Riego, Jaira O.

September 16, 2020

D21A

Hemostasis is the process that controls bleeding at the site of injury. The bleeding
discontinues because of the formation of blood clots that seals the injured part. The process
involves platelets and clotting fragments which are always in the blood in their inactive forms and
activates when there is an injury. These fragments, especially, platelets in their activated form
are involve in all stages of hemostasis. In the muscles most immediate response to injury, called
vascular spasm, they secrete chemicals that make blood vessels to narrow and lessen blood loss.
It also activate with the pain receptors and substances from the endothelium, a simple squamous
epithelium that lines the surface of blood vessels. These platelets are being bonded to each other
and to the endothelium that form platelet plug. Platelets also release substances to attract other
platelets and participate during blood clotting. The place where the platelets bond together is
called the site for coagulation or clotting. Blood coagulation is composed of platelet plug, from
the bond of platelets to the epithelium, and protein strands called fibrin. Coagulation is a chain
reaction from which one clotting factor is needed to activate the other one. Coagulation pathways
can be classified into 2 types – Extrinsic pathway and Intrinsic pathway. The Extrinsic pathway is
quicker than the intrinsic pathway and involves factor VII. The intrinsic pathway is activated by
platelets, exposed endothelium. This pathway is slower than the extrinsic pathway, but more
important. It involves factors XII, XI and IX. When both pathways meet, it is called common
pathway. It produces Thrombin, which has central role in the coagulation cascade and leads
insoluble Fibrogen to produce Fibrin. Thrombin also contributes to the activation of platelets.
Once the repair is done, coagulation must be dissolved to restore blood flow and this process is
called as fibrinolysis.

The liver is responsible for producing most clotting factors, and requires Vitamin K for this
production. This leads to excessive bleeding when someone has been diagnosed of deficiency
with some clotting factors, liver diseases and Vitamin-K deficiency. Unwanted coagulation can be
fetal, known as Thrombosis. It is the most common cause of block arteries that leads to heart
attacks, strokes and such. This problems can be prevented with the platelets repellent property
of the endothelium, anticoagulant factors such as serpins and APC/protein S and Fibrinolysis
cascade and fluidity of normal blood flow. There are also drugs that can prevent thrombosis like
aspirin , clopidgorel, heparin and warfarin.