Dr.Sreedhar Dept. of Physiology

Hemostasis • Prevention of blood loss • Vascular spasm Platelet plug formation Clot formation .

Platelet Plug Formation • Injury to vessel – exposes collagen & -ve charged surface of endothelium • Platelet adhesion and aggregation • Release of ADP. Platelet factor 3 • Temporary plug .

Prothrombin IV – Calcium etc .Clotting Factors • • • • • Factors I to XIII I – Fibrinogen II.

Clotting Mechanism • Formation of Prothrombin Activator Intrinsic mechanism – contact with collagen ( ref book for steps ) Extrinsic mechanism – Tissue injury ( ref book for steps ) • Conversion of Prothrombin to Thrombin • Conversion of Fibrinogen to Fibrin ( Fibrin Stabilizing Factor ) .

Fibrinolysis • Plaminogen in Plasma is converted to Plasmin by Tissue Plasminogen Activators ( streptokinase) Clinically to dissolve clots in Coronory artery • Plasmin causes Fibrinolysis .

Blood in fluid state • Antithrombin III – inhibits thrombin • Protien C – inhibits factor V and VIII ( activated by Thrombomodulin present in endothelial surface ) • Heparin – Mast cells and Basophil cells binds to antithrombin III • Smooth Vascular endothelium • Plasmin .

pulmonary. heparin • Thrombus –clot in blood vessel • Emboli – clot in circulation which can block coronory. protien C. cerebral .Intravascular Thrombosis • Injury to vascular wall • Slow rate of blood flow • Deficiency of antithrombin III.

EDTA. Oxalates. X . in vivo activates antithrombin III inhibits thrombin • Dicoumarol – Vit K antagonist Vit K – important for synthesis of Prothrombin (liver ).IX. VII.Anticoagulants • Citrate.bind to Calcium • Heparin – in vitro .

capillary tube method-3-8 minprolonged in Haemophilia • Bleeding time .time of prick to stoppage of bleeding.Tests for clotting • Clotting time – time of prick to clot formation.filter paper method-2-5 minprolonged in thrombocytopenic purpura( deficiency of platelets ) • Prothrombin time • Thromboplastin generation test .

linked recessive.tendency to bleed genetic disorder.deficiency of vWF.Clotting disorders • Haemophilia . males suffer • Haemophilia A or Classical Haemophiliadeficiency of factor VIII Von Willebrand disease.Vit K dependent . • Haemophilia B or Christmas disease-X-linkeddeficiency of factor IX. females carriers. transmitted as X.a sub constituent of factor VIII-inherited as dominant in both sexes.

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