Presentation on theme: "Practical Hematology. Bone Marrow Aspiration 27-10-2014."— Presentation transcript:
Bone Marrow Aspiration
Bone Marrow (BM) BM is the soft, flexible, spongy tissue inside bones that helps form blood cells. Types of Bone Marrow 1.Red BM: Which consists mainly of hematopoietic tissues. 2.Yellow BM: Which consists mainly of fat tissues.
At birth, all bone marrow is red. With age, more of it is converted to the yellow type. Only around half of adult bone marrow is red. Red marrow is found mainly in the flat bones (pelvis, sternum, ribs, scapulae) and in the cancellous (spongy) material at the epiphyseal ends of long bones (femur and humerus).
Yellow marrow is found in the medullary cavity, the hollow interior of the middle portion of long bones. In cases of severe blood loss, the body can convert yellow marrow back to red marrow to increase blood cell production.
BM Cellular Components 1. Mesenchymal stem cell (Multipotent): which differentiate into osteoblasts, chondrocytes, myocytes, adipocytes and beta- pancreatic islets cells. 2. Hematopoietic stem cell (Pluripotent): which differentiate into RBC, WBC and platelets.
BM Aspiration It is the removal of a small amount of BM in semi-liquid form for examination. BM biopsy removes a small amount of bone and a small amount of fluid and cells from inside the bone.
Procedure 1.Make the animal to be relax (using calmative). 2.Clean and sterilize the skin (shave if necessary). 3.A special needle with a tube attached to it that creates suction should be used. 4.An aspirate needle is inserted through the skin using manual pressure and force until the bone.
5. Once the needle is in the marrow cavity, a syringe is attached and used to aspirate semi-liquid bone marrow. 6. Remove the needle, press the area and then a bandage should apply to the skin. 7. The sample should be directly processed. 8. If several samples are taken, the needle should be changed between the samples to avoid contamination.
9. simple analgesics can be used to ease soreness, which is common for 2–3 days after the procedure. 10. Any worsening pain, redness, fever, bleeding or swelling may suggest a complication and contamination. 11. Avoid washing or wetting of the procedure site for at least 24 hours after the procedure is highly advised.
Sites for BM Aspiration a. Human 1. Posterior iliac crest. 2. Sternum (breastbone). 3. Tibial plateu.
b. Equine, Bovine, Ovine and Caprine 1.Tibia. 2.Iliac crest. 3.Sternum.
Special Drill and needle for BM examination in large animals (equine and bovine)
c. Canine and Feline 1.Proximal humerus. 2.Proximal femur. 3.Wing of the ilium.
Special needle for BM aspiration in small animals
d. Lab Animals 1.Femur (mostly by flashing method). 2.Tibia.
e. Swine 1.Iliac crest (Tuber coxae). 2.Sternum. 3.Femoral epiphysis.
f. Avian 1.Proximal tibiotarsus 2.Femur. 3.Humerus.
Cautions Should be Considered During BM Aspiration 1. Allergic to any medications. 2. Pregnancy cases. 3. Bleeding problems. 4. Medications you are taking.
When the Test is Needed? 1.Look for the cause of problems with RBC, WBC, or platelets in those who have conditions such as thrombocytopenia, anaemia, or an abnormal WBC count. 2.Find blood disorders, such as leukemia, and multiple myeloma. 3.To find out if the cancer has spread and how much it has spread to the bone marrow such as Hodgkin's lymphoma or non- Hodgkin's lymphoma.
4. Disseminated bacterial or fungal infection. 5. Genetic or chromosome problem. 6. Suspicion of BM Toxicity. 7. Clinical trial of some drug and natural products. 8. Collect a sample of bone marrow for medical procedures, such as stem cell transplantation or chromosomal analysis. 9. To get more information about hematopoiesis.
The Risks of BM Aspiration 1. Allergic reaction to anaesthesia. 2. There may be excessive bleeding at the puncture site. 3. Contamination and infection, which are very rare. 4. Long lasting discomfort. These risks are most oftenly associated with conditions that cause a weakened immune system or low platelet count.
BM Tests 1.BM smear. 2.BM culture (needs special media, culture flask, and incubator).