Download MBBS Lumbar Vertebrae Lecture PPT

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atypical

Ossification
Applied anatomy

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General features:

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Lumbar vertebrae have massive body.
Vertebral foramen is triangular.
Spine is quadrangular.
Superior articular facet is concave.

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Inferior articular facet is convex.
Posteroinferior part of root of transverse

process has a rough elevation called
accessory process.

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CLASSIFICATION:

Total no of lumbar vertebrae: 5

Typical: First to fourth.

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Atypical: Fifth.
TYPICAL LUMBAR VERTEBRAE (L1-L4)
BODY:

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Large.
Transverse diameter > anteroposterior diameter.
Attachments:
1. To upper and lower borders:
a) Anterior longitudinal ligament (ALL): in front.

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b) Posterior longitudinal ligament (PLL): behind.
2. Crura of diaphragm: Either side of ALL.
Right crus: upper 3 lumber vertebrae
Left crus: upper 2 lumber vertebrae
3. Behind the crura of diaphragm: Psoas major muscle arises

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from all 5 lumber vertebrae.



VERTEBRAL FORAMEN:

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Triangular in cross section.
Larger than those in

thoracic vertebrae but

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smaller than in cervical
vertebrae.

Lower part of spinal cord

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(Conus medullaris): L1

Dura mater and

arachnoid mater: L1-L5

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Cauda equine: L2-L5


VERTEBRAL ARCH:

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PEDICLES:
? Short and strong.
? Inferior vertebral

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notches are
deeper than the
superior.

? Formation of

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intervertebral
foramen.

? Traversed by

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spinal nerves and
radicular vessels.

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VERTEBRAL ARCH:

LAMINAE:
? Short, strong and

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broad.

? Directed

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posteromedially.

? Gives

attachment to

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ligamentum
flavum.

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VERTEBRAL ARCH:

SPINE:
? Quadrilateral
? Projects horizontally backwards.

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? Thick along its posterior and

inferior borders.

? Attachments to posterior border:

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1. Thoracolumbar fascia
2. Erector spinae
3. Spinalis thoracis
4. Multifidus
5. Supraspinous and infraspinous

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ligaments

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VERTEBRAL ARCH:

TRANSVERSE PROCESS:
? Tapering and thin.
? Homologous with ribs.

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? Accessory process:

rough elevation on the
posteroinferior aspect
of each transverse

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process. It gives
attachment to
intertransverse
ligament.

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VERTEBRAL ARCH:

ARTICULAR PROCEESS:
? Superior articular facet: concave

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& faces medially. Its posterior

border has a rough elevation

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called mammillary process which

corresponds to superior tubercle

of 12th thoracic vertebra.

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? Inferior articular facet: convex,

laterally.

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? Distance between the superior

articular process is relatively

more than inferior articular

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process in L1-L3.

? Relation is reversed in L5
? Equal distance in L4.

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ATYPICAL LUMBAR

VERTEBRA (L5):
ATYPICAL LUMBAR VERTEBRA/L5:

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Body is very large and vertical height of its anterior

surface is greater than its posterior surface.

Transverse process is massive, stout and pyramidal.

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Arises mainly from the pedicle and encroaches on
to the body.

Spine is small in size. Its upper border is rounded

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and down turned at its dorsal part.

The distance between inferior articular process is

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more than superior articular process.

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ANTERIOR RELATIONS OF 5TH LUMBAR

VERTEBRA:
1.Both common iliac arteries.

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2.Both common iliac veins.
3.Formation of inferior vena cava.
4.Median sacral vessels.
5.Sympathetic trunk.

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FAWCETT'S RULE:
OSSIFICATION:

PRIMARY CENTERS: 3 (1 for body and 1 for

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each half of vertebral arch)

APPEARANCE: 9-16 weeks of IUL.

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FUSION:
? Each half of vertebral arch with each other :- 1

year.

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? Vertebral arch with body:- 3-6 years.

9
OSSIFICATON:

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SECONDARY CENTERS:
? 5 (1 each for annular epiphyseal ring (upper and lower

surface of body).

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? 1 each: tip of transverse process
? 1 for tip of spine.

APPEARANCE: puberty

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FUSION: 25 years.

2 Additional centers appear, 1 for each mammillary process.

APPLIED ANATOMY:

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1. SACRALIZATON:

Fusion of L5

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with sacrum.

Transverse

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process of L5

may articulate

with ala of

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sacrum and

compress the L5

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spinal nerve.


SPINA BIFIDA:

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It occurs due to non

fusion of two halves
of the vertebral arch.
Meninges and spinal

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cord are exposed
and may herniate out
in midline through the
gap.

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CAUDA EQUINA

SYNDROME:
Due to compression of

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cauda equina (L2-S1)
Clinical presentation:
1. Flaccid paraplegia
2. Saddle shaped

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anaesthesia

3. Bladder and bowel

involvement

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4. Impotence
5. Absence of knee and

ankle reflex

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THANK YOU.