Spinal Anatomy - Unit 3 Exam

how many lumbar vertebra are there

5

which lumbar vertebra are considered typical

L1-L4

which lumbar vertebra are considered atypical

L5

how does the superior and inferior vertebral notch on the pedicle of lumbar vertebra compare to eachother

superior vertebral notch: slight

inferior vertebral notch: deep

the L3 spinal nerve exits __________ L3

below

what spinal nerve exits through the L2-L3 IVF

L2

how do the pedicles of lumbar vertebra compare to thoracic vetebra

lumbars contain more compact bone when compared to thoracics

what forms the superior-inferior margins of the lumbar vertebra laminae

ligamentum flavum

what happens to the "shingling" of the thoracic vertebra laminae when the spine transitions to lumbar vertebra

it diminishes resulting in a distinct space between segments

at what level does the spinal cord terminate

L1

how does the superior margin of a lumbar laminae compare to the inferior margin

superior - smooth and curved inner surface

inferior - rough inner surface for LF attachment

why are spinal taps taken in the lumbar region of the spine

the space between lumbar segments that forms as a result of the diminishing of the shingling of laminae found in the thoracic region give easy access to the subarachnoid space for a spinal tap

what level are spinal taps taken at

L3-L4

why do lumbar spinous processes increase in length

result of aging

what is "kissing spines" aka baastrup's syndrome

touching of adjacent spinous processes in the lumbar region

what muscles attach to lumbar spinous processes

latissimus dorsi

serratus posterior (L1-L3)

longissimus thoracis (L3,L4)

spinalis thoracis (L1,L2)

multifidus

rotators

interspinalis

what ligaments attach to lumbar spinous processes

interspinous lig.

supraspinous lig.

what is the shape of the lumbar regions vertebral foramen?

what is this the result of?

what is this similar to?

triangular

result of the lumbar enlargement

same as the cervical region

what level is the conus medullaris found at

L1

what level does the cauda equina start at

L2

what is lipomatosis

accumulation of fat that can displace/deform the dural sac

what can cause tethered cord syndrome

surgery

accumulation of fat in epidural space

in a patient with tethered cord syndrome, what would you expect to find on an MRI

conus medullaris extending more inferior than normal with infiltration of adipose tissue into filum terminale, or a lipoma in the filum terminale,

what effect does aging have on lumbar vertebral bodies

decreases vertebral body height and increases circumference

what causes the lordotic curve of the lumbar spine

greater anterior height of the IVD

greater anterior height of the L4 L5 bodies

the vertebral body and IVD of the lumbar region are greater ____________

anteriorly

what muscles attach to the lumbar vertebral bodies

psoas major (T12-L5)

psoas minor (T12-L1)

what ligament attaches the vertebral body to the inferior articular process of the same vertebra

superior transforaminal ligament

what ligament attaches the IVD to the inferior articular processes of the segment above

Middle transforaminal ligament

what ligament attaches the vertebral body to the superior articular process of the same vertebra

inferior transformainal ligament

what ligament attaches the vertebral body and IVD to the transverse process of the vertebra below

superior corporotransverse ligament

what ligament attaches the vertebral body and IVD to the transverse process of the vertebra above

inferior corporotransverse ligament

what ligament attaches the anterior aspect of the dura mater to the posterior aspect of lumbar vertebral bodies and the posterior longitudinal ligament in the anterior epidural space

anterior Hofmann Ligament

midline Hofmann ligament

midline meningovertebral ligament

what is the most numerous and robust of the meningovertebral ligaments

anterior hofmann ligament

midline hofmann ligament

midline meningovertebral ligament

what ligament attaches the posterior aspect of the dural mater to the ligamentum flavum and/or laminae in the posterior epidural space

posterior hofmann ligament

posterior meningovertebral ligament

posterior epidural ligament

what ligament attaches the anterior and lateral aspects of the dural mater to the alteral, flared extensions of posterior longitudinal ligament, which is attached to IVD ligamentum flavum and/or laminae in posterior epidural space

lateral hofmann ligaments

what are the connective tissue bands that attach the exiting dural root sleeve with the inferior pedicles forming the IVFs

lateral root ligament

what is the function of the lateral root ligaments

limit medial and superior mobility of nerve roots

what ligament attaches the PLL and/or vertebral body to anterior dura mater in anterior epidural space

anterior (midline) hofmann ligament

what ligament attaches the ligamentum flavum and/or lamina to the posterior dura mater in the posterior epidural space

posterior hofmann ligaments

what ligament attaches the pedicle to lateral dura mater in lateral epidural space

lateral hofmann ligaments

how do ligament attachments in the epidural space differ between the cervical and thoracic regions and the lumbar region

cervical/thoracic - ascend from dura attachment to vertebra above to resist caudal movement

lumbar - descend from dura attachment to vertebra below to resist cranial movement during flexion

how do the lumbar transverse processes change as you move down the lumbar spine

increases in length from L1-L3 then decreases in length from L4-L5 for the Ilium

the anterior aspect of the transverse process is the lumbar vertebras __________________ while the posterior aspect makes up the _______________

anterior - costal element

posterior - true transverse process

are transverse tubercles present on lumbar vertebra

yes

relatively flat

what muscles attach to lumbar transverse processes

psoas major

quadratus lumborum

longissimus thoracis

rotator longus

rotator brevis

intertransversarii

what ligaments attach to lumbar transverse processes

lumbocostal lig

intertransverse lig

corporotrasnvere lig

what is the posteriorly inferiorly projecting process on lumbar transverse processes near the lamina pedicle junction called

accessory process

what represents a congenital elongation of the lumbar accessory process

styloid process

what does the accessory process of lumbar vertebra serve as an attachment site for

longissimus thoracis

medial intertransversarii lumborum mm.

