BONE MARROW STRCUTURE AND FUNCTION

GUIDED BY Respected S.K. Sharma Sir Lecturer, Deptt. Of Hematology

PRESENTED BY Mahesh Joshi B.Sc. MLT Part II

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.

TYPE OF BONE MARROW

 MAINLY THERE ARE TWO TYPES OF BONE MARROW:

1. RED BONE MARROW 2. YELLOW BONE MARROW

RED BONE MARROW

It is an active marrow producing blood cells i.e., myeloid, erythroid and megakaryocytic cells. Thats why it is called blood forming or haemopoitic marrow . it carries its colour due to hemoglobin in the developing and maturing red cells. During the first few years of life, all bones have red bone marrow and are cellular. Between 5-7 years of age fat cells being to appear. By he age of 18 years, the red marrow is found only in the rips, vertebrae, sternum, hipbone, upper end to numerous and femur, bones of skill , thorax and innominate bones of pelvis . this persists throughout life . red bone marrow contain an abundance of haemopoitic cells along with fat cells and connective tissues.

YELLOW BONE MARROW

It is an inactive marrow made up of fat cells(adipose tissue) and little no. of capillaries and reticulum cells . RBCs are not manufactured in adult life, the yellow marrow occupies spaces, where red marrow is absent. It can be converted to active form in event of abnormal demand.

Bone Structure

A : Bone marrow B : Bone matrix(cortical bone) C : Skeletal muscle

CELLULAR COMPOSITION OF BM

CELL SUPPLY TO BLOOD VESSEL

The bones in the skeleton are not all solid. The outside cortical bone is solid bone with only a few small canals. The insides of the bone contain trabecular bone which is like scaffolding or a honey-comb. The spaces between the bone are filled with fluid bone marrow cells, which make the blood cells, and some fat cells.

CELL SUPPLY TO BLOOD VESSELS

Lymphoid follicles

Bone trabecule Reticulen fibers

Fat cell Vascular sinusoid Haemopoitic cell Adventitial Reticulen cell macrophage

CELL SUPPLY TO BLOOD VESSEL

CELL SUPPLY TO BLOOD VESSELS

FUNCTIONS OF BONE MARROW

1. Formation of BLOOD CELLS. 2. It act as a RESERVOIR. 3. OSTEOGENIC function. 4. CONNECTIVE TISSUE function. 5. Work as a R.E. SYSTEM.

1. FORMATION OF BLOOD CELLS.

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.

4. CONNECTIVE TISSUE FUNCTION

Due to its different connective tissue contents the BM performs several functions associated with the connective tissue.

5. WORK AS A R.E SYSTEM.

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.

B.M ASPIRATION & BIOPSY

Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy liquid part of the bone where blood cells are made. In a bone marrow aspiration, a small amount of liquid marrow is taken from inside the bone so the cells can be examined under a microscope. In a bone marrow biopsy, a small piece of intact bone marrow is removed so the structure of the bone marrow inside its bony framework can be examined. Occasionally, only an aspiration is needed; other times, both tests are done.

Why It's Done

 Doctors perform bone marrow aspirations and biopsies when they're concerned about a problem in the bone marrow.  The tests can help to diagnose:  The cause of anemia (too few red blood cells, which carry oxygen through the body)  The cause of thrombocytopenia (too few platelets, which help the blood to clot)  The cause of an abnormal number of white blood cells, which fight infections  Cancers of the blood, such as leukemia  Whether cancers that started elsewhere have spread to the bone marrow (the assessment of how much a cancer has spread is called staging, and is important in determining treatment and prognosis)  Viral, bacterial, or fungal infections in the bone marrow that might be causing persistent fever or other symptoms  Certain genetic diseases (such as lipid storage diseases)

Method of Bone Marrow Examination:

Aspiration. Trephine Biopsy. Surgical Biopsy.

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.

SITES OF B.M ASPIRATION

Thank

you