Dorsalis Pedis Artery: Difference between revisions

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== Description  ==
== Description  ==
[[File:Arteries of the lower leg, anterior view.png|thumb|[https://en.wikipedia.org/wiki/File:Gray553.png Arteries of the lower leg, anterior view]]]
[[File:Dorsal foot.jpeg|thumb|Dorsal foot]]
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 passes from the ankle joint along the tibial side of the dorsum of the foot to the proximal part of the intermetatarsal space. There it divides into two branches, the first dorsal metatarsal artery and the 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> Along its course, it is accompanied by a deep vein, the dorsalis pedis vein. The extensor hallucis longus and extensor digitorum brevis and longus tendons also can also be located close by. 
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.  


== Peculiarities in Size ==
* 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>


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.
<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> 


== &nbsp;Palpation of the dorsalis pedis artery pulse  ==
== Anatomy ==
 
[[File:Dorsalis pedis artery - Kenhub.png|thumb|Dorsalis pedis artery]]
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.<ref>Moore KL, Dalley AF. ''Clinically Oriented Anatomy.'' Fifth edition. Philadelphia: Lippincot Williams & Wilkins; 2006</ref>
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" />
 
== Branches ==


The branches of the dorsalis pedis artery are:
The branches of the dorsalis pedis artery are:
# '''Lateral tarsal artery:''' ''(a. tarsea lateralis''; tarsal artery) arises from the dorsalis pedis as it 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.
# Lateral tarsal artery
# '''Medial tarsal artery:'''  ''(aa. tarseæ mediales)'' are two or three small branches on the medial border of the foot and join the medial malleolar network.&nbsp;
# Medial tarsal artery
# '''Arcuate artery:''' (''a. arcuata; metatarsal artery)'' arises anterior to the lateral tarsal artery. It passes lateralward, over the bases of the metatarsal bones, beneath the tendons of the Extensor digitorum brevis, it's direction being influenced by its point of origin, and it's anastomoses with the lateral tarsal and lateral plantar arteries. This vessel gives off the second, third, and fourth dorsal metatarsal arteries.
# Arcuate artery
# '''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.
# First dorsal metatarsal artery
# '''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. <ref name=":0" /><br>
# 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>
== 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.


== 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  ==


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Latest revision as of 06:04, 9 June 2022

Original Editor - Priyanka Chugh

Top Contributors - Priyanka Chugh, Lucinda hampton, Nina Myburg, Evan Thomas, Kim Jackson and Joao Costa

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)
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