Dorsalis Pedis Artery: Difference between revisions

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= Dorsalis Pedis artery  =
 
== Description  ==
== Description  ==
[[File:Dorsal foot.jpeg|thumb|Dorsal foot]]
The dorsalis pedis [[Arteries|artery]] is the principal dorsal artery of the [[Ankle and Foot|foot]]. It arises at the anterior aspect of the ankle joint and is a continuation of the anterior tibial artery. 


In human anatomy, the dorsalis pedis artery (dorsal artery of foot), is a blood vessel of the lower limb that carries oxygenated blood to the dorsal surface of the foot. It arises at the anterior aspect of the ankle joint and is a continuation of the anterior tibial artery. It terminates at the proximal part of the first intermetatarsal space, where it divides into two branches, the first dorsal metatarsal artery and the deep plantar artery. The dorsalis pedis communicates with the plantar blood supply of the foot through the deep plantar artery.  
* Position: dorsal surface of the foot, running towards the first dorsal interosseous space
* Origin: direct continuation of the anterior tibial artery
* Termination: as the first dorsal metatarsal artery
* Branches: deep plantar artery, lateral tarsal artery and arcuate artery
* Relations: usually palpable between [[Extensor Hallucis Longus|extensor hallucis longus]] and [[Extensor Digitorum Longus|extensor digitorum longus]] tendons<ref name=":1">Radiopedia Dorsal pedal Artery Available:https://radiopaedia.org/articles/dorsalis-pedis-artery (accessed 9.6.2022)</ref>


<br>  
<ref>Dorsalis pedis artery (highlighted in green) - dorsal view image - © Kenhub https://www.kenhub.com/en/library/anatomy/dorsalis-pedis-artery</ref>
== Palpation Dorsalis Pedis Artery Pulse ==
[[File:Screen Shot 2022-06-09 at 1.36.52 pm.png|thumb|Proper way to take person's pulse]]
The dorsalis pedis artery pulse can be palpated lateral to the extensor hallucis longus tendon (or medially to the extensor digitorum longus tendon) on the dorsal surface of the foot, distal to the dorsal most prominence of the [[Navicular|navicular bone]] which serves as a reliable landmark for palpation. It is often examined, by physicians, when assessing whether a given patient has [[Peripheral Arterial Disease|peripheral vascular disease]]. It is absent, unilaterally or bilaterally, in 2–3% of young healthy individuals.<ref>Moore KL, Dalley AF. ''Clinically Oriented Anatomy.'' Fifth edition. Philadelphia: Lippincot Williams & Wilkins; 2006</ref> 


Along its course, it is accompanied by a deep vein, the dorsalis pedis vein.  
== Anatomy ==
[[File:Dorsalis pedis artery - Kenhub.png|thumb|Dorsalis pedis artery]]
Originates at the level of the distal [[tibia]] between the medial and lateral malleoli, continuing on from the anterior tibial artery. Runs superficially on the dorsal surface of the forefoot, over the [[talus]] and navicular towards the first dorsal interosseous space, where it continues as the first dorsal metatarsal artery.<ref name=":1" />


== Relations ==
The branches of the dorsalis pedis artery are:
 
# Lateral tarsal artery
This vessel, in its course forward, rests upon the front of the articular capsule of the ankle-joint, the talus, navicular, and second cuneiform bones, and the ligaments connecting them, being covered by the integument, fascia and cruciate ligament, and crossed near its termination by the first tendon of the Extensor digitorum brevis. On its tibial side is the tendon of the Extensor hallucis longus; on its fibular side, the first tendon of the Extensor digitorum longus, and the termination of the deep peroneal nerve. It is accompanied by two veins.
# Medial tarsal artery
 
# Arcuate artery
== Peculiarities in Size ==
# First dorsal metatarsal artery
 
# Deep plantar artery <ref name=":0">Gray H. ''[https://www.bartleby.com/107/161.html Anatomy of the Human Body].'' Twentieth edition. Philadelphia: Lea & Febiger; 1918 Available from: https://www.bartleby.com/107/161.html [Accessed on 23 May 2019]</ref>
The dorsal artery of the foot may be larger than usual, to compensate for a deficient plantar artery; or its terminal branches to the toes may be absent, the toes then being supplied by the medial plantar; or its place may be taken altogether by a large perforating branch of the peroneal artery.
== Size Variations ==
 
