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So first and foremost, it's important to understand the different

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types of Bones.

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We all know of the long bones of the body the femur.

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humorous long bones that provide stability

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and support

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now when we think about short bones, these are ones

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that often are sort of rounded like

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the kuneiforms consisting of

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predominantly sort of spongy bone.

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Then we think about the flat Bones the

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ones that are sort of compact bone two layers

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surrounding red marrow formation scapulas being

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one of the characteristic examples of this.

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When we think about a regular bones usually this is the thin

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compact bone.

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Surrounding the cancellous bone.

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An example of which would be the vertebra?

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And then we think about sesamoid bones.

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These are focal sites of ossification.

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They could be in tendons and muscles and

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they may provide a little bit of a pulley system in order

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to take stress off the tendon or the muscle.

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Patella being an example of one of the larger and more

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functional Sesame bones.

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So Anatomy is particularly important for us to

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understand why because it allows us to

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understand. What sites are relative to Wood

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sites.

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Of course in the case of the spinal column,

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the spinal cord is really

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the most important anatomical structure.

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We want to call to mine. Where does that sit that

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sits in the spinal canal which

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is painted red on the schematic. We

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have the posterior elements spinal process

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the lamina. We have the transverse process

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just laterally

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We have the vertebral body anteriorly.

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So really important to note and we're going to talk about where we

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biopsy.

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Through different trajectories relative to this Anatomy.

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When you think about long bone Anatomy, it's important to

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know for a variety reasons. We think about sort of

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the edges of the bone as the apophysis that

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is usually made of dense cortical

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bone. And then the Inner Space is that nice spongy bone

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short bones are as I mentioned before usually comprised

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completely of spongy bone.

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Then there's the day offices the long shaft.

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Hollow portion of the long bone and usually has a

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medullary cavity which is filled with bone marrow and the outer walls

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very similar and fashion have nice dense cortical

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bone So within this transitional margin

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between the epiphysis that offices is

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the metaphysis which is consists of

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that epiphy seal plate and it's this really

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sight of bone elongation or the growth plate as is

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colloquially referred to

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so what are some anatomic considerations in route planning, which

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is really one of the things that I want to sort of call to mine here. So

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biopsy routes a particularly important to be thought

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through with respect to the anatomy regionally

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in question. So what we want to do is

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we want to avoid site-specific critical structures the

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previous Imaging the reference Imaging whether

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that be the previous cross-circle Imaging

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Or the Scout Imaging performed at

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the time of the biopsy really helps to direct this but the

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Radiologists may also be in a position to position

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the patient in specific ways different than

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the reference Imaging in order to sort of maximize safety

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in the trajectory and question that could

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be prone supine to cubitous pronoblique

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supine oblique, whatever it

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may be in order to achieve a nice safe route. So

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no caution and foresight are

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always warranted when we're thinking about spinal biopsies with

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a spinal cord could be damaged. We really want to

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be paying attention to particular sites in question,

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whether they be blood vessels nerves or the court itself.