The dorsalis pedis artery (DPA) is a major blood vessel on the top of the foot (dorsum), continuing directly from the anterior tibial artery. Its primary function is to deliver oxygenated blood to the foot’s structures. The DPA is one of the most accessible peripheral arteries, making it a frequent point of assessment in medical examinations for evaluating lower limb health.
Anatomical Course and Relationships
The dorsalis pedis artery begins at the ankle joint, where the anterior tibial artery passes beneath the extensor retinaculum. It runs superficially across the top of the foot, extending toward the space between the first and second toes. Along its path, the artery rests directly on the talus, navicular, and cuneiform bones.
The artery’s course is generally positioned lateral to the long tendon of the extensor hallucis longus muscle. It is medial to the tendons of the extensor digitorum longus, providing a consistent anatomical landmark. The vessel terminates when it reaches the proximal part of the first intermetatarsal space, diving deep into the sole of the foot to split into the first dorsal metatarsal artery and the deep plantar artery.
Finding the Pulse Site
To locate the pulse, first identify the bony prominence of the ankle and move onto the top of the foot. The pulse is typically found along a line running from the middle of the ankle toward the space between the big toe and the second toe. A practical way to isolate the artery is to identify the tendon of the extensor hallucis longus by extending the big toe upward.
The pulse is usually felt just lateral to this prominent tendon. Use the pads of the index and middle fingers, applying only light pressure. Pressing too hard can compress the artery against the underlying bone and obscure the pulse. If the pulse is not immediately detectable, gently move the fingers slightly sideways along the line of the artery. Note that in a small percentage of healthy individuals, the artery may follow a variant course or be congenitally absent.
Importance in Medical Assessment
Assessment of the dorsalis pedis pulse is a routine part of a lower extremity vascular examination performed by healthcare providers. The ease of access and consistent location of the artery make it an ideal point to quickly evaluate peripheral circulation. Assessing the rate, strength, and rhythm of the pulse provides immediate insight into the blood flow reaching the foot.
A weak, thready, or absent pulse can indicate underlying circulatory conditions, such as peripheral artery disease (PAD). PAD involves the narrowing of arteries, which restricts blood flow and can lead to complications like tissue damage and ulcers. This assessment is also important for monitoring patients after surgery or trauma to the lower leg to ensure blood vessels have not been blocked. Comparing the pulse strength between both feet is a standardized method to detect asymmetry, which suggests a localized vascular obstruction.