Typical Lumbar Spine: L1-L4 Flashcards
1
Q
What is the generic size of the typical lumbar vertebral body from the cranial view?
A
transversely broad
2
Q
What is the generic shape of the typical lumbar vertebral body from the cranial view?
A
reniform or kidney-shaped
3
Q
What is the appearance of the typical lumbar vertebral body from the lateral view?
A
anterior height is greater than posterior height by a few millimeters
4
Q
What characteristics of the L1-L4 vertebral body may be used to differentiate it from the L5 segment? Be specific and complete as to the differences on a segment from each group.
A
- On cranial view, the lateral surface of the pedicle is apparent on a L1-L4 segment.
- At L5 the transverse process originates from the vertebral body, pedicle, and lamina-pedicle region.
- In addition, the vertebral body of L5 is more wedge-shaped on lateral view with a much greater anterior height than posterior height.
5
Q
What would be the direction of the lumbar curve based on osseous features?
A
anterior (lordotic)
6
Q
What is the appearance of the intervertebral disc in the lumbar spine?
A
greater anterior height than posterior height
7
Q
What accounts for the direction of the lumbar curve?
A
the vertebral body and intervertebral disc have a greater anterior height than posterior height
8
Q
What is the direction of the normal lumbar curve?
A
anterior (lordotic)
9
Q
What is the effect of aging on the vertebral body of a lumbar vertebra?
A
- decrease in height
- increase in circumference
10
Q
How many synovial joint surfaces are present at the typical lumbar vertebral body?
A
none
11
Q
What is the joint classification for the spongy bone-intervertebral disc articulation?
A
cartilaginous (amphiarthrosis) symphysis
12
Q
What is the joint classification for the anterior longitudinal lig.?
A
fibrous (amphiarthrosis) syndesmosis
13
Q
What is the joint classification for the posterior longitudinal lig.?
A
fibrous (amphiarthrosis) syndesmosis
14
Q
How many fibrous (amphiarthrosis) syndesmosis joint surfaces are on a typical lumbar vertebral body?
A
4
15
Q
Identify the fibrous (amphiarthrosis) syndesmosis joint surfaces on a typical lumbar vertebral body.
A
- superior and inferior anterior longitudinal lig. attachment sites
- superior and inferior posterior longitudinal lig. attachment sites
16
Q
How many joint surfaces are present on the vertebral body of a typical lumbar?
A
6
17
Q
How many cartilaginous (amphiarthrosis) symphysis joint surfaces are on a typical lumbar vertebral body?
A
2
18
Q
What joint classifications will be observed at the vertebral body of a typical lumbar?
A
- cartilaginous (amphiarthrosis) symphysis
- fibrous (amphiarthrosis) syndesmosis
19
Q
What muscles may attach to a typical lumbar vertebral body?
A
- psoas major
- psoas minor
20
Q
What muscles may attach to the first lumbar vertebral body?
A
- psoas major
- psoas minor
21
Q
What muscle may attach from the second down to the fourth lumbar vertebral body?
A
psoas major
22
Q
Psoas minor will only attach to the vertebral body of which segments?
A
T12 and L1
23
Q
What is the name given to lig. that attach the vertebral body to articular process?
A
transforaminal lig.
24
Q
What are the types of transforaminal lig.?
A
- superior transforaminal
- middle transforaminal
- inferior transforaminal
25
What are the attachment sites of the superior transforaminal lig. at the L1-L2 intervertebral foramen?
- L1 vertebral body
| - inferior articular process of L2
26
What are the attachment sites of the middle transforaminal lig. at the L1-L2 intervertebral foramen?
- intervertebral disc
| - inferior articular process of L1
27
What are the attachment sites of the inferior transforaminal lig. at the L1-L2 intervertebral foramen?
- L2 vertebral body
| - superior articular process of L1
28
What lig. attach the vertebral body to the transverse process?
corporotransverse lig.
29
What corporotransverse lig. are identified?
- superior corporotransverse
| - inferior corporotransverse
30
What are the attachment sites of the superior corporotransverse lig. at the L1-L2 intervertebral foramen?
- L1 vertebral body
- L1-L2 intervertebral disc
- transverse process of L2
31
What are the attachment sites of the inferior corporotransverse lig. at the L1-L2 intervertebral foramen?
