OBJECTIVES:
General features
Classification: Typical and
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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 cervicalvertebrae.
Lower part of spinal cord
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(Conus medullaris): L1Dura 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 aredeeper 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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ligamentumflavum.
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VERTEBRAL ARCH:SPINE:
? Quadrilateral
? Projects horizontally backwards.
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? Thick along its posterior andinferior borders.
? Attachments to posterior border:
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1. Thoracolumbar fascia2. 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 givesattachment 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 whichcorresponds to superior tubercle
of 12th thoracic vertebra.
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? Inferior articular facet: convex,
laterally.
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? Distance between the superiorarticular 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 LUMBARVERTEBRA (L5):
ATYPICAL LUMBAR VERTEBRA/L5:
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Body is very large and vertical height of its anteriorsurface 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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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 L5may 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 nonfusion of two halves
of the vertebral arch.
Meninges and spinal
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cord are exposedand 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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anaesthesia3. Bladder and bowel
involvement
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4. Impotence
5. Absence of knee and
ankle reflex
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THANK YOU.