The Best Areas for Bone Marrow Aspiration in Adults: Posterior Iliac Crest and Sternum

In an adult, what are the two best areas for obtaining active bone marrow by aspiration?A. Vertebra,tibiaB. Sternum,vertebraC. Anterior iliac crest, tibiaD. Posterior iliac crest, sternum

The two best areas for obtaining active bone marrow by aspiration in an adult are the posterior iliac crest and the sternum

The two best areas for obtaining active bone marrow by aspiration in an adult are the posterior iliac crest and the sternum.

Option D (Posterior iliac crest, sternum) is the correct answer. Let’s understand why.

1. Posterior iliac crest: The iliac crest is the curved ridge at the top of the hip bone. The posterior (back) side of the iliac crest contains a thick layer of bone marrow, making it an excellent site for bone marrow aspiration. This site is commonly used due to its accessibility and relatively low risk. It provides a good quality and quantity of bone marrow cells for diagnostic and therapeutic purposes.

2. Sternum: The sternum, also known as the breastbone, is a long flat bone located in the center of the chest. The bone marrow in the sternum is rich in hematopoietic stem cells, which are responsible for the production of blood cells. The sternum is considered a good location for bone marrow aspiration because it is easy to access and provides a sufficient amount of bone marrow for analysis.

Option A (Vertebra, tibia) is incorrect because although bone marrow can be obtained from these sites, they are not considered the best areas due to various reasons.

1. Vertebra: The vertebrae are the individual bones that make up the vertebral column or spine. While bone marrow can be aspirated from specific vertebrae, it is a more invasive procedure and usually only performed for specific diagnostic or therapeutic purposes. It is not commonly used as a routine site for bone marrow aspiration.

2. Tibia: The tibia is the larger of the two bones in the lower leg. Aspiration from the tibia can be challenging due to a thicker cortical bone layer compared to the iliac crest or sternum. Additionally, it carries a higher risk of complications such as injury to nearby structures and damage to the growth plate in younger subjects. Therefore, the tibia is not typically considered one of the best areas for bone marrow aspiration.

Option B (Sternum, vertebra) is incorrect because, as mentioned earlier, the iliac crest is generally preferred over the vertebra for bone marrow aspiration due to accessibility and lower risk factors.

Option C (Anterior iliac crest, tibia) is incorrect because although the anterior iliac crest is similar to the posterior iliac crest in terms of bone marrow accessibility, it is not typically chosen as the best site. The tibia, as explained before, is not considered one of the best sites for bone marrow aspiration due to its cortical bone thickness and higher risk of complications.

In summary, the best areas for obtaining active bone marrow by aspiration in an adult are the posterior iliac crest and the sternum, making option D the correct answer.

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