Arterial supply to the foot

Arterial supply to the foot can be divided into plantar and dorsal components

Plantar arterial supply

Medial plantar artery

• branch off the posterior tibial artery
• smaller calibre vessel
• supplies the medial side of the foot, abductor hallucis and flexor digitorum brevis.
• provides the arterial digital supply to the big toe
• Gives off cutaneous branches that perforate the plantar aponeurosis between abductor hallucis and flexor digitorum brevis

Lateral plantar artery

• branch off the posterior tibial artery
• larger calibre vessel
• crosses the sole obliquely towards the base of the fifth metatarsal bone
• gives off cutaneous branches that perforate the plantar aponeurosis between flexor digitorum brevis and abductor digiti minimi
• gives off a superficial branch that follows its respective nerve
• continues as a deep trunk to form the plantar arch

Plantar arch

• anastomosis of the lateral plantar artery and dorsalis pedis artery
• only arterial plantar arch in the foot
• lies in the neurovascular plan deep to the plantar aponeurosis, superficial to the long tendons (between the first and second anatomical layers)
• travels across the bases of the fourth, third, and second metatarsals
• joins the dorsalis pedis artery in the proximal part of the first intermetatarsal space

Plantar metatarsal arteries (4)

• branches off the plantar arch
• supply the four clefts and digits
• anastomose with the dorsal metatarsal arteries via perforating arteries

Dorsal arterial supply

Dorsalis pedis artery

• continuation of the anterior tibial artery
• starts between the malleoli, over the lower end of the tibia
• runs lateral to extensor hallucis longus 
• runs to the base of the first intermetatarsal space, where its deep branch joins the plantar arch
• also branches to form the lateral tarsal artery, arcuate artery
• continues as the first dorsal metatarsal artery

First dorsal metatarsal artery

• continuation of the dorsalis pedis artery
• supplies the first cleft and the medial side of the dorsum of the great toe

Lateral tarsal artery

• branch off the dorsalis pedis artery 
• travels laterally supplying underlying tarsal bones
• lies beneath extensor digitorum brevis, supplying that muscle

Arcuate artery

• branch off the dorsalis pedis artery
• also travels laterally
• runs beneath the tendons of extensor digitorum brevis, over the bases of the metatarsal bones

Dorsal metatarsal arteries (3)

• branches off the arcuate artery
• travel in the lateral 3 clefts
• give off a proximal and distal perforating branches that communicate with the plantar metatarsal arteries of the plantar arch