Top-of-foot veins !

The top-of-foot veins are surface veins forming an arch on top of the foot; they drain into the two saphenous veins.

Official name: Dorsal venous arch of foot

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What it is

A network of surface veins on the top of the foot, including an arch across the metatarsals.

What it does

Collect blood from the toes and the top of the foot and drain into the great and small saphenous veins.

Key facts

Drains: Toes (dorsal digital veins) and dorsum of foot via dorsal venous arch
Into: Great saphenous vein (medial end) and small saphenous vein (lateral end)

Relations

Course: Dorsal digital veins join into dorsal metatarsal veins, which end in the arch; the arch continues medially as the medial marginal vein into the great saphenous vein and laterally as the lateral marginal vein into the small saphenous vein
Superficial: Skin and thin subcutaneous tissue, crossed by branches of the superficial fibular nerve
Deep: The extensor tendons and the dorsalis pedis artery; perforating veins link the network to the deep veins

How to find it

With the foot hanging down, or with a band placed above the ankle, the arch and its branches stand out across the top of the forefoot.

Examination

Stemmer sign: if the skin fold on the top of the second toe cannot be pinched and lifted, lymphoedema is likely; venous swelling alone usually leaves the fold easy to lift

On imaging

Duplex ultrasound shows the dorsal venous arch and its two ends: the great saphenous vein in front of the medial malleolus and the small saphenous vein behind the lateral malleolus. Normal veins compress fully under the probe; superficial thrombophlebitis shows as a vein that does not compress, with clot inside. Ultrasound also helps find a vein for cannulation when none is visible.

Clinical notes

Ascending venography, the older reference test for DVT, injects contrast into a dorsal foot vein with a band at the ankle to direct it into the deep veins
Used for cannulation when arm veins cannot be used, though phlebitis and clotting are more frequent there

Test yourself

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

Into which veins does the dorsal venous arch of the foot drain?

Medially into the great saphenous vein and laterally into the small saphenous vein, through the marginal veins.

Where does much of the superficial blood of the sole drain?

Around the edges of the foot into the dorsal venous network, so weight on the sole pushes blood up and out.

Which older reference test for DVT uses a dorsal foot vein?

Ascending venography: contrast is injected into a dorsal foot vein with a band at the ankle to direct it into the deep veins.

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

Its names

Official Latin (TA2): arcus venosus dorsalis pedis; venae digitales dorsales pedis TA2 5088
Official Spanish (DeCS): Arco venoso dorsal del pie
English (TA2): Dorsal venous arch of foot

Sources: Terminologia Anatomica (TA2); Anatomy, Bony Pelvis and Lower Limb, Foot Veins.

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Representative model, for educational purposes only.

Top-of-foot veins highlighted on the Durgical 3D model