Procedure – Arterial Access

Master answer

Dorsalis Pedis Artery

• Origin: Continuation of anterior tibial artery at anterior aspect of ankle joint
• Course: Malleoli, over lower end of tibia à Lateral to extensor hallucis longus
  • Base of 1st intermetatarsal space
• Termination: Divides into
  • First dorsal Metatarsal artery: terminal branch
  • Deep Plantar Artery: communicates with plantar blood supply
• Palpation of the dorsalis pedis artery pulse: On dorsal surface of foot
  • lateral to extensor hallucis longus tendon (or medially to extensor digitorum longus tendon)
  • distal to the dorsal most prominence of the navicular bone which serves as a reliable landmark for palpation
• Acceptable choice for cannulation under most circumstances
  • Although it is absent in up to one eighth of the population
  • Loop collateral circulation with branches of Posterior tibial artery
• The posterior tibial artery is a similarly useful vessel for arterial pressure monitoring. Catheters placed in this artery are less susceptible to kinking on dorsiflexion of the foot than in the dorsalis pedis artery, and they may be particularly valuable in neonates and infants

Source: Deranged Physiology – Click to Open