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BONE MARROW
Bone marrow is a cellulovascular tissue occupying the space between the trabecular of bone in marrow cavity, which, because it contains mostly blood cells, haemopoitic cells and fat cells is a soft tissue. It is one of the largest organ in the body, the principal site of all blood forming cells.
Cont
The marrow lies entirely within bone, and its ability to expand is limited. The total volume of bone marrow or haemopoeitic tissue in an adult is 23Lt. It localized in cavity of upper shaft of femur, humorous, pelvis, spine and bone of thorax.
Bone Structure
CELLULAR COMPOSITION OF BM
Lymphoid follicles
Fat cell Vascular sinusoid Haemopoitic cell Adventitial Reticulen cell macrophage
Formation of blood cells:- The formation of RBCS , WBCs and development of platelets is a constant process of BM to maintain the demand of these cells it has been estimated that billion cells/kg of body weigh are produced per day. 2.5 billion RBC/kg/day 2.5 billion PIT/kg/Day 1.0 Billion granulocytes/kg/day
2. IT ACT AS A RESERVOIR.
It
acts as reservoir as it enables significantly increased output in response to increase demand by the body. Red cell production increases to 3 times than normal in acute leukemia, 6 times in chronic leukemia . Erythropoiesis :- 13 times in acute hemolytic anemia. The reserve capacity of the marrow is made up of two elements : The functional reserve of haemopoitic cells which is due to their ability to undergo rapid hyperplasia by mitosis. The large anatomical reserve in the form of fat cells which can e readily replaced by active haemopoitic cells.
3. OSTEOGENIC FUNCTIONS.
The cellular elements which takes part in the formation of bone are formed in the marrow . The osteoblast , osteoclast , osteocyte endosterm blood vessels are found in the marrow.
Due to its different connective tissue contents the BM performs several functions associated with the connective tissue.
Bone marrow is rich in reticuloendothelial cells and serves all other important function of RE system i.e. , mainly defense , destruction mechanism and also removal of unwanted particles.
Aspiration
Trephine biopsy
Definition: Trephine biopsy is 1-2cm long 2-3mm in dia. Of the marrow containing bone taken by rotating specialized needle under pressure. Site: Posterior iliac crest. Rp time: Within 1-7 days.
Definition: Aspiration is aspirate of the contents of bone marrow drawn under pressure by puncturing marrow cavity. Site: Sternum, Posterior iliac crest tibial head, Lumber vertebrae. Rp time: Within 1-2 hours.
Indication: *Anaemia, Suspected leukemia, Neutropenia, Thrombocytopenia myeloma, Lymphomas, Cacinomatosis, Lipid storage disease, Granulomatous condition, Unexplained enlargement of liver, spleen or Lymph nodes. *Cytogenic detail is sharp. *Iron demonstration so easy. *Lymphoid nodules and granulomas are seen more frequently. *Perform in Thrombocytopenic condition (cut off range 60,000)
Additional: Myelosclerosis, Aplastic Anaemia, dry tap on aspiration. *Iron demonstration is not so easy due to decalcification.
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