[[File:Leg-arteries-grays-illustrations.jpeg|thumb|Leg-arteries|alt=|360x360px]]The dorsal artery of the foot may be larger than usual, to compensate for a deficient plantar artery. It's terminal branches to the toes may be absent, the toes then being supplied by the medial plantar artery or its place may be taken altogether by a large perforating branch of the peroneal artery.
== &nbsp;Palpation of the dorsalis pedis artery pulse<br>  ==
 
The dorsalis pedis artery pulse can be palpated readily lateral to the extensor hallucis longus tendon (or medially to the extensor digitorum longus tendon) on the dorsal surface of the foot, distal to the dorsal most prominence of the navicular bone which serves as a reliable landmark for palpation.[1] It is often examined, by physicians, when assessing whether a given patient has peripheral vascular disease. It is absent, unilaterally or bilaterally, in 2–3% of young healthy individuals
 
== Surface Anatomy  ==
 
The dorsalis pedis artery is the distal extension of the anterior tibial artery in the foot. It is located just lateral to the extensor hallucis longus tendon and is best palpated proximal to the first metatarsal-cuneiform joint.<br>
 
== Branches ==
 
The branches of the dorsalis pedis artery are:<br>1. Lateral Tarsal<br>2. Medial Tarsal<br>3. Arcuate<br>4. First Dorsal Metatarsal<br>5. Deep Plantar
 
The'''lateral tarsal artery''' (a. tarsea lateralis; tarsal artery) arises from the dorsalis pedis, as that vessel crosses the navicular bone; it passes in an arched direction lateralward, lying upon the tarsal bones, and covered by the Extensor digitorum brevis; it supplies this muscle and the articulations of the tarsus, and anastomoses with branches of the arcuate, anterior lateral malleolar and lateral plantar arteries, and with the perforating branch of the peroneal artery. 6<br> The '''medial tarsal arteries''' (aa. tarseæ mediales) are two or three small branches which ramify on the medial border of the foot and join the medial malleolar net-work.&nbsp;<br> The '''arcuate artery''' (a. arcuata; metatarsal artery) arises a little anterior to the lateral tarsal artery; it passes lateralward, over the bases of the metatarsal bones, beneath the tendons of the Extensor digitorum brevis, its direction being influenced by its point of origin; and its anastomoses with the lateral tarsal and lateral plantar arteries. This vessel gives off the second, third, and fourth dorsal metatarsal arteries, which run forward upon the corresponding Interossei dorsales; in the clefts between the toes, each divides into two dorsal digital branches for the adjoining toes. At the proximal parts of the interosseous spaces these vessels receive the posterior perforating branches from the plantar arch, and at the distal parts of the spaces they are joined by the anterior perforating branches, from the plantar metatarsal arteries. The fourth dorsal metatarsal artery gives off a branch which supplies the lateral side of the fifth toe.&nbsp;<br> The '''first dorsal metatarsal artery''' (a. dorsalis hallucis) runs forward on the first Interosseous dorsalis, and at the cleft between the first and second toes divides into two branches, one of which passes beneath the tendon of the Extensor hallucis longus, and is distributed to the medial border of the great toe; the other bifurcates to supply the adjoining sides of the great and second toes.&nbsp;<br> The '''deep plantar artery''' (ramus plantaris profundus; communicating artery) descends into the sole of the foot, between the two heads of the first Interosseous dorsalis, and unites with the termination of the lateral plantar artery, to complete the plantar arch. It sends a branch along the medial side of the great toe, and is continued forward along the first interosseous space as the first plantar metatarsal artery, which bifurcates for the supply of the adjacent sides of the great and second toes.


== Significance  ==
== Significance  ==


Lack of a dorsalis pedis pulse may be due to peripheral vascular disease, hypovolemia, or cardiac dysfunction.<br>  
It is easy to palpate as part of an examination of the peripheral arterial system. Impalpable dorsalis pedis pulse is a sign of peripheral arterial insufficiency. Risk factors for peripheral arterial disease include [[Diabetes Mellitus Type 2|diabetes mellitus]], cigarette smoking, [[Older People Introduction|advancing age]], [[hypercholesterolemia]], [[hypertension]], overweight/[[obesity]]<ref>Radiopedia PAD Available: https://radiopaedia.org/articles/peripheral-arterial-disease?lang=us<nowiki/>(accessed 9.6.2022)</ref<ref name=":1" />.
   
