsal bones

and metatarsals 2 - 4

Proximal Tibia Posterior View

lateralmedial

Flexor Digitorum Longus

Originates from the posterior surface of Tibia

distal to Soleal Line

Proximal Tibia Posterior View

lateralmedial

Flexor Digitorum Longus

Originates from the posterior surface of Tibia

distal to Soleal Line

Splits into four slips, inserts onto plantar surface of bases of 2nd -

5th distal phalanges

Proximal Tibia Posterior View

lateralmedial

Flexor Digitorum Longus

Originates from the posterior surface of Tibia

distal to Popliteal Line

Splits into four slips, inserts on plantar surface of bases of 2nd -

5th distal phalanges

Flexes toes 2 – 5Plantarflexes ankle

Ligament Attachments

Proximal right Tibia Posterior View

lateralmedial

Posterior Cruciate Ligament

posterioranterior

Tibial or Medial Collateral Ligament of the Knee

Proximal right Tibia Medial View

Proximal right Tibia

posterior

anterior

Anterior Cruciate Ligament

Bird’s-Eye View

medial lateral

Proximal right Tibia

posterior

anterior

Posterior Cruciate Ligament

Bird’s-Eye View

medial lateral

posterior

anterior

Proximal right Tibia

Posterior horn of medial meniscus

Bird’s-Eye View

posterior

anterior

Posterior horn of medial meniscus

Anterior horn of medial meniscus

Proximal right TibiaBird’s-Eye View

posterior

anterior

Posterior horn of lateral meniscus

Proximal right TibiaBird’s-Eye View

posterior

anterior

Posterior horn of lateral meniscus

Anterior horn of lateral meniscus

Proximal right TibiaBird’s-Eye View

posterior

anterior

Posterior horn of lateral meniscus

Anterior horn of lateral meniscus

Posterior horn of medial meniscus

Anterior horn of medial meniscus

Proximal right TibiaBird’s-Eye View

posterior

anterior

Posterior horn of lateral meniscus

Anterior horn of lateral meniscus

Posterior horn of medial meniscus

Anterior horn of medial meniscus

Proximal right TibiaBird’s-Eye View

Muscle Summaries

Tensor Fasciae LataeOrigin Anterior superior iliac spine, outer

lip of anterior iliac crest and fascia lata

Insertion Via the Iliotibial band onto Gerdy’s tubercle on superior tibia

Action Assist gluteus maximus in maintaining extended knee, abducts hip

Nerve Supply Superior gluteal nerve (L4, L5, S1)

Blood Supply Superior gluteal and lateral circumflex femoral artery

Anterior Thigh

SartoriusOrigin Anterior superior iliac spine

Insertion Superior aspect of the medial surface of the tibial shaft near the tibial tuberosity

Action Flexes and laterally rotates the hip joint and flexes the knee

Nerve Supply Femoral nerve (L2, L3, L4)

Blood Supply Femoral artery

Anterior Thigh

GracilisOrigin Inferior ramus of pubis, and

adjacent ramus of ischium

Insertion Medial surface upper tibial shaft, posterior to sartorius

Action Adducts hip, flexes the knee, medially rotates tibia on femur

Nerve Supply Anterior division obturator nerve (L2, L3)

Blood Supply Obturator artery, medial circumflex femoral artery, profunda femoris artery

SemitendinosusOrigin Superior medial quadrant,

posterior surface ischial tuberosity

Insertion Superior aspect, medial tibial shaft

Action Extends hip, flexes and medially rotates knee

Nerve Supply Tibial portion sciatic nerve (L5, S1)

Blood Supply Perforating branches of profunda femoris artery, inferior gluteal artery, superior muscular branches of popliteal artery

Posterior thigh

SemimembranosusOrigin Superior lateral quadrant of

posterior surface ischial tuberosity

Insertion Posterior surface of the medial tibial condyle

Action Extends hip, flexes and medially rotates the knee

Nerve Supply Tibial portion of sciatic nerve (L5, S1)

Blood Supply Perforating branches of profunda femoris artery, inferior gluteal artery, and the superior muscular branches of popliteal artery

Posterior thigh

PopliteusOrigin Posterior surface of tibia, superior

to soleal line

Insertion Lateral surface of lateral condyle of femur.The tendon passes into the capsule of the knee to the posterior part of the lateral meniscus

Action Unlocks the extended knee by laterally rotating the femur on the tibia.

Nerve Supply Tibial nerve (L4, L5, S1)

Blood Supply Medial inferior genicular branch of popliteal artery muscular, posterior tibial artery

Posterior Leg

SoleusOrigin Posterior aspect of fibular head,

posterior surface of upper fibular shaft, soleal line on posterior tibia and medial border of tibia

Insertion unites with gastrocnemius aponeurosis to form the Achilles tendon, inserts onto posterior and upper surfaces of calcaneum

Action Plantar flexor of ankle

Nerve Supply Tibial nerve (S1, S2)

Blood Supply Posterior tibial, peroneal, and sural arteries

Posterior Leg

Tibialis PosteriorOrigin Posterior aspect interosseous

membrane, superior half of tibia and medial posterior surface of fibula

Insertion Inserts onto navicular tuberosity and sends extensions to other tarsal bones and metatarsals

Action Inverts, adducts, supinates foot, plantar flexes ankle

Nerve Supply Tibial nerve (L4, L5)

Blood Supply sural, peroneal and posterior tibial arteries

Posterior Leg

Flexor Digitorum LongusOrigin Posterior surface of tibia distal to

soleal line

Insertion Splits into four slips, inserts on plantar surface of bases of 2nd - 5th distal phalanges

Action Flexes toes 2 – 5Plantarflexes ankle

Nerve Supply Tibial nerve (S1, S2)

Blood Supply Muscular branch of posterior tibial artery

Posterior Leg

Flexor Hallucis LongusOrigin Inferior 2/3 of posterior surface

of fibula, lower part of interosseous membrane

Insertion Plantar surface of base of distal phalanx of great toe

Action Flexes great toe, weak ankle plantar flexor

Nerve Supply Tibial nerve (S2, S3)

Blood Supply Muscular branches of peroneal and posterior tibial artery

Posterior Leg

Tibialis AnteriorOrigin Lateral condyle of tibia, proximal

2/3rds lateral surface tibia, interosseous membrane

Insertion Medial and plantar surfaces of medial cuneiform and base of first metatarsal

Action Dorsiflexor of ankle, invertor of foot

Nerve Supply Deep peroneal nerve (L4, L5)

Blood Supply Anterior tibial artery

Anterior Leg