Professional Documents
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Definition of Terms
Hemostasis
Coagulation
Fibrinolysis
History
1. Extravascular Component
2. Vascular Component
3. Intravascular Component
a. Platelets
b. Coagulation Factors
c. Fibrinolytic System
1. Extrinsic Pathway
2. Intrinsic Pathway
3. Common Pathway
Balance in Hemostasis
1. Hypo-coagulation
Inherited or acquired
Abnormal bleeding due to either poor clot formation OR increased fibrinolysis
2. Hyper-coagulation
Acquired diseases
Lack of activation of the fibrinolytic system
Phases of Hemostasis
Vasoconstriction
Platelet Activation
Coagulation
Fibrinolysis
1. Arteries
2. Veins
3. Capillaries
1. Lumen
2. Glycocalyx
3. Tunica intima
4. Tunica media
5. Tunica adventitia
1. Non-thrombogenic
2. Significant in supplying nutrients to subendothelial structures
3. Barricades macromolecules and particulate matter circulating in the bloodstream
Non-Thrombogenic
1. Platelet function
Negatively charged surface
PGI2 , nitric oxide, 13-HODE
2. Coagulation
Heparin sulfate, thrombomodulin
3. Fibrinolysis
tPA
Thrombogenic
1. Platelet function
Collagen exposure
Endothelin, vWF, PAF
2. Coagulation
Tissue factor
3. Fibrinolysis
PAI-1
1. Vasoconstriction
Initial response
Regulated by serotonin and thromboxane A2, as well as endothelin-1
2. Platelet adhesion
3. Vasodilation
Regulated by PGI2 and nitric oxide
Platelet Production
Thrombopoiesis
Growth factors:
1. Thrombopoietin
2. Meg-CSF
*GM-CSF and IL-3
*IL-6 and IL-11
1. Megakaryoblast
2. Promegakaryocyte/Basophilic megakaryocyte
3. Megakaryocyte/ Granular Megakaryocyte/ Immature Megakaryocyte
4. Metamegakaryocyte/ Mature Megakaryocyte
5. Platelets
Platelets/Thrombocytes
Glycocalyx
Plasma membrane
Submembrane Area
Separates organelles from the internal side of the platelet plasma membrane
Contains organized systems of filaments obscured by the sol-gel zone
Sol-Gel Zone
Stable gel that regulates the internal arrangement of organelles and the shape
of the platelet
Communication of the organelles with the external surroundings
o Circumferential microtubules/ Tubulin
Maintains platelet’s shape; release of Alpha granule contents
Regulates platelet’s response to stimuli
o Microfilaments
Contraction and pseudopod formation
Actin, myosin, and actomyosin (thrombosthenin): causes the
change in shape upon activation
Mitochondria
ATP synthesis
Glycogen Granules
Lysosomes
Microperoxisomes
Contains lipids
2-7 per platelet; contents are released directly to plasma upon platelet activation
50-80 per platelet; fuses with the SCCS upon platelet activation
Selected platelet specific proteins:
Vascular fibroblasts and smooth
Platelet – derived growth factor
muscle growth
Thrombospondin Adhesion
Inhibits heparin; suppresses
Platelet Factor 4
megakaryocytopoiesis
Inhibits heparin; smooth muscle
Beta-thromboglobulin
growth
Factor V Coagulation
Platelet Factors
Fill the “gaps” when endothelial cells separate during contraction or when the ECs are
sloughing off
PDGF nurture endothelial cells
Platelet Function
Adhesion
Activation
Aggregation
Contact Activation
Activation of Factor XII absorbed by the platelet due to the release of ADP
Collagen-induced activation of platelets
After secondary platelet aggregation, the phospholipid bilayer undergoes the “flip-flop”
rearrangement
Clot Retraction