There is ample collateral circulation of this artery making it a preferred access site of the lower extremity. The operator reaches the artery as if performing a venipuncture aiming directly at the pulsation. The pulse of the dorsalis pedis artery is readily felt on the bony prominence of the navicular bone at the mid-dorsal aspect of the foot. It should not be accessed for cannulation to avoid the risk of ischemic injury to distal part of the extremity. The brachial approach of placing arterial catheters is traditionally considered problematic and prone to complication because of the paucity of arterial collateral circulation. The axillary artery is near the thoracic wall and provides a central pressure waveform as it is advanced further into the subclavian artery. It may be used when peripheral options have failed. The access and maintenance of the axillary artery require abduction of the arm. Both vessels are enveloped by branches of the brachial plexus as they all branch into different structures of the arm. The axillary vein hugs the artery very closely flowing on the medial aspect of the later. ![]() The pulsation of this large vessel can be palpated slightly lateral to the belly of the pectoralis major muscle into the axilla. The axillary artery rises to the superficial area of the axilla in its course through the pectoralis minor muscle which is delineated best while the arm is in the abduction. It is used less commonly but may be accessed situations where other options have been exhausted. The ulnar artery is smaller and not as readily palpable as the radial artery. The artery divides into 2 branches, both of which join a similar division of the radial artery to form a rich, collateral network known as the deep and superficial palmar arch. The ulnar artery is opposite to the radial pulse in the volar aspect of the wrist at the joint of the ulnar bone to the metacarpal bones. The radial artery is a preferred site of insertion. The radial artery is superficial in the thenar area of the wrist where the radial bone joins the metacarpal bones. There, the radial pulse is best felt slightly medial to the extensor tendons of the thumb. The anatomy of every site of insertion must be analyzed to determine the landmarks, the depth, the relationship to adjacent anatomical structures, and the size of the artery. With the knowledge of the contour of these vessels, the operator may easily identify the location of the artery. The arterial pulse may be palpated in the extremities and the neck. As all invasive procedures, the placement of arterial catheters may present complications, with an advised operator who must be ready to intervene promptly to prevent unnecessary harm to the patient. However, practitioners must be mindful of indications and contraindications, proper preparation of equipment and personnel as well as the technique of insertion. With knowledge of anatomy, various sites of insertion are available. More recently, the widely known Seldinger technique has been adopted by guiding catheter into a vessel over a wire previously inserted into the lumen or the artery. The discovery of the arterial waveform by insertion of a catheter into an artery dates to 1847 by the German Physiologist Carl Ludwig. It involves placement of a catheter into the lumen of an artery to provide at least a continuous display blood pressure with access to frequent arterial blood sampling. For additional information visit Linking to and Using Content from MedlinePlus.Arterial catheterization is a procedure that is common to the intensive care settings and the operating room. Any duplication or distribution of the information contained herein is strictly prohibited without authorization. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. ![]() This site complies with the HONcode standard for trustworthy health information: verify here. Learn more about A.D.A.M.'s editorial policy editorial process and privacy policy. is among the first to achieve this important distinction for online health information and services. ![]() follows rigorous standards of quality and accountability. is accredited by URAC, for Health Content Provider (URAC's accreditation program is an independent audit to verify that A.D.A.M.
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