Dorsalis Pedis Artery

The dorsalis pedis artery is the main artery that supplies the dorsum of the foot, which is the upper surface of the foot. It arises from the anterior tibial artery, which is a branch of the popliteal artery in the posterior leg. Palpating the dorsalis pedis pulse is an essential part of a physical examination, particularly in assessing perfusion to the lower limbs. 

The dorsalis pedis artery originates approximately midway between the external and internal malleoli (i.e., the bony projections of the tibia and fibula at the ankle) as the continuation of the anterior tibial artery. It runs anteromedially over the dorsal surface of the tarsal bones, lateral to the extensor hallucis longus and the extensor digitorum longus tendons. The dorsalis pedis artery then reaches the first intermetatarsal space, where it divides into the first dorsal metatarsal artery and the deep plantar artery. The deep plantar artery passes deep between the head of the first dorsal interosseous muscle to enter the sole, where it joins the lateral plantar artery to form the deep plantar arch.

The dorsalis pedis artery is fairly superficial and more easily palpated than the posterior tibial pulse, which is why it is the preferred location for palpating the pulse of the foot. The dorsalis pedis pulse can typically be palpated by pressing one’s fingertips at the first intermetatarsal space, lateral to the extensor hallucis longus tendon.

The dorsalis pedis artery supplies the skin, muscles, bones, and joints of the dorsum of the foot and part of the medial aspect of the ankle joint. Along its course, the dorsalis pedis artery gives rise to four major branches, including the lateral and medial tarsal arteries, the arcuate artery, and the first dorsal metatarsal artery. 

The lateral tarsal artery runs laterally in an arched course beneath the extensor digitorum brevis to supply this muscle and the underlying tarsal bones and joints. Next, the dorsalis pedis artery gives off two or three medial tarsal arteries which supply the tarsal bones and joints on the medial part of the ankle and midfoot. 

The arcuate artery is a small-sized vessel that forms an arch as it runs across the bases of the lateral four metatarsals to reach the lateral aspect of the forefoot, where it may anastomose, or connect, with the lateral tarsal artery to form an arterial loop. Additionally, the arcuate artery gives rise to the second, third, and fourth dorsal metatarsal arteries. These vessels run distally to the toes and are connected to the plantar arch by perforating branches, providing collateral circulation with the posterior tibial artery. Distally, each dorsal metatarsal artery divides into two dorsal digital arteries for the dorsal aspect of the sides of adjoining toes.

The first dorsal metatarsal artery is the last branch of the dorsalis pedis artery and it usually arises at the base of the first and second metatarsals, just before the dorsalis pedis becomes the deep plantar artery. This blood vessel supplies the medial and lateral aspects of the big toe and the medial aspect of the second toe.

The dorsalis pedis artery is a major artery of the foot that supplies the skin, muscles, bones and joints of the dorsum of the foot. It arises as the continuation of the anterior tibial artery when it reaches the ankle joint. The dorsalis pedis artery travels along the anterior surface of the ankle and foot, running between the extensor hallucis longus and extensor digitorum longus muscles before diving into the sole, where it joins the lateral plantar artery to form the deep plantar arch.