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Extrinsic pathway occurs according to the three

basic steps:
1.Release of tissue factor: Traumatized tissue
releases tissue factor or tissue thromboplastin,
which includes specially phospholipids &
lipoprotein complex, that functions mainly as a
proteolytic enzymes.
2.Activation of factor X: The lipoprotein complex
of tissue factor complexes with coagulation factor
and in the presence of ca+2, acts enzymatically on
factor X to form activated factor X.
3.Effect of activated factor X to form prothrombin
activator: The activated factor X combines with
tissue phospholipids of tissue factor or with
additional phospholipids released from platelets as
well as with factor to form the complex of
prothrombin activator.

Intrinsic pathway occurs according to the five


basic steps:
1.Activation of factor XII and release of platelet
phospholipid: Trauma to the blood or exposure of
the blood to vascular wall collagen alters two
important clotting factor in the blood.They are
factor XII & the platelets.When factor XII is
disturbed by coming into contact with collagen or
with a wettable surface such as glass, it takes on a
new cofiguration that converts it into a proteolytic
enzyme called XIIa. The blood trauma also
damages the platelets because of adherence to
either collagen or a wettable surface and this
releases platelet phospholipids that contains the
lipoprotein called platelet factor 3,which also plays
a role in clotting reaction.
2.Activation of factor XI: The activated factor XII
acts enzymatically on factor XI to activate this.
This reaction also requires HMW kininogen and a
accelerator, called prekallikrein.
3.Activation of factor IX: The activated factor XI
acts enzymatically on factor IX to activate this in
presence of Ca+2.
4.Activation of factor X: The activated factor IX,
acts on factor X in concert with factor III, platelet
phospholipids and factor III.
5.Activation of activated factor X to form
prothrombin activator: Activated factor X
combines with factor , platelet phospholipids &
factor III to form the complex called prothrombin
activator.

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