- L2 vertebral body
- L2-L3 intervertebral disc
- transverse process of L2
32
What names identify lig. that attach the dura mater to the vertebral body or pedicle?
- Hofmann lig.
- meningeovertebral
- anterior dural
- Trolard's
33
What are the types of Hofmann lig.?
- anterior Hofmann
- posterior Hofmann
- lateral Hofmann
- proximal root sleeve
34
Hofmann lig. are identified in which regions along the vertebral column?
- cervical - upper thoracic
| - lumbar
35
Cervical-upper thoracic Hofmann lig. will attach what structures together?
dura mater to segments above
36
What is the highest level known to demonstrate Hofmann lig.?
C6
37
What is the proposed function of the cervical-upper thoracic Hofmann lig.?
- resist caudal movement of the dural sac
| - resist gravitational forces on the dura and cord
38
Lumbar Hofmann lig. will attach what structures together?
dura mater to lower segmental levels
39
What is the proposed function of lumbar Hofmann lig.?
resist cranial movement of the dural sac during flexion
40
What is the proposed function of the proximal root sleeve?
resist displacement of the peripheral nerve system in the intervertebral foramen
41
What is the orientation of the pedicle of a typical lumbar?
posterior
42
The pedicle attaches at what location on vertebral body of a typical lumbar?
to the upper third or half of the vertebral body
43
What surface feature is located at the upper margin of the pedicle?
superior vertebral notch
44
What surface feature is located at the lower margin of the pedicle?
inferior vertebral notch
45
Which indentation on the pedicle will be more prominent?
inferior vertebral notch
46
Which spinal nerve will be accommodated on the superior vertebral notch of L2?
L1 spinal nerve
47
Which spinal nerve will be accommodated on the inferior vertebral notch of L2?
L2 spinal nerve
48
What is the direction of projection of the lumbar lamina?
posteromedian
49
What is the description of the lumbar lamina?
- short from medial to lateral
- broad from superior to inferior
- thick from anterior to posterior
50
What lig. attaches to the lamina of a typical lumbar?
ligamentum flavum
51
What joint classification will be associated with the ligamentum flavum attachment?
fibrous (amphiarthrosis) syndesmosis
52
Ossification of the ligamentum flavum attachment site on the lamina results in what feature?
para-articular process
53
What is the name given to the condition of overlap of the laminae?
shingling
54
What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?
- overlap of the laminae, shingling, diminishes
| - overlap of spinous processes, imbrication, diminishes
55
What is the outline of the vertebral foramen of a typical lumbar vertebra?
triangular
56
Which is the greatest diameter of the vertebral foramen of typical lumbars?
transverse
57
How does the size of the vertebral foramen differ along the spine?
cervicals > lumbars > thoracics
58
What part of the CNS is present in the lumbar spine?
the conus medullaris is typically present in the vertebral foramen of L1
59
What part of the PNS is present in the lumbar spine?
the cauda equina is typically present in the vertebral foramina of L2-L4
60
Beginning with the L1 transverse process, what is the generic direction and relative length of each succeeding lumbar transverse process?
Each TVP is directed straight lateral and increases in length from L1-L3. L4 then begins to decrease in length.
61
What is the distal modification of the TVP of typical lumbars?
transverse tubercle
62
What is the name of the elevation near the origin of the lumbar TVP?
accessory process
63
Congenital elongation of the lumbar accessory process results in what feature? What is it's frequency?
- styloid process
| - 7%
64
What parts of the lumbar transverse are homologous to the cervical TVP parts?
- L transverse tubercle = C anterior tubercle
- L accessory process = C posterior tubercle
- L transverse process origin = C true transverse process
- L transverse process = C costal element
65
What osseous part of a cervical TVP is lacking at the lumbar TVP?
costotransverse bar
66
What lig. will attach to the lumbar accessory process?
mammillo-accessory lig.
67
What parts of a vertebra are attached via the mammillo-accessory lig.?
mammillary process and accessory process of the same segment
68
What was believed to the entrapped by the mammillo-accessory lig.?
the medial branch of the dorsal ramus of a lumbar spinal nerve.
69
What is the joint classification of the mammillo-accessory lig.?
none since it attaches parts of the same vertebra
70
What muscles attach to the lumbar accessory process?
- longissimus thoracis
| - intertransversarii
71
What lig. attaches the neck of the 12th rib to the TVP of L1?
lumbocostal lig.
