Toe arteries !

The toe arteries are small arteries running along the sides of each toe, two on the sole side and two on top.

Official name: Dorsal digital arteries of foot

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What it is

Small arteries that run along both sides of each toe, from the arteries on the top and in the sole of the foot.

What it does

Supply the toes.

Key facts

Origin: Plantar metatarsal arteries (plantar arch) and dorsal metatarsal arteries
Branches: Common then proper plantar digital arteries; dorsal digital arteries
Supplies: Toes, including nail beds and pulp

Relations

Course: Plantar metatarsal arteries from the deep arch become common plantar digital arteries and split at the webs into proper digital arteries for adjacent toes; the dorsal metatarsal arteries do the same on top; the medial side of the big toe and the lateral side of the little toe get their own branches

How to find it

The plantar digital arteries lie with the nerves at the plantar corners of each toe; a pencil Doppler placed on the side of the toe pad picks up their signal, and toe pressures are taken with a small cuff around the base of the big toe.

Examination

Toe–brachial index: toe pressure divided by arm pressure; used when stiff, calcified ankle arteries make the ankle–brachial index falsely high; below about 0.7 is abnormal
Capillary refill at the toe pulp: slow return of colour after pressure suggests poor perfusion

On imaging

Too small to assess directly on routine imaging. In blue toe syndrome, Doppler ultrasound and CT angiography look upstream for the embolic source, such as aortic or popliteal plaque or an aneurysm. Toe pressures and pulse-volume recordings measure toe perfusion, and catheter angiography can show digital artery occlusions before revascularization.

Common problems

Narrowing in diabetes or peripheral artery disease can slow healing of toe wounds.

Clinical notes

A digital nerve block at the base of a toe places the anesthetic near the four neurovascular bundles at the corners of the proximal phalanx
In toe-to-hand transfer, whether the dorsal or plantar system dominates for the big or second toe is mapped beforehand
Vasospasm (Raynaud phenomenon) and cold injury affect the toes as well as the fingers

Anatomical variants

When the dorsalis pedis ends early and gives no branches to the toes, the dorsal digital arteries come from the plantar side, through the medial plantar artery and the perforating branches

Test yourself

Think of the answer, then tap the question to see it.

How many digital arteries supply each toe, and which are usually larger?

Four: two plantar and two dorsal; the plantar ones are usually larger.

What does blue toe syndrome with good foot pulses suggest?

Small emboli from atheroma or an aneurysm higher up.

When is the toe–brachial index used instead of the ankle–brachial index?

When stiff, calcified ankle arteries make the ankle–brachial index falsely high; below about 0.7 is abnormal.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2): arteriae digitales dorsales pedis; arteriae digitales plantares communes; arteriae digitales plantares propriae TA2 4719
Official Spanish (DeCS): Arterias digitales dorsales y plantares del pie
English (TA2): Dorsal digital arteries of foot
Also called: plantar digital arteries proper

Sources: Terminologia Anatomica (TA2); Anatomy, Bony Pelvis and Lower Limb: Foot Arteries; Anatomy of the Human Body (20th ed.): The Arteria Dorsalis Pedis (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.

Toe arteries highlighted on the Durgical 3D model