UNIVERSIDADE CATÓLICA DE MOÇAMBIQUE

FACULDADE DE CIÊNCIAS DE SAÚDE

Curso de Medicina – 1º ano

Hemostasis

Zuneid Harun Osman, MD

 Hemostasis
Prevention of blood loss (Guyton e Hall).
Aims
 Hemostatic System
• Platelets

• Vascular Endothelial Cells

• Plasma Coagulation Proteins

 Mechanisms of Hemostasis
• I- Vascular Constriction

• II- Formation of a platelet plug

• III- Formation of a blood clot

• IV- Growth of fibrous tissue into the blood clot

 I- Vascular Constriction
• Local myogenic spasm

• Local autacoid factors

• Nervous reflexes
II- Formation of a platelet plug
 2.1. Adhesion

• Disruption of the endothelial cell lining

• Exposition of adhesive proteins

– Collagens
– vWF
– Thrombospondins
– Laminins
 Cont :
• Platelet Adhesion Receptors (GP I, II, III)
– GP Ib / vWF
– GP IIb-IIIa

– Functio on of vWF in adhesion !!!

• Change in shape

• Spreading reaction
Red blood cell Activated
and platelets platelets
 2. Platelet Secretion
• Stimulated by agonists (thrombin)

• Factor XIII
• PDGF
• Factor V
• HMWK , TXA2
• Protein S , ADP , Ca2+
 3. Agregation
• Stimulated by agonist
– ADP , Thrombin >>> receptor induction

• Divalent cations

• Fibrinogen (GP IIb-IIIa)

III- Formation of a blood clot
Extrinsic Pathway
Fibrinolysis
 Regulatory Mechanisms :
Natural Anticoagulants
• Endothelial Surface Factors

• AT III/Heparin ( IIa, Xa, XIa)

• Protein C (Va, VIIIa)

• Tissue Factor Pathway Inhibitor (TFPI)

 Bibliografia
• Hoffman Ronald et all; Hematology –basic
principles and practice , 3rd edition

• Harrisons; Principles of Internal Medicine, 18th

edition.

• Guyton and Hall, Textbook of Medical Physiology;

twelfth edition

• Robbins & Cotran, Patology, 8th ed