 
== References  ==
== References  ==


1. https://en.wikipedia.org/wiki/Dorsalis_pedis_artery
[[Category:Anatomy]]
 
[[Category:Foot]]
2. http://www.physio-pedia.com/images/a/a2/Anatomical_study_of_Dorsalis_Pedis_artery_%26_its_correlations.pdf
[[Category:Foot - Anatomy]]
 
[[Category:Foot - Interventions]]
3. The dorsalis pedis artery Surface Anatomy. OrthopaedicsOne Articles. In: OrthopaedicsOne - The Orthopaedic Knowledge Network. Created May 02, 2010 12:57. Last modified May 02, 2010 12:57 ver.4. Retrieved 2017-01-13, from http://www.orthopaedicsone.com/x/vgT5AQ.
[[Category:Arteries]]
 
<references />
4. Henry Gray (1821–1865). Anatomy of the Human Body. 1918.<br>http://www.bartleby.com/107/161.html
[[Category:Anatomy Project]]
 
[[Category:Anatomical Landmarks]]
[[Category:Anatomy]] [[Category:Foot]] [[Category:Arteries]]

Latest revision as of 06:04, 9 June 2022

Description[edit | edit source]

Dorsal foot

The dorsalis pedis artery is the principal dorsal artery of the foot. It arises at the anterior aspect of the ankle joint and is a continuation of the anterior tibial artery.

  • Position: dorsal surface of the foot, running towards the first dorsal interosseous space
  • Origin: direct continuation of the anterior tibial artery
  • Termination: as the first dorsal metatarsal artery
  • Branches: deep plantar artery, lateral tarsal artery and arcuate artery
  • Relations: usually palpable between extensor hallucis longus and extensor digitorum longus tendons[1]

[2]

Palpation Dorsalis Pedis Artery Pulse[edit | edit source]

Proper way to take person's pulse

The dorsalis pedis artery pulse can be palpated lateral to the extensor hallucis longus tendon (or medially to the extensor digitorum longus tendon) on the dorsal surface of the foot, distal to the dorsal most prominence of the navicular bone which serves as a reliable landmark for palpation. It is often examined, by physicians, when assessing whether a given patient has peripheral vascular disease. It is absent, unilaterally or bilaterally, in 2–3% of young healthy individuals.[3]

Anatomy[edit | edit source]

Dorsalis pedis artery

Originates at the level of the distal tibia between the medial and lateral malleoli, continuing on from the anterior tibial artery. Runs superficially on the dorsal surface of the forefoot, over the talus and navicular towards the first dorsal interosseous space, where it continues as the first dorsal metatarsal artery.[1]

The branches of the dorsalis pedis artery are:

  1. Lateral tarsal artery
  2. Medial tarsal artery
  3. Arcuate artery
  4. First dorsal metatarsal artery
  5. Deep plantar artery [4]

Size Variations[edit | edit source]

Leg-arteries

The dorsal artery of the foot may be larger than usual, to compensate for a deficient plantar artery. It's terminal branches to the toes may be absent, the toes then being supplied by the medial plantar artery or its place may be taken altogether by a large perforating branch of the peroneal artery.

Significance[edit | edit source]

It is easy to palpate as part of an examination of the peripheral arterial system. Impalpable dorsalis pedis pulse is a sign of peripheral arterial insufficiency. Risk factors for peripheral arterial disease include diabetes mellitus, cigarette smoking, advancing age, hypercholesterolemia, hypertension, overweight/obesity[5] [1].

References[edit | edit source]

  1. 1.0 1.1 1.2 Radiopedia Dorsal pedal Artery Available:https://radiopaedia.org/articles/dorsalis-pedis-artery (accessed 9.6.2022)
  2. Dorsalis pedis artery (highlighted in green) - dorsal view image - © Kenhub https://www.kenhub.com/en/library/anatomy/dorsalis-pedis-artery
  3. Moore KL, Dalley AF. Clinically Oriented Anatomy. Fifth edition. Philadelphia: Lippincot Williams & Wilkins; 2006
  4. Gray H. Anatomy of the Human Body. Twentieth edition. Philadelphia: Lea & Febiger; 1918 Available from: https://www.bartleby.com/107/161.html [Accessed on 23 May 2019]
  5. Radiopedia PAD Available: https://radiopaedia.org/articles/peripheral-arterial-disease?lang=us(accessed 9.6.2022)