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  1. Stages of hematopoiesis in the embryo and fetus and where blood production occurs
    • Mesoblastic period: yolk sac
    • Hepatic period: liver and spleen
    • Myeloid period: bone marrow
  2. Briefly describe the mesoblastic period of blood development (stem cells...)
    mesenchyme cells form blood islands within squamous cells which eventually form primitive blood vessels and blood cells
  3. Describe blood production location (w/ ~time frame) from embryo to adult
    • 0-3 months: yolk sac (100% to 0%)
    • 1-9 months: liver (0% to 80% to 0%)
    • 3-7 months: fetus (0% to 20% to 0%)
    • 4 months+: bones (0% to 100%)
    • Distal long bones stop after childhood (only axial skeleton)
  4. Bone marrow types/contents
    • Red: RBC/WBC/thrombocyte precursors, mature WBCs
    • Yellow: fat
  5. Describe the a cross section of compact bone (from outside in)
    • Bone: surrounds the marrow
    • Hematopoietic cord: houses various cell types (granulocyte, megakaryocyte, erythroblast)
    • Marrow sinus: collects blood cells and funnels them into...
    • Central vein: funnels blood into circulation
  6. What are the indications for bone marrow studies?
    • Primary hematologic diseases
    • Anemia (↓ RBC), erythrocytosis (↓ RBC), polycythemia (↑ all cells)
    • Luekopenia (↓ WBC), leukocytosis (↑ WBC)
    • Immature or abnormal cells in circulation
    • Thrombocytopenia (↓ platelets), thrombocytosis (↑ platelets)
    • Secondary systemic diseases
    • Solid malignant tumors that metastasize to bone marrow
    • Disseminated bacterial, fungal, or protozoan infections
  7. Bone Marrow Sampling sites in order of preference. amt aspirated?
    • Sternum
    • Posterior superior iliac spine (PSIS)
    • Anteriror superior iliac spine (ASIS)
    • 1-2mL bone marrow is aspirated
  8. What does the actual examination of bone marrow aspiration entail?
    • Estimation of cellularity
    • Red marrow vs yellow marrow (normally 1:1 in adults)
    • M:E ratio (ratio of WBC precursors + mature to RBC precursors, typically 4:1)
    • *myeloid:erythroid
    • Nucleated cell differential
    • Slide prep / stain
    • 1000 nucleated cells are counted (RBC precursors, WBC precursors, WBC mature)
    • Special stains
    • Prussian blue stain for iron deposits (iron appears blue)
  9. Describe the cells that encompass the reticuloendothelial system + location
    • Fixed macrophages (liver, spleen, etc)
    • Free macrophages (move through tissue)
    • Endothelial cells (lining cells of blood vessels)
    • Circulating monocytes (macrophage precursors)
  10. Differential cell count of bone marrow normal values for RBC precursors
    • pronormoblast: 0-1.5
    • basophilic normoblast: 0-5
    • polychromatophilic normoblast: 5-30
    • orthochromatic normoblasts: 5-10
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