what lumbar vertebral process is found between the superior and inferior articular processes

pars interarticularis

defects of the pars interarticularis are referred to as what

spondylolysis

what is the orientation of the superior articular facet of lumbar vertebra

BUM

what is the orientation of the inferior articular facet of lumbar vertebra

FoLD

are the superior or inferior articular process width greater in lumbar vertebra

superior

allows "cradling of segment above"

how does the embryonic development of the lumbar vertebra differ from the rest of the spine

2 additional secondary centers of ossification (7 total) for the development of the mammillary processes

what is the process that projects posteriorly from the superior articular process of lumbar vertebra

mamillary process

what does the mammillary process provide attachment for

multifidus

intertransverse mm

mamillo-accessory ligament

what is described as a tough, fibrous band that may represent tendinous fibers of origin of lumbar multifidi or fibers of insertion of the longissimus thoracis pars lumborum

mamillo-accessory ligament

the zygopophysis in infants is positioned ______________ while in matured spines it is ___________ orientated

when does this movement occur

coronally

sagittally

6-18 months

what does the facet movement from a coronal to sagittal position allow for the development of

posture, ability to walk, transference of weight from vertebral body to zygopophysis, and formation of lumbar lordotic curvature

what vertebra has the largest presacral vertebral body

L5

how does the L5 vertebral body appear on lateral x-ray

wedge shaped

this serves as the origin of the transverse process in the L5 vertebra

lateral margin of the pedicle

what does the transverse process originate from on the L5 vertebra

vertebral body

pedicle

pars interarticularis

what muscles attach to the L5 transverse process

psoas major

quadratus lumborum

longissimus thoracis

rotator lumborum

intertransversarii

what does the accessory process of the L5 vertebra provide attachment for

longissimus thoracis

medial intertransversarii lumborum

mammillo-accessory ligament

what ligament attaches the transverse process of L5 to the sacral ala

lumbosacral ligament

what ligament attaches the transverse process of L5 to the iliac crest

iliolumbar ligament

what lumbar vertebra has the greatest distance between the articualr processes

L5

what plane does the L4 articular facets lie in

coronal

what muscles attach to the L5 spinous process

longissimus thoracis

multifidus

rotator lumborum

interspinalis

what ligaments attach to the L5 spinous process

interspinous

supraspinous

what is knife-clasp syndrome

when the spinous process of L5 becomes elongated and during extension enters the sacral spinal canal

sacral height is greater in ______ while width is greater in ________

males

females

what effect does sleeping in a supine posture at a young age have on the sacrum

increases sacral curve

why is increased sacral kyphosis and increased slope of the superior S1 bony endplate associated with spondylolisthesis in children

increased stress on L5 pars interarticularis promotes L5 slippage

how many primary centers of ossification are found in the sacrum segments

one in the centrum

2 in neural arch

what is unique about the costal element of the sacrum

it develops separately and fuses with the neural arch to form the lateral masses

where are the secondary centers of ossification found on the sacrum

superior-inferior aspect of body

lateral-anterior aspect of costal element

spinous tubercles

auricular surface

when does the sacrum fuse by

~25

what is the shape of the S1 vertebral body

kidney shaped

where does the last true IVD lie

between L5 and S1

what is the shape of the vertebral foramen of the sacrum (sacral canal)

triangular

what is the anterior lip of the S1 body known as

sacral promontory

what forms the sacral ala

S1 true transverse process and costal element

what causes the concaved shape of the anterior surface the sacral ala

psoas major

what are the remnants of the IVD found on the anterior view of the sacrum

transverse ridges

are anterior (ventral) sacral foramen or dorsal sacral foramen greater in size

anterior (ventral) sacral foramina

what passes through the anterior sacral foramen

ventral primary rami

lateral and median sacral arteries

segmental veins

what view would you expect to see the S1 vertebral body, vertebral foramina, anterior lip of S1, and the sacral ala

base (superior) view

what view would you expect to see the transverse ridges, ventral sacral formaina, costal element (s1-s3/4), and s1 true transverse process

pelvic (anterior) view

what view would you expect to see the S1 superior articular process/mamillary process, superior articular facet, dorsal sacral foramen, median sacral crest, intermediate sacral crest, lateral sacral crest, sacral cornu, sacral hiatus

dorsal (posterior) view

what forms the median sacral crest

laminae/spinous tubercle fusion

what forms the sacral hiatus

lack of fusion of S4/S5 laminae/spinous tubercle

what forms the intermediate sacral crest

articular process/facet fusion

what forms the lateral sacral crest

transverse tubercle fusion

what forms the sacral cornu

S5 inferior articular facet

what can be found in the sacral hiatus

cauda equina

spinal meninges

Co1 spinal nerve

S5 sacral spinal nerve

what is the orientation of the S5 superior articular facet

BUM