MECHANISM OF BLOOD CLOTTING

Onset Of Formation Of Blood Clot:

 15 – 20 sec…… in severe trauma.

 1 – 2 min…… in minor trauma.
 Ultimate step in clot formation is the
conversion of fibrinogen which is a soluble
protein that is produced by the liver and is
normally always present in the plasma to
fibrin which is insoluble thread like molecule.
thrombin
Fibrinogen Fibrin
 The original fibrin web is weak because the
fibrin threads are loosely interlaced.

 Rapidly, various chemical linkages are

formed between adjacent strands to
strengthen and stabilize the clot mesh work.
 The cross linkage process which is catalyzed
by a clotting factor known as factor XIII
(Fibrin stabilizing factor).
FINAL COMMON PATHWAY
 The clotting cascade may be triggered by
the intrinsic pathway or the extrinsic
pathway:

 The intrinsic pathway precipitates clotting

within damaged vessels as well as clotting of
blood samples in test tubes.
 EXTRINSIC PATHWAY FOR INITIATING
CLOTTING

 Traumatized tissue releases a complex of several

factors called tissue factor that activates factor
seven and hence initiates extrinsic pathway. 
 Coumadin works by inhibiting the vitamin K
dependent coagulation factors.
 Heparin works by binding to antithrombin III
(ATIII)that acts on a bunch of different factors on
both sides of the cascade, but seems to have more
of an effect on the intrinsic arm than it does on
the extrinsic arm of coagulation. 
 CLOT RETRACTION
 After clotting within 20-30min, the clot
retracts(contracts) leaving yellowish fluid called
serum.
 In diseases with low platelet count, the clot
retraction is impaired
HAEMOSTATIC FUNCTION TESTS
 Bleeding time
 Clotting time
 Prothrombin time
 Activated partial thromboplastin time
  PT/INR