Dorsalis Pedis Artery

Dorsalis Pedis artery

 Description

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.

Along its course, it is accompanied by a deep vein, the dorsalis pedis vein.

Palpation of the dorsalis pedis artery pulse

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

Divisions

The vertebral artery can be divided into four divisions:

1. The first division runs posterocranial between the longus colli and the scalenus anterior.<ref name="bbb" /> The first division is also called the ‘pre-foraminal division’.<ref name="aaa" />
   #The second division runs cranial through the foramina in the cervical transverse processes of the cervical vertebrae C2.<ref name="bbb" /> The second division is also called the foraminal division<ref name="aaa" />.
   #The third division is defined as the part that rises from C2. It rises from the latter foramen on the medial side of the rectus capitis lateralis, and curves behind the superior articular process of the atlas. Then, it lies in the
   #groove on the upper surface of the posterior arch of the atlas, and enters the vertebral canal by passing beneath the posterior atlantoöccipital membrane<ref name="bbb" />.
   #The fourth part pierces the dura mater and inclines medial to the front of the medulla oblongata.<ref name="bbb" />

Supply

It supplies 20% of blood to the brain (mainly hindbrain) along with the internal carotid artery (80%).

Clinical Relevance

It lies close to the vertebral bodies and facet joints where it may be compressed by osteophyte formation or injury to the facet joint.

In older individuals, artherosclerotic changes and other vascular risk facotrs (e.g. hypertension, high cholesterol, smoking, diabletes) may contribute to altered blood flow in the arteries.

The vertebral and carotid artieries are stressed primarily by rotation, extension and traction, but other movements may also stretch the artery. As little as 20% of rotation and extension have been shown to significantly decrease vertebral artery blood flow<ref name="Magee" />.&nbsp;

The greatest stresses are placed on the verterbal arteries in 4 places:

1. on entry to the C6 transverse process
   #within the bony canals of the vertebral transverse processes
   #between C1 and C2
   #between C1 and entry of the arteries into the skull.

The most common mechanism for non-penetrating injury to the vertebral artery is extension with or without side flexion or rotation<ref name="Magee" />.

Symptoms, which may be delayed include:

• vertigo
  *nausea
  *tinitus
  *drop attacks
  *visual disturbances
  *and in rare cases strok or death

References

1. https://en.wikipedia.org/wiki/Dorsalis_pedis_artery 2. *Vertebral Artery Test
*Cervical Arterial Dysfunction

• Vertebral Artery Test
  *Cervical Arterial Dysfunction