The Tibial Nerve


	Head and Neck

	Vagus (X)

	Spinal Accessory Nerve (XI)

	Cervical Plexus (C2-4)

	Brachial Plexus (C5-T1)

	Upper Extremity

	Musculocutaneous

	Radial

	Median

	Ulnar

	Lower Extremity

	Ilioinguinal / Iliohypogastric

	Femoral

	Sciatic

	Common Peroneal

	Tibial

	Sural

The Tibial Nerve in the Leg (prone)

The tibial nerve is a continuation of the common sciatic nerve that provides almost all the sensory innervation of the plantar aspect of the foot. The tibial nerve is best imaged in the leg just distal to where the gastrocnemius muscles taper. The tibial nerve dives deep between the medial and lateral heads of the gastrocemius muscle to enter the leg (Video 1.4 MB).

The tibial nerve joins the posterior tibial artery in the leg. The nerve often meanders close to and away from the posterior tibial artery along its course. The tibial nerve lies on the posterior (heel) side of the posterior tibial artery in the leg. The normal neurovascular bundle consists of the tibial nerve, posterior tibial artery, and two posterior tibial veins in the leg. The medial calcaneal branch of the tibial nerve can often be seen with ultrasound imaging.

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References

Fornage BD. Sonography of peripheral nerves of the extremities. Radiol Med (Torino). 1993 May;85(5 Suppl 1):162-7. Review. PMID: 8392740

Heinemeyer O, Reimers CD. Ultrasound of radial, ulnar, median, and sciatic nerves in healthy subjects and patients with hereditary motor and sensory neuropathies. Ultrasound Med Biol. 1999 Mar;25(3):481-5. PMID: 10374990

Peer S, Kovacs P, Harpf C, Bodner G. High-resolution sonography of lower extremity peripheral nerves: anatomic correlation and spectrum of disease. J Ultrasound Med. 2002 Mar;21(3):315-22. PMID: 11883543