72
What is the joint classification for the lumbocostal lig. and its attachment?
fibrous (amphiarthrosis) syndesmosis
73
What muscles may attach to the TVP of a typical lumbar vertebra?
- psoas major
- quadratus lumborum
- longissimus thoracis
- rotator brevis
- rotator longus
- intertransversarii
74
Which of the erector spinae muscles attach to the TVP of a typical lumbar?
longissimus
75
Which of the transversospinalis muscle groups attach to the typical lumbar TVP?
rotators
76
What lig. attach to the TVP of a typical lumbar vertebra?
- lumbocostal
- mammillo-accessory
- intertransverse
77
What joint classifications are present at the TVP of a typical lumbar?
fibrous (amphiarthrosis) syndesmosis
78
What is the name of the lamina-pedicle junction of a typical lumbar?
pars interarticularis
79
What is the name of the prominent linear elevation in the lumbar spine between superior and inferior articular processes?
pars interarticularis
80
What are the posterior elements of the vertebra?
- zygapophysis
- lamina
- spinous process
81
What are the anterior elements of the vertebra?
- vertebral body
| - pedicle
82
What is the position of the pars interarticularis relative to the aophyseal regions of a typical lumbar?
lateral to the spinous process, medial to the TVP, in between the articular processes
83
What is characteristic of the L1-L4 articular processes?
The transverse diameter of superior articular processes of an L1-L4 segment will be greater than the transverse diameter of the inferior articular processes of that same segment.
84
What is the reported angulation of typical lumbar articular facets?
they lie in the vertical plane
85
What is the orientation of the typical lumbar superior articular facet?
- backward, upward, medial (BUM)
| - typically concave
86
What is the orientation of the typical lumbar inferior articular facet?
- forward, lateral, downward (FoLD)
| - significant convexity
87
What is the name given to the projection on the lumbar superior articular process?
mammillary process
88
What muscles will attach to lumbar superior articular processes?
- multifidis
| - intertransversarii
89
What muscles will attach to the mammillary process?
- multifidis
| - intertransversarii
90
What lig. will attach to the lumbar superior articular process and TVP?
mammillo-accessory
91
What additional lig. are said to attach to lumbar articular processes?
transforaminal lig.
92
What is the joint classification for the typical lumbar zygapophysis?
synovial plane (diarthrosis arthrodia)
93
How many synovial joints are present on a typical lumbar?
4
94
Identify the synovial joints present on a typical lumbar.
- two superior articular facets
| - two inferior articular facets
95
What is the position of the lumbar zygapophysis in children?
lies in the coronal plane
96
What is the position of the lumbar zygapophysis in adults?
- lies in the sagittal plane for L1/L2, L2/L3, and L3/L4
| - lies in the coronal plane for L4/L5 and L5/S1
97
What name is given to zygapophyses between vertebral couples that lie in the same plane?
joint symmetry
98
What names are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane or position and the other lies in the sagittal plane or position?
joint asymmetry or joint tropism
99
What is the usual condition for typical lumbar spinous processes?
they are non-bifid
100
What is the usual appearance of the typical lumbar spinous process?
rectangular with the long axis in the superior-inferior orientation
101
What is the osseous modification at the distal end of the spinous process?
spinous tubercle
102
What are the names of the condition in which the typical lumbar spinous process increases in length due to the aging process?
Baastrup's syndrome or "kissing spines"
103
What muscles will attach to the typical lumbar spinous process?
- latissimus dorsi
- serratus posterior inferior
- iliocostalis lumborum
- longissimus thoracis
- spinalis thoracis
- multifidis
- rotator longus
- rotator brevis
- interspinalis
104
What muscles from the five layers of the true back are present in the lumbar spine?
- layer 1: latissimus dorsi
- layer 2: none
- layer 3: serratus posterior inferior
- layer 4: erector spinae
- layer 5: transversospinalis
105
Which is the only region of the spine where all erector spinae muscle groups will have an attachment to the spinous process?
lumbar spine
106
Which transversospinalis muscles will b present at the spinous process of a typical lumbar?
- multifidis
| - rotators
107
Which transversospinalis muscle will be absent at the spinous process of a typical lumbar?
semispinalis
108
Which muscle attached to the spinous process of typical lumbar vertebrae would not be considered part of any layer of the true back?
interspinalis
109
What lig. will attach to the typical lumbar spinous process?
- interspinous
| - supraspinous
